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The Effects of Nativity Status on Well-Being Among Medicare Beneficiaries by Race/Ethnicity: A Multi-group Analysis

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Abstract

Nativity status is related to stress, health and well-being, but the literature is scant concerning whether these effects differ by race/ethnicity for older adults. We examined direct and indirect effects of nativity status on stress, coping resources, health, and depression/anxiety for the three largest racial/ethnic groups [Non-Hispanic White (NHW), Non-Hispanic Black (NHB), and Hispanic] in the U.S. using the Transactional Model of Stress and Coping. We obtained the data from Round 1 of the National Health and Aging Trends Study (NHATS; U.S.-born Medicare beneficiaries = 4093, foreign-born Medicare beneficiaries = 382, N = 4475). We used the multi-group analysis function in structural equation modeling to examine similarities and differences in the stress coping processes for the three racial/ethnic groups. The results indicated there are multiple pathways from nativity status to depression or self-rated health. For all three groups, being foreign-born was directly associated with higher stress and indirectly associated with lower self-rated health via stress. Only for Hispanic older adults was being foreign-born directly associated with higher depression/anxiety. For NHWs, being foreign-born was indirectly associated with higher depression/anxiety via less coping resources. Nativity status may have similar effects on self-rated physical health but may exert very different effects on depression/anxiety, depending on race/ethnicity. Nativity status will require special attention for both assessment and management of depression/anxiety as well as self-rated health among older adults of all racial/ethnic backgrounds and especially for older Hispanics.

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Acknowledgements

The National Health and Aging Trends Study (NHATS) is sponsored by the National Institute on Aging (Grant Number NIA U01AG032947) through a cooperative agreement with the Johns Hopkins Bloomberg School of Public Health. The authors would like to thank Dr. Anita P. Barbee and Dr. Michael Cunningham for commenting on an earlier draft of this article.

Funding

Support for this publication was provided by a grant from the Robert Wood Johnson Foundation-New Connections program (ID 73836). The views expressed here do not necessarily reflect the views of the Foundation.

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Authors and Affiliations

  1. Kent School of Social Work, University of Louisville, Louisville, KY, USA

    Heehyul Moon & Sunshine M. Rote

  2. College of Education, Daegu University, Gyeongsan-si, Gyeongsangbuk-do, Republic of Korea

    Hyesook Kim

  3. School of Aging Studies, College of Behavioral and Community Sciences, University of South Florida, Tampa, FL, USA

    William E. Haley

  4. College of Health and Human Services, Bowling Green State University, Bowling Green, OH, USA

    Jeanelle S. Sears

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  1. Heehyul Moon
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Moon, H., Kim, H., Rote, S. et al. The Effects of Nativity Status on Well-Being Among Medicare Beneficiaries by Race/Ethnicity: A Multi-group Analysis. J Immigrant Minority Health 23, 755–763 (2021). https://doi.org/10.1007/s10903-020-01072-9

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