Guided by the theories of human capital and acculturation, this study investigated the association of immigrant status among older people with their physical and mental health outcomes, health services utilization, and health insurance coverage. Specifically, it examined the interactive effects of immigrant status, education, acculturation, race, and ethnicity on these dependent variables. The study used a national representation sample of 7,345 older Americans from the first wave of the Asset and Health Dynamic of the Oldest Old study (AHEAD) survey. We used both logistic regression and ordered logit regression for our multivariate analyses. The findings are as follows: (1) immigrant status was negatively associated with level of depression, number of IADL difficulties, and on types of health insurance coverage. Immigrant status had a significant relationship only with the utilization of outpatient surgery, but not on other health services utilization. (2) There were significant interactive effects of race and ethnicity and immigrant status on these dependent variables. The findings support the existence of double jeopardy among those who are simultaneously an immigrant and a member of a racial and ethnic minority group in the United States. (3) Acculturation has strong associations with health insurance coverage and with number of difficulties with IADL. © Springer Science+Business Media, LLC 2009.

Education Acculturation Health disparity Race and ethnicity Old immigrants

information processing depression insurance health disparity Health Status Disparities mental health human Insurance Coverage daily life activity statistics Activities of Daily Living health service Aged ethnology United States Humans male Emigrants and Immigrants Acculturation female cultural factor health services Article migration age Age Factors Utilization Review Healthcare Disparities health care disparity Data Collection