Despite lower socioeconomic status, immigrants often in better health than their naturalized counterparts

Health disparities research has frequently focused on the "health immigration paradox", which finds that recent Latino immigrants are often in better health than their naturalized counterparts, despite lower socioeconomic status. Little previous research has focused on the health status of foreign-born people over the age of 50, who make up over a third of all immigrants.

"We found that older foreign-born people who immigrated as children or young adults and became citizens have better health after age 50 compared to those who did not become citizens," says lead author Zoya Gubernskaya, Ph.D., of the University at Albany, SUNY. "And those who naturalized sooner—within 10 years of immigration—have lower odds of having health limitations in older age compared with those who naturalized later, and with noncitizens."

The researchers analyzed demographic and self-reported health data about foreign-born populations from two large, nationally representative surveys, the American Community Survey and the Integrated Health Interview Series, to look at patterns of health disparities in this group.

For immigrants who come to the U.S. in later life, the story is quite different, says Gubernskaya. The researchers found that those who immigrated in middle or older age and then became citizens had worse functional health compared with noncitizens, who tend to be younger.

She explained that immigrants who come to the U.S. when they are older may have poorer health to begin with. "They are in greater need of health care due to their age. But their options for accessing health care are much more limited compared to long-term immigrants," Gubernskaya says.

The positive effects of naturalization for foreign-born people who immigrate as children on health status appear to be due to a combination of race, ethnicity and education. Foreign-born people who came to the U.S. as young adults had benefits from naturalization that were independent of these social and economic variables.

Older immigrants may constitute a risk group, say the researchers, due to pre-existing health issues and a lack of economic resources. In the absence of comprehensive immigration and health care reform, this might lead to growing health disparities among the older foreign-born and increased pressure on public health care programs, the researchers cautioned.

Carlos Crespo, Dr.P.H., interim dean of Portland State University's College of Urban and Public Affairs in Oregon believes that naturalization has little to do with health status of minority immigrants and that, instead, low wages, language barriers, and poor or nonexistent access to quality health care are the most important influencers of immigrants' health at any age and regardless of citizenship status.