Immigration is a loaded issue in the United States, and it often is discussed in the context of health care utilization and expense. One contentious debate is whether rising healthcare costs in the U.S. are attributable, in part, to uninsured immigrants obtaining medical treatment in expensive emergency rooms because they lack health insurance. That particular argument– that immigrants contribute disproportionately to healthcare costs — is not supported by data. Evidence repeatedly shows that healthcare expenditures for legal and undocumented immigrants are typically 30-50% lower than in U.S. born adults.
But here’s an additional facet of the debate that is often overlooked: Immigrants are often healthier, and live longer, than U.S. born citizens. In fact, these better immigrant health outcomes (lower mortality rates from heart disease and cancer, for example) occur despite lower levels of education and income (two health risk factors) observed in immigrants vs. native-born citizens. The better mortality rates of first-generation immigrants may be attributable to the healthy habits they bring with them from their own countries: more walking and routine physical activity, growing their own fruits and vegetables, and eating a healthy diet low in processed foods.
Sadly, however, the immigrant advantage quickly wears off. As Sabrina Tavernise of the New York Times notes, the “longer [immigrants] live in this country, the worse their rates of heart disease, high blood pressure and diabetes.” As immigrants adopt American behaviors– eating out, smoking, being physically inactive, consuming calorie dense, high-processed foods– they also adopt American disease and mortality disadvantages. Even more alarming are the preliminary reports that offspring of immigrants also lose the immigrant advantage in health and mortality. For example, while Hispanic immigrants live about 3 years longer than American-born adults, Hispanic children born in the U.S. demonstrate marked health disparities relative to non-Hispanic children such as substantially higher rates of obesity and Type II diabetes.
Ralph Waldo Emerson wrote that “the first wealth is health,” but the reality of American health behaviors and lifestyles unfortunately means that for many immigrants, wealth comes at great cost…good health. Accordingly, it is this trend and its health, medical and financial consequences that should be a central aspect of the discussion on immigration and health care.