Immigrants Healthier Than Native-Born, But Advantage Fades

July 13, 2021 — Immigrants to the U.S. are healthier and have better health outcomes on average than native-born Americans, according to a new study in the journal Health Affairs.

But the longer that immigrants live in the U.S., the more their health profiles resemble those of the native-born.

These findings are among a wealth of details about immigrants’ self-reported health and access to health care included the study. The researchers analyzed data from two large surveys, one national and the other focused only on California. The latter survey was used because it included data on undocumented immigrants that was lacking in the national poll.

Four groups of adult immigrants were compared to native-born adults: naturalized citizens, noncitizen immigrants in the U.S. for more than 5 years, noncitizen immigrants here for 5 years or less, and undocumented immigrants.

Self-reported health status among naturalized immigrants — who, by definition, must be in the country for at least 5 years — was similar to that of citizens born in the U.S., the study found. “In contrast, a higher share of noncitizen immigrants who had been in the U.S. for more than 5 years (30.1%) and who had been in the U.S. for 5 years or less (41.6%) had ‘excellent’ health compared with U.S.-born adults (27.1%).”

Both naturalized and noncitizen immigrants had lower rates of high blood pressure, heart disease, arthritis, asthma, and mental conditions, compared with U.S.-born adults. But naturalized citizens were more likely than the native-born to have type 2 diabetes.

The story was different for undocumented people. In the California survey, twice as many undocumented immigrants (33%) reported being in fair or poor health than native-born citizens (16.5%), and only 29.3% of the undocumented said they were in very good or excellent health, compared to 54.2% of native-born Californians.

In the national survey, the noncitizen adult immigrants were considerably younger, on average, than the U.S.-born adults, which partially explains their better health status. In addition, the study notes, “Chronic conditions are likely to be underdiagnosed among underserved immigrants because of poor access to health care.”

Arturo Vargas Bustamante, PhD, a professor of health policy and management, at UCLA’s Fielding School of Public Health, and the paper’s lead author, told WebMD that a third reason for the disparity between the health status of immigrant and native- born populations is the “healthy immigrant effect.” What this means is that people who choose to face the rigors and challenges of emigrating to a foreign nation tend to be stronger, physically and mentally, than other people from their home country.