Immigration and the Life Course: Contextualizing and Understanding Healthcare Access and Health of Older Adult Immigrants

Abstract

Objective: Immigrant health discussions often focus on acculturation and omit discussions on historical events that may underlie health differences among immigrant older adults. This paper provides a historical overview of immigration policy and flows to the U.S. and examines insurance access and health difficulties by sending country.

Methods: We analyzed the "Immigrants Admitted to the United States, Fiscal Years 1972-2000" and 2015-2019 American Community Survey datasets to examine the number of admitted immigrants, sociodemographic profiles for current immigrant older adults, and the predicted probabilities of health insurance access and health difficulties.

Results: Our results highlight alignment of immigration flows with immigration legislation and vast heterogeneity in migration, health, and healthcare access of immigrants by sending country.

Discussion/implications: Public health practitioners must consider how historical events and social factors contribute to the healthcare access and health of immigrant populations, as demographic shifts will require interventions that promote equitable healthy aging.

Keywords: health difficulties; health insurance; immigration; life course; older adults.

Figure 1.

Number of admitted immigrants by Asian country and year of admission, among immigrants would be 65–85 years old in 2019. Note. IRCA = Immigration Reform and Control Act; IIRAIRA = Illegal Immigrant Reform and Immigrant Responsibility Act; PWORA= Personal Responsibility and Work Opportunity Reconciliation Act.

Figure 2.

Number of admitted immigrants by Central and South American country and year of admission, among immigrants would be 65–85 years old in 2019. Note. IRCA = Immigration Reform and Control Act; IIRAIRA = Illegal Immigrant Reform and Immigrant Responsibility Act; PWORA= Personal Responsibility and Work Opportunity Reconciliation Act.