Migration and Cognitive Health Disparities: The Arab American and Refugee Case
J Gerontol B Psychol Sci Soc Sci. 2022 Sep 3:gbac129. doi: 10.1093/geronb/gbac129. Online ahead of print.
OBJECTIVES: This study investigates whether year of arrival to the U.S. and birthplace relate to post-migration cognitive difficulties among foreign- and U.S.-born Arab Americans in later life.
METHODS: We analyzed 19 years (2000-2019) of data from the American Community Survey (ACS) Public Use Microdata Samples (weighted N = 393,501; ages ≥ 50 years). Cognitive difficulty was based on self-reported data, and weighted means, percentages, adjusted prevalence estimates, and adjusted odds ratio were calculated.
RESULTS: Controlling only for demographics, foreign-born Arabs reported higher odds of cognitive difficulty compared to U.S.-born Arabs across all arrival cohorts (p<.001). After accounting for economic and integration factors, those who arrived between 1991-2000 had higher odds (OR = 1.06, 95% CI =1.00, 1.19, p<.01), while those who arrived after 2001 had lower odds (OR = 0.87, 95% CI = 0.78, 0.97, p <.001) of cognitive difficulty. Lacking English proficiency (OR = 1.90, 95% CI = 1.82, 1.98, p <.001) was related to higher odds, whereas not being a U.S. citizen was significantly associated with lower odds (OR = 0.89, 95% CI = 0.52, 0.94, p <.001) of cognitive difficulty. Yet, results varied by birthplace. Migrants born in Iraq consistently reported the highest odds of cognitive difficulty across all arrival cohorts.
CONCLUSIONS: Migration history and birthplace may be important factors explaining cognitive disparities among the diverse group of Arab migrants and Arab Americans. Future research examining mechanisms underlying these associations and the impact of migration on cognitive health is needed to address cognitive disparities in migrants.