Citizenship Status and Chronic Health Conditions among Asians in the U.S.

Introduction: Studies have shown that citizenship affords people with a range of health benefits and resources. Limited research, however, has explored how citizenship may be tied to the health of Asian Americans, a rapidly growing and increasingly stigmatized social group. Methods: Drawing on social exclusion theory and the concept of the ‘alien citizen’, this study uses data from the 2021–2022 California Health Interview Survey to investigate the relationships between citizenship status and chronic health conditions among Asians in the US. Results: After controlling for various sociodemographic factors and health behaviors, the prevalence of having a chronic health condition was significantly higher among Asian U.S. citizens than among their non-citizen counterparts (prevalence ratio (PR) = 1.372, P < 0.001). Furthermore, when stratifying citizenship by nativity status, findings indicate that U.S.-born citizens have a greater prevalence of having a chronic health issue, relative to naturalized U.S. citizens (PR = 1.187, P < 0.01). Discussion: Having U.S. citizenship, relatively higher earnings, and access to healthcare services does not exclude Asian Americans from experiencing chronic health issues, which often get masked due to the model minority myth. The findings of this study also underscore the health problems faced by Asians who are born in the U.S., highlighting the importance of examining citizenship by nativity status and raising implications for the social belonging of this population.