Trajectory of Health and Functioning of Minority Immigrant Elders: A Latent Growth Curve Analysis

Abstract

Using 1992 to 2010 longitudinal data from the Health and Retirement Study, this study investigated the health trajectories over the life course for non-immigrants, and immigrants who came to the United States at different age. This research analyzed the initial HRS cohort (born 1931 to 1941) in the US (N=8,803). Birth place was examined (foreign born=864). The outcome variables included biennial measure of whether they were still alive or not, self-reported health, number of ADL/ IADL difficulties, depression (CES-D), and number of diagnosed diseases. We fit Cox proportional hazards models to identify the risk factors of mortality. Latent Growth Curve (LGC) modeling is performed to estimate changes of different health outcomes across the 18-year period. The results indicated that immigrants are 39% less likely to die than their non-immigrant counterparts. Further, estimates from LGC analysis showed that immigrant elders reported significantly worse health conditions and ADL, with a faster rate of deterioration. Immigrants also reported a higher level of depression. However, the decline rate of mental health was slower among immigrants than non-immigrants. When comparing across the immigrant groups, elders who moved to the United States at the older age (50 or older) had a hazard ratio of 28% comparing with the younger age (below 18) group. Findings point to the importance of considering all these correlates in improving the overall quality of care for minority immigrants to reduce racial and ethnic health disparities among older population in the US.