U.S.-Born Older Asians' Diminishing Health Advantage Relative to Other Racial Groups, 2005-2022

Abstract

Objectives Previous studies have shown that Asian Americans have lower disability and mortality rates than other racial/ethnic groups, indicating a more favorable health profile. This phenomenon is often attributed to the large proportion of Asians being foreign-born and positively selected. However, the health status of U.S.-born older Asians and its trend over time remain unclear. Methods We used data from the American Community Survey to describe changes in age-adjusted disability prevalence among native-born older Asians relative to other racial/ethnic groups since 2005. Results Although U.S.-born Asians aged 50 and older had lower disability prevalence than other racial/ethnic groups in 2005-09, their prevalence stagnated over time, while other groups experienced reductions. Consequently, the health advantage of U.S.-born older Asians diminished between 2005 and 2022. A key explanation for this phenomenon is a relative decline in socioeconomic status (SES) among older Asians compared to Whites over time. Asians experienced stagnation in high school attainment and a clear decline in the proportion of the population above the bottom income quintile, while Whites (and most others) experienced improvement in both SES measures. Furthermore, U.S.-born older Asians with low SES experienced an increase in disability, a trend not observed in any other racial or nativity group. We found suggestive evidence that declining community and family support among native-born older Asians may have also eroded their health advantage. Discussion The "model minority"stereotype increasingly misrepresents the well-being of U.S.-born older Asians, a population that requires further research attention.