Legal Status Exposure, Health, and Kinship Networks among Latino Immigrants

Project Summary This project explores how immigrant legal status exposures impact the health and wellbeing of older (50+) Latino immigrants. The unauthorized Latino foreign-born population in the US is currently aging in place, leading to a growing number of older Latinos who experienced years of hardship throughout their adult lives and, as older adults, are excluded from the US social safety net system. The aging of the Latino population is thus likely accompanied by two related trends: (1) dramatic increases in the share of older Latinos without full access to the public programs that have been shown to considerably reduce poverty and increase access to health care among older American citizens, and (2) increased reliance by older Latinos on kinship networks – chiefly their middle-aged children – for daily financial and health care needs. Our goal is to document these trends and explore how they impact the health and wellbeing of older Latinos. The project has three specific aims. First, we will investigate how immigrant legal status exposures are related to older Latino immigrants’ health and their access and utilization of health care. Our key innovation is to use longitudinal Health and Retirement Survey (HRS) data that is linked to the Social Security Administration (SSA) and Medicare/Medicaid files. We will use information from linkages to these administrative data to measure immigrants’ legal status and time spent in each status and then model the relationship between legal status exposures and levels and trajectories in both physical (e.g. functional limitations, allostatic load, mortality risk) and mental health (e.g. depression, cognitive decline, Alzheimer's disease), and access/utilization of health care. Second, we will investigate the availability and effectiveness of kinship networks of older Latinos. We will use HRS data to explore questions related to (1) the characteristics of older Latinos' kinship networks by immigrant legal status, and (2) the relationship between the size/characteristics of older Latino's kinship networks and their unmet need for assistance, as well as their health and access/utilization of health care. Third, we will develop a microsimulation model to project the size and composition of older Latino immigrants and their kinship networks. The microsimulation will enable us to model health outcomes and the level of kinship support for Latinos as this population ages in place over the next decade. Additionally, we will use the model to compare the “status quo” scenario to multiple potential policy changes that would alter the level of support for older immigrants or offer a pathway to legalization and citizenship, and impact older Latinos. The proposed research will inform science and policy about access to care and contribute to building evidence- based interventions for promoting health and wellbeing among the aging Latino immigrant community.