Survival differences among native-born and foreign-born older adults in the United States

Abstract

Background: Studies show that the U.S. foreign-born population has lower mortality than the native-born population before age 65. Until recently, the lack of data prohibited reliable comparisons of U.S. mortality by nativity at older ages. This study provides reliable estimates of U.S. foreign-born and native-born mortality at ages 65 and older at the end of the 20(th) century. Life expectancies of the U.S. foreign born are compared to other developed nations and the foreign-born contribution to total life expectancy (TLE) in the United States is assessed.

Methods: Newly available data from Medicare Part B records linked with Social Security Administration files are used to estimate period life tables for nearly all U.S. adults aged 65 and older in 1995. Age-specific survival differences and life expectancies are examined in 1995 by sex, race, and place of birth.

Results: Foreign-born men and women had lower mortality at almost every age from 65 to 100 compared to native-born men and women. Survival differences by nativity were substantially greater for blacks than whites. Foreign-born blacks had the longest life expectancy of all population groups (18.73 [95% confidence interval {CI}, 18.15-19.30] years at age 65 for men and 22.76 [95% CI, 22.28-23.23] years at age 65 for women). The foreign-born population increased TLE in the United States at older ages, and by international comparison, the U.S. foreign born were among the longest-lived persons in the world.

Conclusion: Survival estimates based on reliable Medicare data confirm that foreign-born adults have longer life expectancy at older ages than native-born adults in the United States.

Figure 1. Age-Specific Death Rates and 95% Confidence Intervals for Native-born and Foreign-born Populations in the United States in 1995.

Figure 2. Life Expectancies and 95% Confidence Intervals at Age 65 for Selected Countries and for the U.S. Total and Foreign-born Populations in 1995.

Figure 3. Years Added to U.S. Total Life Expectancy and 95% Confidence Intervals at Selected Ages for Native-born and Foreign-born Populations in 1995.