The Effects of Nativity Status on Well-Being Among Medicare Beneficiaries by Race/Ethnicity: A Multi-group Analysis
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ORIGINAL PAPER
The Effects of Nativity Status on Well‑Being Among Medicare Beneficiaries by Race/Ethnicity: A Multi‑group Analysis Heehyul Moon1 · Hyesook Kim2 · Sunshine M. Rote1 · William E. Haley3 · Jeanelle S. Sears4
© Springer Science+Business Media, LLC, part of Springer Nature 2020
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. Keywords Nativity status · Older adults · Stress coping · Race/ethnicity · Medicare beneficiaries
Introduction Approximately 14 percent of the population in the United States (U.S.) are foreign-born individuals and this number is predicted to increase to more than 17 percent by the year 2065 [1]. Despite the projected increase in the diversity Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10903-020-01072-9) contains supplementary material, which is available to authorized users.
and number of foreign- born older adults, from 4.6 million in 2010 to more than 16 million by 2050 [2], research on immigrant/foreign-born older adult mental health has been limited [3, 4]. Depression is one of the leading causes of disability worldwide and specifically in high-income nations such as the U.S. [5]. In addition, depression and anxiety along with other indicators of psychological distress increase the risk of premature mortality [6]. There is also evidence
* Heehyul Moon [email protected]
1
Kent School of Social
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