The Impact of Immigration on the Living Arrangements and Health of the Elderly

移民对老年人生活安排和健康的影响

• 批准号: 9353279
• 负责人: Kristin F. Butcher
• 金额: $ 7.96万
• 依托单位: NATIONAL BUREAU OF ECONOMIC RESEARCH
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-15 至 2021-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9353279
• 关键词: Activities of Daily Living; Admission activity; Affect; Age; Aging; Area; Attention; Caring; Categories; Cessation of life; Child; Chronic Disease; Data Set; Disease; Elderly; Family; Health; Health Services; Health Services Accessibility; Home environment; Immigrant; Immigration; Individual; Institutionalization; Link; Living Arrangement; Mental Health; Methodology; Morbidity - disease rate; Native-Born; Outcome; Policies; Population; Probability; Process; Provider; Retirement; Role; Services; United States; Well in self; cost; disability; experience; innovation; migration; mortality; public health relevance; secondary analysis

 DESCRIPTION (provided by applicant): As the elderly population of the United States grows, identifying determinants of aging trajectories is of heightened importance. This project investigates the effect of immigration on the trajectories of health, disability, living arrangemens, and well-being of the native-born elderly age 75 and up. Fully 22 percent of health service workers are foreign born; in some states the fraction exceeds 50 percent. By expanding the pool of caretakers, inflows of foreign-born workers may affect the access to, cost, and quality of in-home or institutional care for the elderly. Immigration may also encourage substitution from informal family care to professional care for the elderly, and may allow the elderly to purchase support services such as house cleaning or gardening that allow them to age in place longer. The care-taking and living situations of the elderly, in turn, may have profound implications for their morbidity, mortality, and subjective well-being, especially among those who cannot manage the activities of daily living on their own. The specific aims of the project are as follow: (1) To investigate the link between immigrant concentrations in local areas and living arrangements of the native born elderly. Are immigrant-exposed elderly individuals more likely to age-in-place, less likely to live with or near their own children, or less likely to live in an institutional setting? (2) To investigate the link between immigrant concentrations in local areas and care-taking arrangements of the native born elderly. Does immigrant labor substitute for informal family care-taking arrangements among those who need assistance? (3) To investigate the link between immigrant concentrations in local areas and the health trajectories, disability, and mortality of the elderly. Conditional on baseline health, does aging in an area with many immigrants affect limitations to activities of daily living, morbidity, the management of chronic disease, or the probability of death? If so, what are the mechanisms? (4) To investigate the link between the outcomes in Specific Aims 1 through 3 and the subjective well-being of the elderly. The project incorporates secondary analysis of four large national datasets. It uses an innovative methodology to account for endogenous migration of both native born elderly and immigrants. This allows the causal impact of immigration on the health and caretaking arrangements of the elderly to be isolated. High rates of immigration in recent decades may transform the aging experiences of the native born elderly, but the impacts of immigration on the native elderly have received little attention. As the nation debates admissions policies for immigrants and as baby boomers reach retirement age, the role of immigrants in the provision of health and other services to the elderly has direct and urgent policy relevance.

 描述（由申请人提供）：随着美国老年人口的增长，确定老龄化轨迹的决定因素变得越来越重要。该项目调查移民对 75 岁及以上本土出生老年人的健康、残疾、生活安排和福祉轨迹的影响。足有 22% 的卫生服务工作者出生在国外；在某些州，这一比例超过 50%。通过扩大看护人员的数量，外国出生的工人的流入可能会影响老年人获得家庭或机构护理的机会、成本和质量。移民还可能鼓励老年人从非正式家庭护理转向专业护理，并可能允许老年人购买房屋清洁或园艺等支持服务，使他们能够在原地安享晚年。反过来，老年人的照顾和生活状况可能对其发病率、死亡率和主观幸福感产生深远的影响，特别是对于那些无法自行处理日常生活活动的老年人。 本项目的具体目标如下：（1）调查当地移民集中度与本土老年人居住安排之间的联系。受到移民影响的老年人是否更有可能就地养老，不太可能与自己的孩子一起生活或靠近自己的孩子，或者不太可能生活在机构环境中？ (2)调查当地移民集中度与本地出生老年人的照顾安排之间的联系。移民劳工是否可以替代那些需要援助的人的非正式家庭照顾安排？ （3）调查当地移民集中度与老年人健康轨迹、残疾和死亡率之间的联系。以基线健康状况为条件，在移民众多的地区，老龄化是否会影响日常生活活动限制、发病率、慢性病管理或死亡概率？如果有，机制是什么？ (4) 调查具体目标1至3的结果与老年人主观幸福感之间的联系。 该项目结合了对四个大型国家数据集的二次分析。它使用创新的方法来解释本地出生的老年人和移民的内生移民。这使得移民对老年人的健康和照顾安排的因果影响得以隔离。 近几十年来的高移民率可能会改变本土老年人的老龄化经历，但移民对本土老年人的影响却很少受到关注。随着国家对移民准入政策的争论以及婴儿潮一代达到退休年龄，移民在向老年人提供医疗和其他服务方面的作用具有直接而紧迫的政策相关性。