Why Do Immigrants Without U.S. Citizenship Often Have Better Health Than Natives in Low-Skilled Jobs?

Immigrants in the United States often exhibit better overall and mental health than native-born Americans, especially when they hold low-skilled jobs. This trend, known as the “immigrant health advantage,” is particularly pronounced among those who do not possess U.S. citizenship. Research shows that non-citizen immigrant workers in low- or medium-skilled jobs report better physical health and less psychological distress than their native-born American counterparts. However, this advantage diminishes for immigrants in highly skilled positions.

Access to healthcare remains a major challenge for immigrants, regardless of their status or skill level. Even in highly skilled jobs, non-citizens are less likely to have health insurance or a regular place for medical consultation than native-born Americans. Citizenship plays a key role: it provides access to public assistance programs like Medicaid, reduces stress related to legal precarity, and fosters a sense of social belonging.

The reasons for this health advantage among low-skilled workers may be explained by positive selection: immigrants in these jobs are often healthier than natives holding the same positions. Additionally, their professional expectations, often more modest than those of Americans, may reduce stress and improve their mental well-being. Conversely, highly skilled immigrants, despite being financially better off, face pressures related to their uncertain legal status, which can harm their health.

These findings highlight the importance of considering both occupational skill level and citizenship status to understand health inequalities among immigrants. They also reveal that the immigrant health advantage is not uniform and depends heavily on their professional and administrative situation.

References and Sources

About This Study

DOI: https://doi.org/10.1007/s10903-026-01901-3

Title: Health across the “Skills Spectrum”: Occupational Skill, U.S. Citizenship Status, and the Immigrant Health Advantage

Journal: Journal of Immigrant and Minority Health

Publisher: Springer Science and Business Media LLC

Authors: Rebecca Anna Schut; Nicole Samala