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

Objectives: United States (U.S.) immigrants are rapidly aging, although little is known on how acculturation influences their disability risk. Methods: We pooled 2000–2018 data (n = 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. Results: Among middle aged immigrants, citizenship was associated with higher odds of ADL disability after accounting for socioeconomic factors. Among both middle aged and older immigrants, English proficiency was associated with lower odds of ADL disability until accounting for socioeconomic factors. Among older immigrants, lower ADL disability odds were observed among those with English proficiency and greater U.S. duration. Discussion: Acculturation had heterogenous influences on ADL disability risk among aging U.S. immigrants, while the interplay of these mechanisms shaped varied outcomes.