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

项目摘要 该项目探索移民法律身份暴露如何影响老年人(50岁以上)的健康和福祉。 拉丁裔移民。美国未经授权的拉美裔外国出生人口目前正在老龄化， 导致越来越多的年长拉美裔人在成年后经历了多年的苦难 而且，作为老年人，他们被排除在美国的社会安全网体系之外。拉丁裔人口的老龄化是 因此，可能伴随着两个相关的趋势：(1)老年拉丁裔比例急剧增加，没有完全 获得公共项目的机会已被证明显著减少了贫困并增加了获得 老年美国公民的医疗保健，以及(2)老年拉美人对亲属网络的更多依赖- 主要是他们的中年子女--满足日常财务和保健需要。我们的目标是记录这些 并探讨它们如何影响年长的拉丁裔人的健康和福祉。该项目有三个具体的 目标。 首先，我们将调查移民法律身份暴露与年长的拉丁裔移民的健康之间的关系 以及他们获得和利用卫生保健的情况。我们的主要创新是使用纵向健康和退休 链接到社会保障管理局(SSA)和Medicare/Medicaid文件的调查(HRS)数据。我们 将使用这些管理数据的链接信息来衡量移民的合法身份和时间 在每种状态下花费，然后对法律地位暴露和级别之间的关系进行建模 生理(如功能限制、不平衡负荷、死亡风险)和心理健康(如 抑郁症、认知功能减退、阿尔茨海默氏症)以及获得/利用保健服务。 其次，我们将调查老年拉丁裔亲属网络的可用性和有效性。我们将使用 HRS数据，以探索与以下相关的问题：(1)按移民划分的年长拉丁裔亲属网络的特征 法律地位，以及(2)老年拉丁裔亲属网络的规模/特征与 他们对援助的未得到满足的需要，以及他们的健康和获得/利用卫生保健的情况。 第三，我们将开发一个微观模拟模型来预测年长的拉美裔移民的规模和构成 以及他们的亲属关系网。微观模拟将使我们能够模拟健康结果和 在接下来的十年里，随着拉美裔人口的老龄化，为他们提供亲属支持。此外，我们还将使用 一种模型，用于将“现状”情景与多个潜在的政策变化进行比较，这些变化将改变 支持老年移民或提供获得合法身份和公民身份的途径，并影响年长的拉美裔人。 这项拟议的研究将为科学和政策提供有关获得护理的信息，并有助于建立证据-- 以促进老龄拉美裔移民社区健康和福祉为基础的干预措施。

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.