Disability crossover: Is there a Hispanic immigrant health advantage that reverses from working to old age?

Abstract

Background: Hispanic immigrants have been found to be more likely to have a disability than US-born populations. Studies have primarily focused on populations aged 60 and older; little is known about immigrant disability at younger ages. Objective: Taking a broader perspective, we investigate whether Hispanic immigrants have lower disability rates in midlife; if so, at what ages this health advantage reverses; and the correlates of this pattern. Methods: Using American Community Survey 2010-2014 data, we estimate age-specific disability prevalence rates by gender, nativity, education, and migration age from age 40 to 80. We also present estimates by six types of disability. Results: Compared to non-Hispanic whites, disability prevalence among foreign-born Mexican women is lower until age 53 (men: 61) and greater after 59 (66). Similar patterns hold for other foreign-born Hispanics. Crossovers are observed in rates of ambulatory, cognitive, independent living, and self-care disability. Evidence of a steeper age-disability gradient among less-educated immigrants is found. Minimal differences are noted by migration age, challenging an acculturation explanation for the crossover. Contribution: The paper contributes to a better understanding of immigrant-native disability patterns in the United States. It is the first to systematically document a Hispanic immigrant health advantage in disability that reverses from working to old age. Hispanic immigrants (particularly foreign-born Mexican women), may face steeper risk trajectories, consistent with their greater concentration in low-skill manual occupations. We call for increased scholarly attention to this phenomenon.