Immigrant Legal Status and Health: Legal Status Disparities in Chronic Conditions and Musculoskeletal Pain Among Mexican-Born Farm Workers in the United States.

Immigrant legal status determines access to the rights and privileges of U.S. society. Legal status may be conceived of as a fundamental cause of health, producing a health disparity whereby unauthorized immigrants are disadvantaged relative to authorized immigrants, a perspective that is supported by research on legal status disparities in self-rated health and mental health. We conducted a systematic review of the literature on legal status disparities in physical health and examined whether a legal status disparity exists in chronic conditions and musculoskeletal pain among 17,462 Mexican-born immigrants employed as farm workers in the United States and surveyed in the National Agricultural Workers Survey between 2000 and 2015. We found that unauthorized, Mexican-born farm workers have a lower incidence of chronic conditions and lower prevalence of pain compared with authorized farm workers. Furthermore, we found a legal status gradient in health whereby naturalized U.S. citizens report the worst health, followed by legal permanent residents and unauthorized immigrants. Although inconsistent with fundamental cause theory, our results were robust to alternative specifications and consistent with a small body of existing research on legal status disparities in physical health. Although it is well known that Mexican immigrants have better-than-expected health outcomes given their social disadvantage, we suggest that an epidemiologic paradox may also apply to within-immigrant disparities by legal status. We offer several explanations for the counterintuitive result.

Two Sources of Error in Data on Migration From Mexico to the United States in Mexican Household-Based Surveys.

We examine the nature and degree of two sources of error in data on migration from Mexico to the United States in Mexican household-based surveys: (1) sampling error that results when whole households migrate and no one is left behind to report their migration; and (2) reporting errors that result when migrants are not identified by survey respondents. Using data from the first two waves of the Mexican Family Life Survey, which tracked Mexican migrants to the United States from 2002 to 2005, we find that one-half of migrants from Mexico to the United States are not counted as a result of these two sources of error. Misreporting is the larger source of error, accounting for more than one-third of all migrants. Those who are not counted, especially whole-household migrants, are a unique group. Their omission results in an underestimate of female migrants, child migrants, and migrants from the Mexican border region, and an overestimate of migrants from the periphery region.