Does a healthy immigrant effect exist for internal migrants? Findings from a representative sample of 5.4 million older Americans

Abstract

Immigrants in North America and Europe typically have better health outcomes than the native-born population in the host country. Less is known about whether this occurs among internal migrants. This study aimed to: (1) Determine if older Americans who live in their natal state have a higher prevalence and odds of disabilities (memory problems, hearing problems, vision problems, limitations in activities of daily living, functional limitations) compared to internal migrants; (2) Identify if older American immigrants have a higher prevalence and odds of disabilities compared to internal migrants. Chi-square and logistic regression analyses were conducted using 10 years of nationally representative data from the American Community Survey with 5.4 million older adults. Compared to internal migrants, older adults living in their natal state had significantly higher odds of all disabilities after adjusting for age, sex, and race. Controlling for education partially attenuated these associations for four of the disability outcomes. After adjustment for education, age, sex and race, the odds of four types of disabilities were significantly lower for international immigrants compared to internal migrants. Our findings add to the growing body of research exploring elements of the healthy migrant effect for internal migrants as well as international migrants.