Comparative Health Status of Late-Life Immigrants: Using Multiple Health Indicators

This study compares health status of older adults by nativity (U.S.-born vs. foreign-born) and length of stay in the U.S. using four different health care measures. A “healthy immigrant effect” has been empirically supported among young immigrants. However, studies are inconclusive regarding late-life immigrants. Using three waves of data from the Second Longitudinal Study of Aging (1994-2000) and the linked mortality file, this study compared 1) chronic health conditions (yes/no for 10 conditions; the number of conditions (0-10)); 2-3) longitudinal trajectories of the number of functional impairments in ADL and IADL (0-13) and self-rated health; and 4) mortality through 2002 between three groups (age 70+) - 1) late-life immigrants with less than 15 years of residence in the U.S. ( n=133); 2) older foreign-born individuals with 15+ years in the U.S. (n=672); and 3) the U.S.-born (n=8,642). Logistic and Poisson regression, Hierarchical Generalized Linear Modeling, and survival analysis (Kaplan-Myer and Cox proportional hazard models) were used. First, after controlling for demographic variables, late-life immigrants were less likely to suffer from osteoporosis and cancer and demonstrated lower numbers of chronic conditions compared to their U.S.-born counterparts. Second, the U.S.-born and longer-term immigrants reported better self-rated health over time, as well as lower numbers of functional impairments compared to late-life immigrants. Finally, late-life immigrants were associated with longer survival time and lower hazards of mortality over time. In conclusion, a healthy immigrant effect was only partially supported among older adults depending on the health status measure selected.