The authors would like to thank everyone who participated in this research by completing the survey. We also send our appreciation to Dr. Grace Lartey, Scholastique Nikuze and Liliana Loboguerrero for their valuable assistance during this research process.
INTERNATIONAL STUDENTS: A COMPARISON OF HEALTH STATUS AND PHYSICAL HEALTH BEFORE AND AFTER LIVING IN THE UNITED STATES
Due to globalization and an increased need for a high quality schools of education, the number of individuals attending higher education in foreign countries continues to grow (McLachlan & Justice, 2009). The United States has been the leading host country of international students from all over the world since 1940 (Institute of International Education, 2010). According to the authors of the Open Doors report (2009), the number of foreign students who attended colleges and universities in the United States during the 2008-2009 academic year reached an all-time high of 671,616, an increase of 8% from the previous year, the largest increase since 1980.
The Open Doors report (2009) indicated that international students make significant contributions to the host campuses and states. For example, monetary contributions of the international students to the USA economy during the 2008-2009 academic year alone was $17.8 billion. The main expenses of international students were tuition and living expenses, such as housing and food. Other expenses included health insurance, school supplies, transportation and the care of family members who accompanied the international students. In addition to financial contributions, international students contribute significantly by enriching the cultural diversity of the host campuses and states. International students bring knowledge and creativity, and they contribute to the workforce. Active engagement by international students in classrooms has become a valuable asset to the American students, since engagement in class contributes new knowledge and skills for American students. This enables them to better understand international students, to acquire awareness of world politics and different world cultures. Ogah (2000) noted that an encounter with international students is the best way for many individuals to become exposed to many different cultures.
International students have unique multifaceted needs and challenges (Tidwell & Hanassab, 2007). For example, McLachlan and Justice (2009) noted that international students' challenges were primarily related to academic responsibilities, as well as social and psychological challenges caused by culture shock. These issues pose challenges to international students' health, and faculty are often frustrated because they do not have remedies for helping students solve their problems. Given the increased number of international students and their contributions to their host institutions, it is important to understand international students' needs in order to provide appropriate services for them to improve their wellbeing (Brown & HoIloway, 2008).
Due to a lack of research dealing with issues surrounding international students and despite their increased enrollment at American institutions, international students often remain invisible and their needs go overlooked (Mori, 2000). Thus, McLachlan and Justice (2009) pointed to the need for more research in health and outreach services for international students. Because many international students eventually become long term USA residents (Mathews, 2010) and international students' challenges are comparable to those of other immigrant populations (Iowa Center on Health Disparities, 2003; WHO, 2010; Zysberg, 2005), in this paper, international students' and immigrants' health and health behaviors are considered as one category and referred to as either "international students" or "immigrant" depending on the literature cited. Therefore, in this paper, the term "immigrants" refers to all foreign-bom populations, including international students. …