 In addition to language barriers, some Asian subgroups emphasize a higher level of trust between health care practitioners and patients, and as a result, may feel alienated using the more formalized American health care system.A study by Jacqueline Lucas, Daheia Barr-Anderson, and Raynard Kington indicates that black male immigrants demonstrate better health outcomes than US-born black men.This finding comports with the "healthy immigrant effect," which describes the idea that those who immigrate to 'developed countries' tend to enjoy better health than the native-born populations.