A longstanding puzzle in social epidemiology is that immigrants often arrive in the United States healthier than the native-born population. Yet, this advantage tends to fade as they grow older. Many researchers have suggested that acculturation — the process through which immigrants adopt the language, culture and behaviours of their new country — may contribute to this decline in health. However, a new study published in the Journal of Health and Social Behavior suggests the story is more complicated.
The study found that acculturation itself may actually protect health in later life. Older immigrants who spoke English well had 40 to 50 per cent lower odds of disability compared with those who had limited English proficiency. Similarly, immigrants married to U.S.-born spouses, often viewed as a sign of greater social integration, had 10 to 20 per cent lower odds of disability than those married to foreign-born spouses. These findings suggest that adapting to American society can provide important social and health benefits.
The research also identified a more complex pattern known as “acculturative discordance,” which occurs when immigrants are highly acculturated in some ways but not others. Immigrants who were married to U.S.-born spouses but did not speak English well faced higher risks of ambulatory disability than immigrants who had both limited English proficiency and foreign-born spouses. Ambulatory disability, which includes difficulties with walking or climbing stairs, is the most common disability among older Americans and affects roughly one in four adults aged 65 and older.
“Some immigrants behave and feel very much like Americans, yet they get perceived as foreigners because they don’t sound like the average American or they live in an immigrant enclave,” says Leafia Ye, assistant professor of sociology at the University of Toronto and author of the study. “The results indicate that this discordance can be physically stressful — and show up as disability in later life.”
The study drew on data from the American Community Survey conducted by the U.S. Census Bureau and included 958,211 immigrants between the ages of 65 and 80. Another important finding was that acculturation appeared to offer stronger health protection for white immigrants than for Black, Hispanic and Asian immigrants. As a result, highly acculturated white immigrants were more likely to maintain their health advantage over the U.S.-born population in later life. In contrast, racially minoritized immigrants were more likely to lose that advantage.
“Racially minoritized immigrants experience another layer of discordance — as they adapt more to U.S. society, they might also confront more racial discrimination and exclusion,” says Ye, who is also affiliated with the Institute for Life Course & Aging and the Global Migration Lab at the Munk School of Global Affairs & Public Policy. “This study highlights that being ‘half-included’ is a difficult experience. Immigrants may be blending in more while simultaneously facing barriers to full acceptance, and the health consequences of that experience should not be ignored.”
More information: Leafia Zi Ye et al, Is Acculturation the Culprit? Acculturative Discordance and Immigrants’ Later-Life Health, Journal of Health and Social Behavior. DOI: 10.1177/00221465261450447
Journal information: Journal of Health and Social Behavior Provided by University of Toronto
