Disentangling contributions of demographic, family, and socioeconomic factors on associations of immigration status and health in the United States.

BACKGROUND: In the United States, immigration policy is entwined with health policy, and immigrants' legal statuses determine their access to care. Yet, policy debates rarely take into account the health needs of immigrants and potential health consequences of linking legal status to healthcare. Confounding from social and demographic differences and lack of individual-level data with sensitive immigration variables present challenges in this area of research.
METHODS: This article used the restricted California Health Interview Survey (CHIS) to assess differences in self-rated health, obesity, and severe psychological distress. Between US-born citizens, naturalised citizens, lawful permanent residents (LPR), undocumented immigrants, and temporary visa holders living in California.
RESULTS: Results show that while immigrant groups appear to have poorer health on the surface, these differences were explained predominantly by older age among naturalised citizens and by lower-income and education among LPRs and undocumented immigrants. Favourable family characteristics acted as protective factors for immigrants' health, especially among disadvantaged immigrants.
CONCLUSION: Immigration policy that limits access to healthcare and family support may further widen the health disadvantage among immigrants with less legal protection. © Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.