Health Selection Among New Immigrants

Objectives. We sought to quantify the extent of health selection (i.e., the degree to which potential immigrants migrate, or fail to migrate, on the basis of their health status) among contemporary US immigrant groups and evaluate the degree that selection explains variation in self-rated health among US legal permanent residents. Methods. Data came from the New Immigrant Survey 2003 cohort. We estimated the extent of positive and negative health selection through a unique series of questions asking immigrants in the United States to evaluate their health and compare it to that of citizens in their country of origin. Results. The extent of positive health selection differed significantly across immigrant groups and was related to compositional differences in the socioeconomic profiles of immigrant streams. Conclusions. The salience of socioeconomic status and English-language ability in explaining health differentials across immigrant groups reinforces the importance of further research on the role of these factors in contributing to the health of immigrants above and beyond the need for additional attention to the health selection process. (Am J Public Health. 2008;98:2058-2064. doi:10.2105/AJPH.2006.100974)