Are the Foreign-Born Older Adults More Depressed Than the Native-Born Older Adults As They Get Older in the U.S.?

Background/Purpose

While the number of older immigrants in the United States has almost doubled in the last two decades, studies exploring their mental health status compared to the native-born seniors in the U.S. are few. Healthy immigrant effect predicts that, although immigrants are generally healthier than the native-born population in a receiving country upon arrival, they experience a rapid decline of health status over time compared to the native-born populations. Empirical studies conducted in European countries or Canada have reported the accordant results. However, little studies have examined the deteriorating trend of mental health status, particularly, depression trend between immigrant seniors and native-born seniors in the U.S. The purpose of this study is to examine the change in depression among immigrant seniors and native-born seniors whose age is greater than 50 and to explore critical factors that affect the different trend of depression between the two population.

Methods

This study used 13^th wave data of the RAND Health and Retirement Study (HRS) collected in 2016. The sample (N=20,094) consists of individual respondents whose age is greater than 50. The dependent variable is the depression measured as a binary variable. The main independent variable is nativity measured by whether the birth place is a state in the U.S. or outside the U.S. territory. The other independent variable is age of respondents. Logistic regression analysis was conducted to examine whether nativity would significantly predict depression after controlling for physical health status as well as demographic and socio-economic variables.

Results

The results showed that the direct term of nativity was not a significant predictor (OR=.94, p=.37) of depression in the basic model only including demographic variables as covariates. However, when adding the interaction term between age and nativity in the model, the interaction term was significant (OR=1.030, p<.001), indicating that foreign-born elders were 1.03 times more likely to show depression symptom than the native-born counterparts as they get aged one year more. When adding the socio-economic status variables in the first model, the odd ratio of the interaction term is still statistically significant (OR=1.023, p<.001). After adding the physical health related variables (e.g. self-rated health, IADL) in the second model, the significance of the interaction term between age and nativity stayed (OR=1.019, p=.001). The results suggest the role of nativity in the relationship between aging and depression such that foreign-born elders are more likely to be depressed than the native-born elders even holding the demographic, socio-economic status and physical health status constant.

Conclusions and Implications

Our findings suggest that foreign-born elders have a higher probability of suffering from depression as they are aged compared to the native-born elders in the U.S. even after controlling for major demographic, socio-economic and physical health related components. These results empirically support the argument of healthy immigrant effect regarding the deteriorating trend of health among immigrant population even in mental health area. These findings imply that immigrant seniors would need more attention in relation with mental health care, particularly depression on their way to the healthy aging.