Relationship between acculturation, health status, and health insurance

BACKGROUND: Extant studies link increasing length of stay in the U.S. with worse current health status for immigrants, but few studies reported the association with change in health status since arrival in U.S. OBJECTIVE: To examine the association between length of stay and change in health status, and the moderating effect of health insurance. METHODS: New Immigrant Survey data from 2003 were analyzed (n=6,495). Years of residence in U.S. (<1 year, 1-5 years, 6-10 years, 11-15 years, and >15 years); current health status; change in health status since arrival in U.S.; and access to and type of insurance were self reported. Multivariate logistic regression models were fit. RESULTS: Those who resided in the U.S. >15year were 2.11 (95% CI: 1.48-3.02) times more likely to report fair or poor current health, and 6.76 (95% CI: 4.34-10.53) times more likely to report worse change in health than recent immigrants (< 1 year) after adjusting for covariates. These associations were stronger for uninsured immigrants. Those with insurance were more likely to have received certain preventive screenings than those without insurance. CONCLUSIONS: An inverse relationship between residence in the U.S. and change in health status suggests acculturation may be harmful to immigrants' health. Moderating effect of health insurance may be partially due to the fact that having insurance can provide access to preventive care. Attention needs to be paid to immigrant health, especially for those without health insurance, who are at increased risk for worsening health status over time spent in the U.S.