Mapping Immigrant Health Trajectories: Investigating the Implications of Institutional Selection and Post-arrival Support Across Legal-Entry Pathways

Abstract

Immigrants initially arrive in the United States in better health than the U.S.-born, but this advantage tends to diminish over time. The factors behind the existence and decline of the immigrant health advantage (IHA) are a subject of ongoing debate. While prior research has mainly focused on ethno-cultural group differences and individual selection dynamics, this study investigates how institutional selection and support, varying with different legal-entry pathways, affect immigrants' initial health status and subsequent health trajectory. Leveraging microdata samples from the Annual Social and Economic Supplement of the Current Population Survey (ASEC-CPS), the research offers a comparative analysis of work disability and self-rated health across the U.S.-born demographic and three legal-entry groups: employment-based, refugee, and U.S.-territory entries. The findings reveal a significant initial health advantage for both employment-based and refugee entries compared to the U.S.-born. However, while the health advantage holds steady for refugee entry over longer durations of stay, it diminishes for employment-based entry. These findings hold important implications for policies regarding immigration and immigrant integration.