In 2019, immigrants made up 13.7% of the U.S. population, totaling 44 million people—that number having more than tripled since the 1970s. The immigrant population’s median age in 2019 was 45.7 years, making it older than the U.S.-born population, which had a median age of 36.5 years. Older immigrant populations have been rising in the United States. The number of immigrants ages 60 and older is expected to increase sixfold from about 3 million in 1990 to 20 million by 2050. By the year 2060, foreign-born immigrants will represent almost a quarter of the U.S. older population.
Asian Americans are one of the fastest growing minority groups in the United States, and account for 31% of the U.S. older immigrant populations, and will by 2055 surpass Hispanics to be the largest immigrant group. While many young and adult immigrants came to the United States, mainly for educational and job opportunities, the reasons for immigration for older immigrants are very different. Many came here for family unification and to help raise grandchildren, and a small percentage may come into the country as refugees. Voluntary versus involuntary immigration has a significant impact on older adults’ health and well-being in the United States.
Older Immigrants in the United States
Many older immigrants came to the United States to join their adult children and relatives, often to provide household support for those adult children and to care for their grandchildren. Therefore, intergenerational support is common among many immigrant families, particularly among newly immigrated families. Using data from the Population Study of Chinese Elderly (PINE), a population-based epidemiological study of 3,157 Chinese older adults ages 60 and older in Chicago, our recently published study found that 74% of the participants came to the United States for family reasons. More than a third of them lived in a multigenerational household.
‘Living in ethnic enclaves can have protective effects on older immigrants’ physical and mental health status.’
The majority of these immigrants, 60%, lived in the Chinatown area. As shown in the literature, due to limited social connections and resources, many older immigrants and their families may choose to live in ethnic enclaves. These communities are essential sources of coping for immigrants as they provide economic, social and cultural resources for adaptation. Studies also have documented that living in ethnic enclaves can have protective effects on older immigrants’ physical and mental health status.
Family plays a critical role in immigrants’ lives. Among older immigrants, language and cultural barriers in receiving communities increase their reliance upon family—adult children in particular. For those who live outside of ethnic enclaves, the role of adult children becomes even more important.
Older Refugees in the United States
Since 1980, after the creation of the federal Refugee Resettlement Program, about 3 million refugees have been resettled in the United States. Not many statistics break down specifics on which countries older refugees are coming from, but we do know that older refugees represent a special group of the immigrant population. For instance, they are likely to have a high prevalence of mental health problems.
Twenty years ago, our team conducted a study among 300 Russian older immigrants in Boston. Almost all of these study participants were refugees. They came to the United States. after the breakdown of the former Soviet Union, and their average age was 73. These were new immigrants, with an average length of stay in the United States of seven years. These participants were highly educated, with 85% having at least a college degree. However, their average household income was low, with only 6% reporting a household income of $10,000 or above; thus, 96% of them had Medicaid coverage. An overwhelming majority of them (92%) reported having at least one English limitation. Close to half of the participants reported having emotional problems.
Mental health problems can be a particular concern among older immigrant refugees.
Our study findings suggest that in addition to facing many challenges such as language barriers, limited financial resources, unfamiliarity of the healthcare system and cultural adaptation, mental health problems can be a particular concern. These issues may be partially explained by lack of social support, and traumatic and stressful events they encountered before or during the immigration process.
Strategies to Improve Older Immigrants’ Health and Well-being
It is critical to work with community organizations to improve older immigrants’ health and well-being. Social services could help older immigrants to better integrate into the receiving society via promoting cultural participation and facilitating intergenerational support. Programs are needed to help adult children provide more support for older immigrants, including transportation and translation services.
More culturally appropriate and meaningful programs (including English learning programs) are needed to facilitate older immigrants’ social engagement. Particular attention should be given to older immigrants with low levels of education and acculturation. Considering the heterogeneity in preferred languages and other related factors, it is important to understand each group’s immigration history, immigration status and language needs of each language subgroup in order to provide tailored services and reduce these immigrants’ vulnerability.
Bei Wu, PhD, is the Dean's Professor in Global Health and vice dean for Research at the Rory Meyers College of Nursing, as well as co-director at the NYU Aging Incubator at New York University in New York.