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Between 1990 and 2000, the foreign-born population in the United States grew by more than half. In 1990, there were 19.8 million foreign-born individuals in the United States, composing 7.9% of the total population. By 2000, the number of foreign-born residents had risen to 31.1 million, representing 11.1% of the U.S. population–the highest proportion since 1930. The share of the U.S. foreign-born population began to wane in 1910, falling from 14.8% to 11.1% between 1910 and 1930. By 1970, the foreign-born as a percentage of the total U.S. population had reached a low of 4.7%. The proportion only began to climb again during the 1980s.

The volume and nature of immigration to the United States are the results of legislative and social forces that influence the political, economic, physical and mental health, and life chances of immigrants and their families. Multicultural approaches to immigrant health must encompass an understanding of the spectrum of sociopolitical and historical factors that affect immigrants in the United States. To that end, this entry presents an overview of key historical policies and trends concerning immigration, including those that promote or “pull” immigration of specific groups to the United States, as well as factors that “push” groups to leave their countries of origin. Controversial issues and psychosocial contexts are highlighted to illustrate frameworks for adopting a multicultural approach to immigrant health.

A Note on Terminology

The term foreign born refers to persons who were not U.S. citizens at their time of birth, regardless of naturalization or legal status, and includes all immigrants and legal nonimmigrants (e.g., refugees). The term immigrant refers to persons who left their country of origin to reside in another country or state and who have not become naturalized citizens of that new country. Once naturalized, the immigrant becomes a foreign-born citizen. Popular parlance, however, applies the term immigrant to all persons of immigrant origin regardless of naturalization status. For this reason, this entry will employ the terms immigrant and foreign born interchangeably to describe both naturalized citizens and noncitizen foreign-born persons.

Historical Overview of Immigration Policy in the United States

Debates about immigration policy date back to the colonial era, when an influx of German and Scotch Irish immigrants arrived during the early 1700s. During this period, concerns about the integration of immigrants and economic shortfalls fueled anti-immigrant sentiment; however, these concerns dissipated during the American Revolution, when immigration promoted the success of the nation. For more than 200 years, U.S. immigration policy followed a cyclical pattern of pull, promoting immigration during periods of national political or economic need, then opposing immigration when the influx of newcomers had reached a critical mass. This trend was most visible with regard to immigrants from so-called undesirable racial or ethnic groups. For example, during the 1860s, Chinese immigrants were recruited to work on the Central Pacific Railroad Company's transcontinental railroad. A period of economic decline following the completion of the project led Congress to pass the Chinese Exclusion Act of 1882, which prevented immigration of Chinese laborers for 10 years. Two years later, the law was revised to exclude all Chinese and remained in force until 1943.

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