Search results

Social and economic disparities between racial/ethnic groups are a feature of the American context into which immigrants are incorporated and a key determinant of population health. We ask whether racial/ethnic disparities in diabetes vary by nativity and whether native-immigrant disparities in diabetes vary by race and over time in the United States. Using the 2000–2015 National Health Interview Survey, we estimate logistic regressions to examine the interaction of race/ethnicity, nativity, and duration in the US in shaping diabetes patterns. Relative to their native-born co-ethnics, foreign-born Asian adults experience a significant diabetes disadvantage, while foreign-born Hispanic, Black, and White adults experience a significant advantage. Adjusting for obesity, education, and other covariates eliminates the foreign-born advantage for Black and White adults, but it persists for Hispanic adults. The same adjustment accentuates the disadvantage for foreign-born Asian adults. For Black and Hispanic adults, the protective foreign-born effect erodes as duration in the US increases. For foreign-born Asian adults, the immigrant disadvantage appears to grow with duration in the US. Relative to native-born White adults, all non-white groups regardless of nativity see a diabetes disadvantage because the racial/ethnic disadvantage either countervails a foreign-born advantage or amplifies a foreign-born disadvantage. Racial/ethnic differentials in diabetes are considerable and are influenced by each group’s nativity composition. Obesity and (for the foreign-born) time in the US influence these disparities, but do not explain them. These findings underscore the importance of unmeasured, systemic determinants of health in America’s race-conscious society.