Explaining the Immigrant Health Advantage: Self-selection and Protection in Health-Related Factors Among Five Major National-Origin Immigrant Groups in the United States

Abstract

Despite being newcomers, immigrants often exhibit better health relative to native-born populations in industrialized societies. We extend prior efforts to identify whether self-selection and/or protection explain this advantage. We examine migrant height and smoking levels just prior to immigration to test for self-selection; and we analyze smoking behavior since immigration, controlling for self-selection, to assess protection. We study individuals aged 20–49 from five major national origins: India, China, the Philippines, Mexico, and the Dominican Republic. To assess self-selection, we compare migrants, interviewed in the National Health and Interview Surveys (NHIS), with nonmigrant peers in sending nations, interviewed in the World Health Surveys. To test for protection, we contrast migrants’ changes in smoking since immigration with two counterfactuals: (1) rates that immigrants would have exhibited had they adopted the behavior of U.S.-born non-Hispanic whites in the NHIS (full —assimilation ); and (2) rates that migrants would have had if they had adopted the rates of nonmigrants in sending countries (no-migration scenario). We find statistically significant and substantial self-selection, particularly among men from both higher-skilled (Indians and Filipinos in height, Chinese in smoking) and lower-skilled (Mexican) undocumented pools. We also find significant and substantial protection in smoking among immigrant groups with stronger relative social capital (Mexicans and Dominicans).

Smoking Trends among U.S. Latinos, 1998–2013: The Impact of Immigrant Arrival Cohort

“…Importantly, our results are suggestive that cohort effects may be a non-trivial source of bias in cross-sectional studies that examine the relationship between duration of residence and health; future studies should use methods that assess arrival cohort effects. Considering the changing tobacco contexts in immigrants’ origin countries, smoking prevention and cessation interventions should take into account not only time in the US, but also the period during which immigrant cohorts arrived in the US, as well as the smoking trends in immigrants’ origin countries [34,35,36], particularly at the time the immigrant cohort left. For instance, if an immigrant arrives in the U.S. at a time when smoking is already low, the decrease in smoking may be lower in magnitude.…”

Prevalence and Trends in Morbidity and Disability Among Older Mexican Americans in the Southwestern United States, 1993–2013

“…A growing body of evidence suggests that foreign-born Hispanics are more likely to engage in negative lifestyle behaviors such as smoking, alcohol consumption, and unfavorable dietary changes with longer residence in the United States (Fenelon, 2013; Kimbro, 2009; Turra & Goldman, 2007). Although the foreign-born may be more likely to engage in negative lifestyle behaviors with increased duration in the United States, recent research by Riosmena, Kuhn, and Jochem (2017) finds Mexican immigrants have lower smoking initiation and higher smoking cessation rates after immigration compared to Mexican nonmigrants and non-Hispanic whites. Indeed, Lariscy, Hummer, and Hayward (2015) document the favorable longevity foreign-born Mexican Americans experience is in large part due to low levels of smoking and lower mortality from lung cancer and respiratory diseases, particularly among women.…”

The Role of Education in the Relationship Between Age of Migration to the United States and Risk of Cognitive Impairment Among Older Mexican Americans

“…Conversely, residing in the United States for a longer period of time can lead to higher socioeconomic status through greater educational attainment, better employment opportunities, and incorporation into mainstream institutions (Gonzalez et al, 2009; Gubernskaya et al, 2013; Treas, 2015), all of which are protective of health in later life. Potentially important gender differences for changes in health and behaviors with greater duration spent in the United States have also been reported, with foreign-born women experiencing greater increases in body mass index (Hao & Kim, 2009) and being less likely to smoke (Riosmena, Kuhn, & Jochem, 2017) compared to foreign-born men. Thus, age of migration should be considered when assessing health differentials among older immigrants (Gubernskaya, 2015; Hummer & Hayward, 2015).…”