Disability Among Middle Aged and Older Immigrants: Differences by Citizenship, English Proficiency, and Years in United States

ObjectivesUnited States (U.S.) immigrants are rapidly aging, although little is known on how acculturation influences their disability risk.MethodsWe pooled 2000-2018 data (<i>n</i> = 50,075) from the National Health Interview Survey (NHIS) to examine odds of activities of daily living (ADL) disability among middle aged (40-64) and older (65+) immigrants based on three acculturation indicators while accounting for various measures.ResultsAmong middle aged immigrants, citizenship was associated with <i>higher</i> odds of ADL disability after accounting for socioeconomic factors. Among both middle aged and older immigrants, English proficiency was associated with <i>lower</i> odds of ADL disability until accounting for socioeconomic factors. Among older immigrants, <i>lower</i> ADL disability odds were observed among those with English proficiency <i>and</i> greater U.S. duration.DiscussionAcculturation had heterogenous influences on ADL disability risk among aging U.S. immigrants, while the interplay of these mechanisms shaped varied outcomes.