Does an Immigrant Health Advantage Exist Among US Whites? Evidence from a Nationally-Representative Examination of Mental and Physical Well-Being

Abstract

This study examines whether an immigrant health advantage exists among US Whites, a group often used as a reference category in research on racial and ethnic health disparities. Using recent data from the National Health Interview Survey (2019-2022), I disaggregate non-Hispanic White adults (n = 41,752) by nativity status and use logistic regression models to assess differences in six measures of mental and physical health. The analysis includes self-reported conditions (depression, anxiety, fair/poor self-rated health) and diagnosed conditions that require interaction with the healthcare system (hypertension, diabetes, and chronic obstructive pulmonary disease, COPD). Foreign-born Whites have a significantly lower prevalence of each health outcome relative to US-born Whites. The immigrant health advantage remains significant for depression, anxiety, fair/poor health (i.e., self-reported conditions) and diagnosed hypertension, after adjusting for sociodemographic and healthcare characteristics. In contrast, the inclusion of these explanatory factors reduces the nativity gap in diagnosed diabetes and COPD to non-significance. Overall, the results indicate important variation in health among Whites that is missed in studies that focus on US-born Whites, alone. Scholars must continue to monitor the health of White immigrants, who are projected to grow to 20% of the US immigrant population in the years to come.

Keywords: Immigrant health; Mental health; Physical health; White immigrants; non-Hispanic Whites.

Fig. 1

Odds ratios of self-reported health conditions by nativity status with 95% confidence intervals Note: Odds ratios derived from logistic regression models in Table 2, Panel A. The unadjusted models include nativity status (Model 1) and the adjusted models include all covariates (Model 2)

Fig. 2

Odds ratios of diagnosed health conditions among whites by nativity status with 95% confidence intervals, National Health Interview Survey 2019–2022 Note: Odds ratios derived from logistic regression models in Table 2, Panel B. The unadjusted models include nativity status (Model 1) and the adjusted models include all covariates (Model 2)