Association for Public Policy Analysis & Management

Studies have found that immigrants have fared better than the U.S. born on a number of health outcomes, including chronic health conditions and obesity, as well as their self-rated health (Antecol and Bedard, 2006; Cunningham et al., 2008; Singh and Miller, 2004; Singh and Siahpush, 2002). The immigrant population has similarly outperformed native-born Americans in infant health, showing lower rates of preterm, low birth weight, and infant mortality (Hummer, Powers, Pullum, Ginger, & Frisbie, 2007; Wingate & Alexander, 2006). These connections are often attributed to positive health selection of immigrants, which points out that healthier individuals are more likely to move to a new country (Jasso et al., 2004; Ro and Bostean, 2015). Research on immigrant health has specifically focused on the Hispanic/Latino population and has found evidence of the “healthy immigrant effect” for Hispanic/Latino immigrants to the U.S. by comparing the health status of immigrants to the U.S.-born natives and their counterparts in the originating countries (Abraído-Lanza et al., 2005; Markides & Eschbach, 2005). However, little work has been done to test the “healthy immigrant effect” for Asian immigrants, including Koreans. A lack of data comparing migrants and non-migrants has precluded researchers from being able to test this hypothesis.

The primary contribution of this study is to explore if the health selection holds true for the Asian immigrant population. I do so by comparing health status of Korean immigrants in the U.S. to both that of Koreans in Korea and that of Korean Americans who were born in the U.S by pooling and harmonizing the Korean Health Panel and the restricted National Health Interview Survey data files. For a better comparison, I generate a propensity score to emigrate among Koreans in Korea based on the demographic characteristics of those who migrate to the U.S. and divide Korean residents in to five categories of very low, low, average, high, and very high propensity groups. Then, I compare the very low, very high propensity groups with the first-generation Korean immigrants to the U.S. to see if there is evidence of health selection.

This study finds that the first-generation Korean immigrants show the highest rate of self-rated health followed by Koreans with very high propensity to emigrate and with very low propensity. On health status, Koreans residing in Korea with very high propensity to migrate experience the most favorite outcomes on all chronic diseases of diabetes, coronary heart diseases, cancer, hypertension, and asthma. Logistic regression results show that having very low propensity to migrate is significantly associated with lower self-rated health and higher prevalence of chronic diseases. The findings suggest that health selection is present among Korean immigrants to the U.S. compared to non-migrants in Korea. This is the first work to explore health selection among Korean immigrants by linking two nationally representative data from Korea and the U.S.