Self-Rated Health of US Older Adults in the General Social Survey (GSS) 1972–2021: Complexity of the Associations of Education and Immigration

Background: Multiple studies have shown a link between high education and better self-rated health (SRH). However, recent studies have suggested that immigrants may experience a weaker association between education and SRH than native-born individuals. Aim: Using a national sample of US older adults, this investigation studied whether there is an inverse association between education and SRH and whether immigration status moderates this association. Methods: This study is based on marginalized diminished returns (MDRs) that argues socioeconomic status (SES) resources, such as education, may generate less favorable health outcomes for marginalized groups. Data were from the General Social Survey (GSS) 1972–2021, a cross-sectional survey in the US. A total of 7999 participants who were 65+ years old were included. The independent variable was education, measured as years of schooling and treated as a continuous variable. The dependent variable was poor/fair (poor) SRH. Immigration status was the moderator. Age, sex, and race were control variables. Logistic regressions were used for data analysis. Results: We found that higher levels of education were protective against poor SRH. However, this effect was weaker for immigrants than for US-born individuals. Conclusions: This study found that native-born US older individuals are more likely to experience the protective effect of their education against poor SRH compared to their immigrants. Eliminating health inequality between immigrant and US-born individuals needs policies that go beyond socioeconomic status (SES) equality and address barriers that hinder highly-educated immigrants.