Latino health paradox or healthy immigrant phenomenon? Adult morbidity in the Integrated Health Interview Series 2000-2009

Ross Macmillan, Università Bocconi
J. Michael Oakes, University of Minnesota
Naomi Duke, University of Minnesota
Wen Fan, University of Minnesota
Liying Luo, University of Minnesota
Hollie Nyseth, University of Minnesota
Regan Sieck, University of Minnesota
Alain Vandormael, University of Minnesota

Health is central to research on both immigration and assimilation, and differences in health among immigrants are a focal part of health disparities research. In these fields, immigrant health has been deemed “paradoxical” because a) immigrants tend to have better health than is predicted by their socioeconomic position and b) acculturation into American society is associated with declines in immigrant health status despite increases in socioeconomic position and related utilization of health care. Importantly, much of our understanding of immigrant health and its paradoxical nature come from studies of Hispanics. Using newly released data from the 2000-2009 Integrated Health Interview Series, we extend inquiry to 10 distinct immigrant groups based on global region of birth. The research has three facets. First, we systematically assess health both across different immigrant groups and in relation to the prominent US born racial and ethnic groups. Second, we examine education gradients and assimilation trajectories across immigrant groups. Finally, we assess the ability of widely recognized explanatory factors to account for health differences across immigrant groups, educational gradients, and assimilation effects. Across four health outcomes, health advantages among immigrants are robust regardless of group, educational gradients and marginally detrimental acculturation trajectories are generally consistent, and there is limited ability of the explanatory factors to account for the immigrant health advantages. We conclude that these highlight the significance of healthy immigrant selection and discuss implications for the “paradox” of immigrant health and existing theory and research on assimilation processes and health disparities research.