1. Physical and Mental Health Characteristics of US-born and Foreign-born Adults, 1997–2002 Achintya N. Dey Jacqueline Wilson Lucas Division of Health Interview Statistics

2. Background  Immigrants comprise 11.5% of U.S. population, largest percentage since the 1930’s  PRWORA (1996) restricted immigrants’ access to health benefits and care, placing their health at risk  Status of immigrant health, particularly physical and mental health status, needs to be studied and monitored Data source: CDC/NCHS, National Health Interview Survey 1997- 2002Preliminary Data

3. Purpose Research questions:  Are there differences between the native born and foreign-born US population in health characteristics such as mental health status, perceived health status?  Are there differences between the native born and foreign-born US population in risk factors for chronic diseases, such as obesity, smoking, diabetes, hypertension, and cardiovascular disease?

4. Methods  Data came from Sample Adult component of the 1997- 2002 NHIS (n=196,101)  Socio-demographic characteristics of US-born and Foreign-born adults 18 years old and over  Odd ratios of selected physical and mental health measures of US-born and Foreign-born adults, adjusting for: Age, Sex, Race, Education, Income, Employment status, Family size, Marital status, MSA/Non-MSA, Region of residence

5. Measurement of Health Physical health:  Self-assessed health  Need help in activities of daily living (ADL)  Need help in instrumental activities of daily living (IADL)  Selected chronic diseases and health behaviors:  Obesity,smoking, hypertension, diabetes, cardiovascular diseases, coronary heart disease, heart disease, stroke, angina Mental health:  Serious psychological distress (K6 battery)

6. Percent of Current Immigrants and Region of origin Data source: CDC/NCHS, National Health Interview Survey 1997-2002Preliminary Data

7. Age Group by Nativity Status, 1997 - 2002 Data source: CDC/NCHS, National Health Interview Survey 1997-2002 Preliminary Data

8. Sex by Nativity Status, 1997 - 2002 Data source: CDC/NCHS, National Health Interview Survey 1997-2002 Preliminary Data

9. Education by Nativity Status, 1997 - 2002 Data Source: CDC/NCHS, National Health Interview Survey 1997-2002 Preliminary Data

10. Family Income by Nativity Status, 1997 - 2002 Data source: CDC/NCHS, National Health Interview Survey 1997-2002 Preliminary Data

11. Employment Status by Nativity Status, 1997 - 2002 Data source: CDC/NCHS, National Health Interview Survey 1997-2002Preliminary Data

12. Place of Residence by Nativity Status, 1997 - 2002 Data source: CDC/NCHS, National Health Interview Survey 1997-2002 Preliminary Data

13. Region of residence by Nativity Status, 1997-2002 Data source: CDC/NCHS, National Health Interview Survey 1997-2002 Preliminary Data

14. Adjusted Odds Ratios and Confidence Intervals of Selected Chronic Diseases by Nativity Status, 1997-2002 Ref. group US-born All Foreign- born 0-4 years 5-9 years 10 & more years Obesity (BMI >= 30) 0.56 (0.53 – 0.60) 0.32 (0.28 – 0.37) 0.45 (0.40 – 0.51) 0.67 (0.63 – 0.71) Current Smoking 0.62 (0.58 – 0.66) 0.58 (0.51 – 0.66) 0.50 (0.44 – 0.57) 0.67 (0.62 – 0.72) Hypertension0.75 (0.71 – 0.80) 0.49 (0.42 – 0.56) 0.56 (0.49 – 0.65) 0.84 (0.79 – 0.89) Diabetes0.71 (0.64 – 0.78) 0.48 (0.35 – 0.65) 0.40 (0.30 – 0.53) 0.78 (0.71 – 0.86) Cardiovascular diseases 0.77 (0.70 – 0.85) 0.67 (0.49 – 0.91) 0.60 (0.45 – 0.80) 0.79 (0.72 – 0.87) Foreign-born living in US Data source: CDC/NCHS, National Health Interview Survey 1997-2002Preliminary Data

15. Adjusted Odds Ratios and Confidence Intervals of Selected Health Status by Nativity, 1997-2002 Ref. group US-born All Foreign- born 0-4 years 5-9 years 10 & more years Need help with IADL (Yes) 0.73 (0.64 – 0.83) 0.30 (0.19 – 0.49) 0.51 (0.35 – 0.73) 0.83 (0.73 – 0.94) Need help with ADL (Yes) N.S.N.S.0.60 (0.37 – 0.96) N.S. Self-assessed health status (exc/vg/good) 1.31 (1.22 –1.41) 1.83 (1.52 – 2.21) 1.79 (1.51 – 2.13) 1.16 (1.08 – 1.26) Serious psychological distress (Yes) 0.81 (0.71 – 0.93) 0.72 (0.55 – 0.95) 0.48 (0.35 – 0.64) N.S. Foreign-born living in US Data source: CDC/NCHS, National Health Interview Survey 1997-2002 Preliminary Data

16. Summary  Immigrants adults enjoy better health than their US-born counterparts:  Health behaviors, such as lower risk of smoking and obesity.  Lower risk of diabetes  Less likely to report having hypertension and cardiovascular diseases.  Immigrants were more likely to rate their health positively  Immigrants were less likely to have serious psychological distress  The longer immigrants live in US, the more similar they become to the native born population