Term of Award

Spring 2024

Degree Name

Doctor of Public Health (Dr.P.H.)

Document Type and Release Option

Dissertation (open access)

Copyright Statement / License for Reuse

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


Department of Health Policy and Community Health

Committee Chair

Bettye Apenteng

Committee Member 1

Linda Kimsey

Committee Member 2

Samuel Opoku



Background: Immigrant health disparities existed before the COVID-19 pandemic. However, the pandemic may have exacerbated these issues, resulting in even more significant healthcare challenges for immigrants. Most pandemic-related studies have focused on significant immigrant populations (Latinx), specific states or counties, neglecting other immigrant populations. Additionally, there has been limited research on the impact of the pandemic on the mental health of immigrants during the pandemic. This study aimed to investigate whether the pandemic disproportionately affected healthcare utilization, outcomes, and mental health among U.S. immigrants.

Methods: The study analyzed secondary data from the Medical Expenditure Panel Survey (2018 to 2021). Binary logistic regressions were employed to address the study's research questions.

Results: Overall, immigrant status was associated with decreased odds of health utilization. The study confirmed the Healthy Immigrant Effect (HIE) on immigrants' physical and mental health. During the pandemic period, reduced healthcare utilization, heightened emotional distress, and poor self-reported general health among U.S. residents occurred. The effect of the pandemic on healthcare utilization, health status, and mental health was found to be uniform among U.S. residents in the short term.

Conclusion: In summary, immigrants were not disproportionately affected during the pandemic. However, this study underscores existing disparities in healthcare service utilization among immigrant populations. It highlights the imperative for policymakers and stakeholders to prioritize equitable healthcare services and adequate emergency preparedness measures. Further research into the recovery phase of the pandemic is needed to examine the long-term impact of the pandemic on healthcare access and outcomes and address potential barriers to care access among U.S. immigrant communities.

INDEX WORDS: Immigrants, COVID-19 pandemic, emergency visits, hospital discharge, self-reported health status, mental health

Research Data and Supplementary Material


Available for download on Wednesday, April 18, 2029