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

项目摘要 该项目探讨了移民法律的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。美国未经授权的拉丁裔外国出生人口目前正在老龄化， 导致越来越多的老年拉丁美洲人在他们的成年生活中经历了多年的困难 作为老年人，他们被排除在美国社会安全网系统之外。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）没有完整的拉丁美洲老年人的比例急剧增加， 获得公共方案，这些方案已被证明可以大大减少贫困， 老年美国公民的医疗保健，（2）老年拉丁美洲人对亲属网络的依赖增加- 主要是他们的中年子女-用于日常的经济和保健需要。我们的目标是记录这些 趋势，并探讨他们如何影响老年人的健康和福祉。该项目有三个具体 目标。 首先，我们将调查移民法律的身份暴露与老年拉丁裔移民的健康状况之间的关系 以及他们获得和利用卫生保健的机会。我们的主要创新是使用纵向健康和退休 与社会保障管理局（SSA）和医疗保险/医疗补助文件相关联的调查（HRS）数据。我们 将使用这些行政数据的链接信息来衡量移民的法律的地位和时间 然后对法律的状态风险与级别之间的关系进行建模， 在身体（例如功能限制，非稳态负荷，死亡风险）和心理健康（例如， 抑郁症、认知能力下降、阿尔茨海默病）和获得/利用卫生保健。 其次，我们将调查的可用性和有效性的亲属网络的老年人。我们将使用 HRS数据，以探索与以下问题相关的问题：（1）移民的老年拉丁美洲人亲属网络的特征 法律的地位，以及（2）老年拉丁美洲人的亲属网络的规模/特征之间的关系， 未得到满足的援助需求，以及他们的健康和获得/利用保健服务的机会。 第三，我们将开发一个微观模拟模型，以预测老年拉丁裔移民的规模和构成 和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 在未来十年内，随着拉美裔人口的老龄化，对拉美裔人的亲属支持。此外，我们将使用 模型比较“现状”的情况下，多个潜在的政策变化，将改变水平 支持老年移民或提供合法化和公民身份的途径，并影响老年拉丁美洲人。 拟议的研究将为获得护理的科学和政策提供信息，并有助于建立证据- 为基础的干预措施，以促进健康和福祉之间的老龄化拉丁美洲移民社区。

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.