 Speculation behind this phenomenon looks towards the fact that the immigrant population is generally younger than the native-born population as a whole; others believe that these medical conditions simply have not yet been detected given immigrants' lower rates of health coverage.A literature review by Kathryn Derose, Jose Escarce, and Nicole Lurie indicates that immigrant health outcomes appear to worsen as levels of acculturation increase.This may be attributable to a combination of personal behavioral changes and systemic factors, the latter of which includes disparate deliveries of medical care and public health services such as immunizations.