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Effects of Nativity, Length of Residence, and County-Level Foreign-Born Density on Mental Health Among Older Adults in the U.S.

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Abstract

Using the 2004–2007 Medical Expenditure Panel Survey data that are linked to county-level data from the Area Health Resources Files, this study examined whether the healthy immigrant effect applies to mental health of foreign-born older adults. Additionally, testing a protective ethnic density effect on older foreign-born individuals’ mental health, this study examined how the percentage of foreign-born population in the county affected the relationship between older adults’ immigration status (U.S.-nativity and length of residence in the U.S.) and their mental health status. The sample included 29,011 individuals (level-1) from 920 counties (level-2) across 50 states and D.C. Using the Mental Component Summary of the Short-Form 12, the Kessler Index (K-6), and the Patient Health Questionnaire (PHQ-2), U.S.-born individuals (n = 24,225), earlier immigrants (≥15 years in the U.S.; n = 3866), and recent immigrants (<15 years in the U.S.; n = 920) were compared. The results indicate that recent immigrants showed worse mental health on all three measures compared with U.S.-born individuals and on the K-6 and PHQ-2 compared with earlier immigrants. Higher county-level foreign-born densities were associated with worse mental health status of individuals. However, the significant interactions found in the full conditional multilevel models indicated that the high foreign-born density functioned as a risk factor for worse mental health only among recent immigrants but not among the U.S.-born. In conclusion, the results revealed the vulnerability of older recent immigrants, especially those living in the counties with high foreign-born densities.

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Acknowledgments

This study was funded by the Silberman Fund Faculty Grant Program (PI: S. Choi) and the National Institute on Aging (K01AG045342; PI: G. Kim). The data analysis in this paper was conducted at the Atlanta Research Data Center, and the support of the Agency for Healthcare Research and Quality (AHRQ) is acknowledged. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Aging or AHRQ.

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Authors and Affiliations

  1. College of Social Work, The University of Tennessee, Knoxville, TN, USA

    Sunha Choi

  2. Alabama Research Institute on Aging and Department of Psychology, The University of Alabama, Tuscaloosa, AL, USA

    Giyeon Kim

  3. School of Social Welfare, Soongsil University, 369 Sangdo-Ro, Dongjak-Gu, Seoul, 06978, Korea

    Sungkyu Lee

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  1. Sunha Choi
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Correspondence to Sungkyu Lee.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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This article does not contain any studies with human participants performed by any of the authors. This study used a publicly available secondary database, which does not contain any identifying information.

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Choi, S., Kim, G. & Lee, S. Effects of Nativity, Length of Residence, and County-Level Foreign-Born Density on Mental Health Among Older Adults in the U.S.. Psychiatr Q 87, 675–688 (2016). https://doi.org/10.1007/s11126-016-9418-2

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  • DOI: https://doi.org/10.1007/s11126-016-9418-2

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