Immigrant status, health, and mortality in later life
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Given the growing importance of the immigrant population in the United States, identifying the determinants of immigrant health following migration is critical to understanding the impact of international migration on the health of the nation. Using the Health and Retirement Study (HRS), this study examined nativity differences in mortality and physical functioning in later life, with special attention to (1) the determinants of nativity differences in mortality and physical functioning and (2) the association between mortality and disability in terms of the compression of morbidity paradigm. This study found that immigrant men had lower mortality compared to their U.S.- born counterparts of similar racial/ethnic backgrounds. However, immigrant women were indistinguishable from U.S.-born women of similar racial/ethnic backgrounds. With respect to physical functioning, immigrants showed lower levels of functional limitations but were indistinguishable from U.S.-born residents of similar racial/ethnic backgrounds in terms of disability. The data also showed that the effect of immigrant status somewhat differs across mortality and physical functioning. While all foreign-born racial/ethnic minorities showed lower or comparable mortality risks compared to native-born whites, foreign-born Hispanics showed poorer functional health than native-born whites. This study also found that socioeconomic status, social integration, and health behaviors play important roles in explaining the observed nativity differences in mortality and physical functioning. In particular, compared to prior research, the results indicate that socioeconomic factors better explain the observed nativity differences in mortality and physical functioning compared to social integration and health behaviors. This study also illustrated that integrating mortality and disability is a valuable way to investigate immigrant health. Compared to U.S.-born residents, the analysis of active life expectancy revealed that mortality is loosely coupled with disability for immigrants and that, except for foreign-born whites, immigrants’ lengthy lives are expected to be a prolonged period of disability. Overall, the results indicate that immigrant’s socioeconomic adaptation into U.S. society has a great impact on immigrant health in later life. This study also suggests that social policies aimed at promoting immigrant health need to be accompanied by a more general effort to integrate immigrants into U.S. society.