Racial/Ethnic Differences in Cognitive Difficulty in the U.S.: Does Nativity Matter?

Emma K.T. Benn, Mount Sinai School of Medicine
Ashley Fox, Mount Sinai School of Medicine
Kezhen Fei, Mount Sinai School of Medicine
Eric Roberts, Mount Sinai School of Medicine
Bernadette Boden-Albala, Mount Sinai School of Medicine

Despite longstanding interest in the immigrant health paradox among Latinos, less research has examined nativity-related heterogeneity in health outcomes among other racial/ethnic minorities in the US. We used 2009 ACS PUMS data to explore racial/ethnic differences in cognitive difficulty and possible effect modification by nativity in a nationally representative, multiethnic sample of adults, after accounting for important covariates. We observed higher odds of cognitive difficulty among NHBs (OR=1.08, 95% CI=1.05-1.10) and non-Hispanic Native Americans/Pacific Islanders (NHNAPIs; OR=1.62, 95% CI=1.53-1.72), while a protective effect was observed among Hispanics and non-Hispanic Asians (NHAs) compared to NHWs. Foreign born adults had lower odds of cognitive difficulty than US born adults, regardless of race/ethnicity. Among foreign born adults, Hispanics, NHAs, NHNAPIs, and NHWs had similar odds of cognitive difficulty, whereas a protective effect was observed for NHBs (OR=0.78, 0.70-0.87) compared to NHWs; thus revealing a complex race/ethnicity-nativity relationship with cognitive difficulty, especially among NHBs.