Differences in Survival Status Between the Foreign-born and Native-born Diabetes Patients Over a 13-year Period

Document Type

Conference Abstract

Publication Date


Publication Title

APHA Annual Meeting and Expo 2019 Abstracts


Studies on immigrant health indicate that foreign-born older Americans have a mortality advantage over their native-born counterparts, despite their lower socioeconomic status. It has been referred as the “immigrant health paradox”. However, inconsistent findings have been reported over a variety of health outcomes. We compared the all-cause mortality of foreign-born diabetes patients to those who were born in the United States over 13 years.

Data were from the Diabetes Study 2003, an off-year survey of the Health and Retirement Study (HRS) to the 2002 HRS participants who had diabetes. The survival status was obtained from the Exit Surveys of HRS. Years of schooling, Hemoglobin A1c, Total Illness Burden Index, and other control variables were entered into logistic regression to predict their survival from 2003 through the end of 2016.

After excluding cases with missing values, a total of 1,233 diabetes patients were grouped into those who aged 65 or older in 2003 (Mean age=74.0, N=866 and 535 of them had died by 2016) and those who were 64 or younger in 2003 (Mean age=59.6, N=367 and 112 of them had died by 2016). Results showed that foreign-born diabetes patients were less likely to die over the follow-up years when compared to their US-born counterparts. However, the association between immigrant status and mortality was seen only among the older group (Odds Ratio=.46, p=.01), after controlling for covariates.

Our findings seem to suggest that the mortality advantage in a group of older diabetes patients seen only among the older cohorts of immigrants.