Skip to content

Abstract Search

Primary Submission Category: Migration

Health across the “Skills” Spectrum: Occupational Attainment, U.S. Citizenship Status, and the Immigrant Health Advantage

Authors:  Rebecca Schut, Nicole Samala,

Presenting Author: Nicole Samala*

Despite extensive research on the immigrant health advantage (IHA), key questions surrounding immigrant health in the 21st century remain. First, increasing immigrant educational and occupational heterogeneity necessitate further research into immigrant health across the “skills” spectrum. Second, whether citizenship moderates the relationship between nativity and health is underexplored. Third, although much of the IHA literature has focused on physical health, assessing other (e.g., mental health) outcomes can provide a more holistic picture of immigrant well-being.

Using the 2000-2018 National Health Interview Survey, we assess whether immigrant health varies across the “skills” spectrum, measured as Bureau of Labor Statistics “job zones.” We also evaluate whether U.S. citizenship moderates the relationship between nativity and health. Outcomes include self-rated health (SRH), mental health (sadness; hopelessness; Kessler (K6) distress scale scores), and healthcare access (health insurance status; whether one has a usual source of medical care).

Immigrants in low skill jobs hold SRH advantages over the low skill U.S. born; this advantage diminishes, but is not eliminated, as skill level increases. Low and mid skill immigrants have lower (better) K6 scores and report less hopelessness than the U.S. born. High skill immigrants report more hopelessness; higher (worse) but statistically insignificant K6 scores; and more sadness. All skill levels of immigrants are less likely to have insurance/a usual source of care.

By citizenship, low and mid skill non-U.S. citizen immigrants have the greatest advantages in SRH and most mental health outcomes. High skill non-citizens report higher levels of sadness. Non-citizens consistently report poorer healthcare access, even at the highest skill levels. Together, findings present a complex picture of the role that skill and U.S. citizenship play in shaping immigrant health, adding important nuance to the existing IHA literature.