Immigration and the Life Course: Contextualizing and Understanding Healthcare Access and Health of Older Adult Immigrants

Abstract

Objective Immigrant health discussions often focus on acculturation and omit discussions on historical events that may underlie health differences among immigrant older adults. This paper provides a historical overview of immigration policy and flows to the U.S. and examines insurance access and health difficulties by sending country. Methods We analyzed the “Immigrants Admitted to the United States, Fiscal Years 1972–2000” and 2015–2019 American Community Survey datasets to examine the number of admitted immigrants, sociodemographic profiles for current immigrant older adults, and the predicted probabilities of health insurance access and health difficulties. Results Our results highlight alignment of immigration flows with immigration legislation and vast heterogeneity in migration, health, and healthcare access of immigrants by sending country. Discussion/Implications Public health practitioners must consider how historical events and social factors contribute to the healthcare access and health of immigrant populations, as demographic shifts will require interventions that promote equitable healthy aging.

Divergent Immigrant Health Trajectories: Disparities in Physical Health Using a Multidimensional Conceptualization of Legal Status

“…US citizen immigrants earn 8 to 11 percent more in annual income compared to noncitizens (Pastor and Scoggins 2012). Furthermore, US citizenship grants people better access to healthcare, although this benefit varies by country of origin (Bacong and Ðoàn 2022). Non-US citizens are not eligible for federal assistance programs until after the completion of 5 years as legal US residents (Goldman, Smith and Sood 2005).…”

“…Instead, existing immigrant health research tends to focus on the nativity component of immigration status and individual-level or community-level explanations for observed outcomes. In this literature, researchers have established that foreign-born individuals tend to be in better health than their native-born counterparts (e.g., Cunningham, Ruben and Venkat Narayan 2008). This immigrant health advantage is largely explained by self-selection of healthier individuals into migration (Landale, Gorman and Oropesa 2006; Riosmena, Kuhn and Jochem 2017), cultural influences such as dietary habits and strong social networks (Eschbach et al 2004; Riosmena, Kuhn and Jochem 2017), and data quality issues (Patel et al 2004; Turra and Elo 2008).…”

“…This immigrant health advantage is largely explained by self-selection of healthier individuals into migration (Landale, Gorman and Oropesa 2006; Riosmena, Kuhn and Jochem 2017), cultural influences such as dietary habits and strong social networks (Eschbach et al 2004; Riosmena, Kuhn and Jochem 2017), and data quality issues (Patel et al 2004; Turra and Elo 2008). Yet, the immigrant health advantage is not universal; disparities in health exist among foreign-born populations by country of origin, race/ethnicity, and over time (Angel, Buckley and Sakamoto 2001; Singh and Siahpush 2002; Jasso et al 2004; Cunningham, Ruben and Venkat Narayan 2008; Gubernskaya, Bean and van Hook 2013; Boen and Hummer 2019). The present study advances this body of work by demonstrating how a nuanced examination of the legal components of immigration status can uncover further disparities in immigrant health.…”