Saturday, 15 January 2005 - 8:00 AM

This presentation is part of: Health-Related Services for Older Adults

Health Disparities Among Immigrant and Non-immigrant Old People: The effects of Acculturation and Human Capital

Purpose: Social work has long been working with the immigrant populations since the settlement house era. Today, as one in ten Americans are foreign born and one in five Americans have at least one parent who is foreign born, health care for old immigrants has become an important issue in reducing health disparities. Guided by the theories of human capital and acculturation, this study investigated the influence of immigrant status among older people on physical and mental health outcomes, health services utilization, and health insurance coverage. Specifically, it examined the interactive effects of immigrant status, human capital, acculturation, race, and ethnicity on these dependent variables.

Methods: The study used a national representation sample of 7,345 older Americans from the first wave of the AHEAD survey. The study employs both logistic regression and ordered logit regression in multivariate analysis.

Findings: Major findings are: (1) immigrant status has negative repercussions on depressive symptoms, number of difficulties with IADL, and on health insurance coverage. Immigrant status has a significant effect only on the utilization of outpatient surgery, but not on other health services. (2) There were significant interactive effects of race and ethnicity and immigrant status on these dependent variables. The findings support the existence of double jeopardy among those who are simultaneously an immigrant and a member of a minority group in the United States. (3) Acculturation has strong effects on health insurance coverage. With regard to physical and mental health outcomes and health services utilization, acculturation had a significant effect only on difficulties with IADL.

Implications: As American society becomes more diverse, reducing health disparities is a national priority. Although the publication of the Institute of Medicine report on health disparity in 2003 is laudable, there needs to be a greater attempt to understand and eliminate health disparities between immigrant and non-immigrant populations. Social work should not shy away from setting the national agenda of reducing health disparity among the immigrant populations.

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