Abstract
The population of immigrants who resettle in older and middle age, also known as late-life immigrants (LLI), is expected to grow threefold by 2050. The stressors of aging and resettlement predispose LLI to negative health outcomes, including the development of cardiovascular disease (CVD). Despite the passage of the Patient Protection and Affordable Care Act (PPACA), affordable health insurance remains out of reach for most newly arrived LLI. Simultaneously, increasing numbers of uninsured LLI are presenting to emergency departments with life-threatening complications of CVD, including myocardial infarction. Little is known about the financial and clinical benefits of expanding access to health insurance for LLI. This study, a secondary analysis of data from the National Health and Nutrition Examination Survey (NHANES), (1) examined the association between health insurance coverage and CVD risk (using two separate dependent measures: Framingham Risk Score and the presence of Metabolic Syndrome) among older immigrants and (2) explored the role of health insurance in CVD relative to other socially determined access barriers within immigrants’ social ecology using hierarchical block regression. Early results found foreign born middle-aged and older adults to be a heterogeneous group who are less likely to be insured than the native born. Moreover, uninsured older immigrants have worse CVD risk profiles than their insured counterparts. Health insurance is a critical barrier to health access within immigrants’ complex social ecology. A cost-benefit analysis is needed to determine the most effective method of expanding insurance coverage to recently arrived LLI.