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Disentangling contributions of demographic, family, and socioeconomic factors on associations of immigration status and health in the United States
  1. Adrian Bacong1,
  2. Heeju Sohn2
  1. 1 University of California Los Angeles, Los Angeles, California, USA
  2. 2 Department of Sociology, Emory University, Atlanta, Georgia, USA
  1. Correspondence to Heeju Sohn, Department of Sociology, Emory University, 1555 Dickey Drive, 232 Tarbutton Hall, Atlanta, GA 30322, USA; heeju.sohn{at}


Background In the United States, immigration policy is entwined with health policy, and immigrants’ legal statuses determine their access to care. Yet, policy debates rarely take into account the health needs of immigrants and potential health consequences of linking legal status to healthcare. Confounding from social and demographic differences and lack of individual-level data with sensitive immigration variables present challenges in this area of research.

Methods This article used the restricted California Health Interview Survey (CHIS) to assess differences in self-rated health, obesity, and severe psychological distress. Between US-born citizens, naturalised citizens, lawful permanent residents (LPR), undocumented immigrants, and temporary visa holders living in California.

Results Results show that while immigrant groups appear to have poorer health on the surface, these differences were explained predominantly by older age among naturalised citizens and by lower-income and education among LPRs and undocumented immigrants. Favourable family characteristics acted as protective factors for immigrants’ health, especially among disadvantaged immigrants.

Conclusion Immigration policy that limits access to healthcare and family support may further widen the health disadvantage among immigrants with less legal protection.

  • Social inequalities
  • Health inequalities
  • Marital status
  • Migration

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  • Twitter Adrian Bacong @AdrianBacong.

  • Acknowledgements This project was supported by Grant Number K99HD096322 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) and benefited from facilities and resources provided by the California Center for Population Research at UCLA (CCPR), which receives core support (P2C-HD041022) from NICHD. Adrian Bacong was also supported by the 2018 UCLA Graduate Summer Research Mentorship Fellowship.

  • Contributors AB and HS both contributed to the research question and analysis of the results. AB gained access to the restricted data and wrote the code in Stata. HS was responsible for writing the article as well as its overall content.

  • Funding This project was supported by Grant Number R00HD096322 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data may be obtained from a third party and are not publicly available.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.