From Vital and Health Statistics of the National Center for Health Statistics Number 157 � June 13, 1988 

Health of the Foreign-Born Population: United States, 

1985-86 

by Gerry E. Hendershot, Ph.D., Division of Health Interview Statistics 

Introduction 

Foreign-born persons constitute a large and growing 

proportion of the U.S. population. Their origins are diverse, 

but they share the common experience of having migrated 

to the United States fkom another nation. That common 

experience and the ethnic diversity it encompasses may 

have implications for the health status and medical care 

utilization of the foreign-born population. 

In 1985, the National Center for Health Statistics, by 

means of the National Health Interview Survey (NHIS), 

began collecting information on the birthplace of adult 

persons 1S years of age and over in its sample households, 

making it possible for the first time to estimate a wide range 

of national health statistics for the foreign-born population. 

Two years of data (1985 and 1986) were combined to make 

reliable estimates because the 1985 NHIS sample was only 

three-fourths as large as originally planned, and the 1986 

sample was only one-half as large (for budgetary reasons). 

The purpose of this report is to present such estimates for 

the following selected indicators of health status and health 

care: respondent-assessed general health; limitation of normal activities due to a chronic health condition; days in bed 

due to health conditions; hospitalization; and physician 

contacts. 

Immigrants from different origins have different characteristics. The statistics in this report are for all foreignborn persons, foreign-born persons of Mexican ethnic 

origin, and foreign-born persons of all Hispanic ethnic 

origins (Mexican and other Hispanic). However, reliable 

estimates could not be made for foreign-born persons of 

other specific ethnic origins because of the relatively small 

sizes of the samples of those persons.

1 For comparison, health statistics also are shown for the 

U.S.-born population according to Hispanic and Mexican 

origin. In the discussion that follows, the focus is on two 

comparisons— that between the total U.S.-born population 

and the total foreign-born population and that between the 

total U.S.-born population and the foreign-born population 

of Mexican origin. Of course, many other comparisons can 

be made with the data that are presented. 

Unless otherwise indicated, differences between the 

U.S.-born and foreign-born populations discussed in this 

report have been tested and found to be statistically significant. It should be noted that many factors affect health 

status and health care. Therefore, any differences betsveen 

the U.S.-born and foreign-born populations in these respects may not be the result of differences in birthplace but 

may be the result of other factors not considered here. A 

brief discussion of statistical reliability and other aspects of 

the NHIS design is presented in the Technical notes to this 

report. 

Characteristics of the foreign-born 

population 

Table 1 shows the number and selected sociodemographic characteristics of the U.S.-born and the foreignborn adult, civilian noninstitutionalized populations. “U.S. 

born” means born in one of the 50 U.S. States and 

“foreign born” means born outside the 50 U.S. States. The 

categories of birthplace do not necessarily correspond to 

categories of citizenship or legal status, for which data were 

not available in the NHIS. Classification of persons as 

“Hispanic” or “Mexican” was based on responses to a 

question that asked if the sample person’s national origin or 

ancestry corresponded to any of those on a printed list of 

Hispanic origin groups. Persons were classified as Hispanic 

if their national origin or ancestry was Puerto Rican, 

Cuban, Mexican/Mexicano, Chicano, other Latin 

American, or other Spanish. They were further classified as 

Mexican if their national origin was Mexican/Mexicano, or 

Chicano. As used in this report, the term origin refers to 

Hispanic or Mexican origin as determined in this manner. 

US. DEPARTMENT OF HEALTH AND HUMAN SERVICES . Public Health Service . Centers for Disease Control 
Table 1. Number of persons 18 years of age and over and 

percent distribution by age, sex, education, and annual family 

income, according to birthplace and Hispanic origin: United 

States, 1985-86 

[Data are based on household Interviews of the civilian noninstttutionalized 

population. The survey design, general qualifkation, and information on the 

reliibilily of the estimates are given In Technksl notes.] 

U.S. born Foreign born 

HisPic Hispanic 

CharacterMh2 Total’ Total 2 Mexkarr Total’ Total 2 Mexkarr 

Number in thousands. . . 156,584 5,706 4,190 14,876 5,228 2,036 

Age Percent distribution 

18-44 years . . . . . . . . . . 56.2 75.1 77.3 59.2 69.1 76.5 

45-64 years. . . . . . . . . . 26.0 19.0 17.6 24.5 21.4 16.1 

65 years and over . . . . . 15.8 5.8 5.0 16.3 9.5 7.4 

Sex 

Male . . . . . . . . . . . . . . 47.3 46.6 46.9 47.5 49.3 54.3 

Female . . . . . . . . . . . . 52.7 53.4 53.1 52.5 50.7 45.7 

Education 

Less than 12 years. . . . . 23.3 32.5 38.2 35,5 52.9 73.3 

12yeafs . . . . . . . . ...< 40.0 38.6 37.4 28.2 24.2 15.8 

More than 12 years. . . . . 36.6 29,0 26.4 36.3 22.9 10.9 

Annual family income 

Less than $20,000 . . . . . 40.0 46.0 48.2 47.0 58.0 67.0 

$20,000 or more . . . . . . 60.0 54.0 51.8 53.0 42.0 33.0 

llncludes persons of unknownHispanicorigin. 

‘Includes persons of unkncwn Mexican orlgln. 

31ncludes psrsons wilh unknown sducation arxl fsrnlly Inmme. 

It should be noted that the classification of birthplace and 

origin is based on information given by household 

respondents. 

Adjusting by the immigration that occurred in the early 

1980’s, the 1985-86 NHIS estimate for the total foreignborn adult population— about 14.9 million—is consistent 

with the number enumerated in the 1980 Census of Population–14.l million (US. Bureau of the Census, 1980). 

For the foreign-born population of Mexican origin, however, the NHIS estimate—about 2.0 million (with a sampling 

error of about 0.1 million)—is slightly lower than the 

number enumerated in the 1980 census—2.2 million. Because the actual foreign-born population of Mexican origin 

is believed to have increased in the early 1980’s, this 

suggests that the NHIS sample underestimates that population. There is no known reason to believe, however, that 

the possible underestimate creates a bias in the health 

statistics for the foreign-born population of Mexican origin 

presented in this report. 

Table 1 also shows that, as a whole, the foreign-born 

population is similar to the U.S.-born population with 

respect to age and sex distributions but differs with respect 

to education and incomcx Compared with the U.S.-born 

population, foreign-born persons are more likely to have 

less than 12 years of education and more likely to have a 

family income below $20,000 per year. 

Comparing the U.S.-born population with the foreignborn population of Mexican origin, the only immigrant 

group identified by a specific origin in this report, foreignborn persons of Mexican origin are younger, more likely to 

be male, much more likely to have less than a high school 

education, and more likely to have a family income under 

$20,000. Because the foreign-born adult population, especially that of Mexican origin, differs from the U.S.-born 

adult population with respect to these sociodemographic 

characteristics, the health statistics in tables 2-6 are stratified by these variables. 

Respondent assessed health status 

Table 2 shows the percent of persons 18 years of age 

and over who were reported to have been in fair or poor 

health, based on answers to the question: “Would you say 

(the sample person’s) health is excellent, very good, good, 

fair, or poor?” Overall, the foreign-born and the U.S.-born 

populations were equally likely to have been in fair or poor 

health–12.9 percent. However, foreign-born persons with 

less than 12 years of education and those with a family 

income below $20,000 were less likely than U.S.-born 

persons of similar education and income to have been in 

fair or poor health. 

Comparing the foreign-born population of Mexican 

origin with the U.S.-born population, the same statements 

can be made, but the differences are larger; that is, foreignborn persons of Mexican origin who were less 

well-educated or who had lower incomes were much less 

likely than U.S.-born persons with those characteristics to 

have been in fair or poor health. 

Table 2. Percent of persons 18 years of age and over who were 

in fair or poor health, by age, sex, education, and annual family 

income, according to birthplace and Hispanic origin: United 

States, 1985-86 

[Dsfa are based on household Interviews of the ch41iennoninstltutionalized 

population. The survey design, general qualWdioff, and information on the 

rel!ablllty of the estimates are given in Technkal notes.] 

U.S. born FoWgn born 

His/.wfIo HisPzuW 

Cherecteristk? Total’ Tofel 2 Mexkwr Total’ Total 2 Mexican 

Age 

18 years and over . . . . . 12.9 13.0 13.3 12.9 14.3 13.0 

W-44yeefs.. . . . . . . . . 5.7 8.6 7.3 

45-64 years . . . . . . . . . . 18.4 22.7 2H 1% 25.6 2:: 

65 yeare end over . . . . . 30.3 37.7 34.6 33.0 39.4 43.9 

sex 

Male . . . . . . . . . . . . . . 11.9 11.1 11.4 11.0 11.4 11.5 

Female . . . . . . . . . . . . 13.8 14.6 15.1 14.6 17.1 14.8 

Educafiin 

Lesthsn 12yeafs . . . . . 29.0 24.7 24.2 21.4 18.4 13.7 

12yeafe . . . . . . . . . . . . 10.4 9.5 8.6 10.2 11.7 13.5 

More than 12 years. . . . . 5.2 4.1 4.7 6.2 7.1 6.1 

Annual family income 

Less than $20,000 . . . . . 22.1 21.1 21.4 17.9 17.6 12.8 

$20,000 Or IrIOre . . . . . . 6.7 5.7 5.2 8.5 9,5 11.9 

‘Irwludes persons of unkrwm Hispanic origin. 

‘Irwludes perems of unkrmm Mexirxm origin. 

Limitation in activity 

Table 3 shows the percent of persons who were reported to have been limited in normal activities because of 

a chronic health condition. In every catego~ of every 
advancedata 3 

Table 3. Percent of persons 18 years of age and over who were 

limited in activity by age, sex, education, and annual family 

income, according to birthplace and Hispanic origin: United 

Statea, 1985-86 

[Data are based on househoidinterviews of the civilian noninstiiutionalized 

population. The survey design, general qualification, and information on the 

rclinbility of the estimates are given in Technical notes.] 

U.S. born Foreign born 

Hispanic Htiparrk 

CharacterWo Total 7 Total 2 Mexhxm Total’ Total 2 Mexican 

Age 

18 yeare and over . . . . . 17.6 13.2 12.1 13.2 12.5 6.9 

18-44 yeWs. . . . . . . . . . 6.9 e.3 e.o 5.4 5.7 3.9 

45-64 years. . . . . . . . . . 23.8 23.7 2i.e 17.2 21.9 le.3 

65 years and over . . . . . 39.6 42.0 42.0 11.7 41.5 40.4 

Sex 

fvfalo. . .. i . . . . . . . . . 16.9 12.7 11.6 11.9 10.5 7.4 

Female . . . . . . . . . . . . 18.2 13.7 12,3 14.4 14.5 10.7 

Education 

Less than 12 years. . . . . 31.5 22.3 20.2 20.0 15.5 9.8 

12yews . . . . . . . . . . . . 14.7 9.9 8.0 10.7 9.5 7.3 

More Ihan 12 years. . . . . 11.7 7.3 6.9 7.9 e.6 6.3 

Annuai family income 

Less than $20,000 . . . . . 26.7 19.8 18.4 17.1 14.5 9.4 

$20,000 or more . . . . . . 11.7 7.7 6.4 9.5 9.8 7.7 

%cludes pm.ons of unkncwn Hispanic origin. 

‘Includes persons of unknwn Mexican origin. 

variable considered in table 3, the foreign-born population 

was lws likely than the comparable U.S.-born population to 

IMvc had a limitation of activity. 

The same pattern of differences is found when comparing the foreign-born population of Mexican origin and the 

U.S.-born population In most categories, foreign-born persons of Mexican origin were less likely than U.S.-born 

persons to have had a limitation of activity. (The exceptions 

are persons 45 years of age and over and those with more 

than 12 years of education, among whom the U.S.-born 

population and the foreign-born population of Mexican 

origin did not differ significantly.) 

Bed days 

Table 4 shows the percent of persons who had 4 days or 

more during the year before interview when they stayed in 

bed for more than one-half of the day because of a health 

condition. Four bed days per year is more than the average 

for the U.S. population. With the exception of persons 45 

years of age and over, foreign-born persons in every category shown were significantly less likely than U.S.-born 

persons to have had 4 bed days or more. 

Comparing the foreign-born population of Mexican 

origin with the U.S.-born population, the same pattern of 

differences was found. The differences, where they existed, 

were even larger: Foreign-born persons of Mexican origin 

were much less likely than U.S.-born persons with similar 

socioeconomic characteristics to have had 4 bed days or 

more in the year before interview (although the difference 

is not statistically significant for those with 12 years of 

education). 

Table 4. Percent of persons 18 years of age and over who had 

4 bed days or more in the iast year, by age, sex, education, and 

annuai family income, according to birthplace and Hispanic 

origin: United States, 1985-86 

[Data are based on household interviews of the chrllian noninstiiutionalized 

population. The survey design, general qualification, and information on the 

reliability of the estimates are given in Technicai notes.] 

U.S. born Foreign born 

Hi.spank Hispanic 

Characterktlc Total’ Total 2 Mexican Total 1 Total 2 Mexican 

Age 

18 years and over . . . . . 22.8 22.6 21.9 

16-44 years . . . . . . . . . . 22.4 21.8 21.5 

45-64 years . . . . . . . . . . 21.7 23.4 21.4 

65 years and over . . . . . 26.3 30.9 29.9 

Sex 

Male . . . . . . . . . . . . . . 18.5 18.0 17.1 

Female . . . . . . . . . . . . 26.8 26.6 26.2 

Education 

Less than 12 years. . . . . 27.1 25.3 24.3 

12yesrs . . . . . . . . . . . . 21.3 19.9 19.6 

More than 12 years. . . . . 21.9 23.2 22.1 

Annual family Income 

Less than $20,0043 . . . . . 26.9 24.7 24.3 

$20,000 or more . . . . . . 20.5 20.3 19.3 

‘Includes persons of unknwn Hispanic origin. 

‘Irwludes psrsuns of unknown Mexicen origin. 

Hospital stays 

18.8 17.6 13.6 

15.6 14.0 10.6 

20.7 23.1 20.5 

27.6 31.6 30.2 

15.3 12.3 10.4 

22.0 22.8 17.4 

20.9 17.e 13.8 

18.9 19.6 16.1 

16.6 14.9 

20.5 17.9 13.1 

17.7 17.4 15.2 

Table 5 shows the percent of persons who were hospitalized overnight on one occasion or more during the 12 

months before interview. In every category shown, the 

foreign-born population was less likely than the comparable 

Tabie 5. Percent of persons 18 years of age and over who had 

1 or more hospitai staya in the iast year, by age, sex, education, 

and annuai famiiy income, according to birthplace and Hispanic 

origin: United Statea, 1985-86 

[Data are based on household intefvfews of the civilian nonlnstlutionallzed 

population. The survey design, general qualification, and information on the 

reliability of the estimates are given in Technical notes.] 

U.S. born Foreign born 

Hispanic H!.spenic 

Charecterktic Total’ Total 2 Mexican Total’ Total 2 Mexican 

Age 

16 years and over . . . . . 10.6 9.7 9.7 9.5 ~0.O 6.9 

18-44 years . . . . . . . . . . 9.0 9.5 9.8 8.1 9.5 8.8 

45-64 yeare . . . . . . . . . . 10.5 e.2 7.5 7.e 7.7 6.3 

65 years and over . . . . . 18.1 17.7 17.5 17.0 18.4 15.6 

sex 

Male . . . . . . . . . . . . . . 8.6 5.5 4.6 7.0 5.6 4.2 

Femste . . . . . . . . . . . . 12.8 13.4 14.1 11.8 14.2 14.5 

Education 

Lass than 12 years. . . . . 15.0 11.7 11.6 11.6 10.1 9.2 

12years . . . . . . . . . . . . 10.2 9.2 8.7 10.0 10.9 9.8 

More than 12 years. . . . 8.8 8.2 8.7 7.1 8.5 6.2 

Annual family Income 

Less than $20,000 . . . . 13.5 11.7 11.5 10.4 10.3 8.8 

$20,000 or more . . . . . . 9.1 7.7 7.7 8.6 9.3 9.0 

‘Includes persons of unkncwn Hispanic origin. 

21ndudes persons of unkn-wn Mexican origin. 

9.8 
4 advancedata 

U.S.-born population to have been hospitalized. However, 

most of the differences were small, and for some categories, 

they were not statistically significant—persons 65 years of 

age and over, females, persons with 12 years of education, 

and those with family incomes of $20,000 or more. 

The same pattern of differences is found when the 

comparisons are made between the U.S.-born population 

and the foreign-born population of Mexican origin, although the differences, because smaller, are statistically 

significant only for some catergories—males, persons with 

less than 12 years of education, and those with family 

incomes under $20,000. 

Physician contacts 

Table 6 shows the percent of persons with six physician 

contacts or more (visit or telephone call with a doctor or 

health care provider working under a doctor’s supervision) 

during the year before interview. Six visits is above the 

average for the U.S. population. Although the differences 

were not large, foreign-born persons were significantly less 

likely than U.S.-born persons in most sociodemographic 

categories shown to have had six physician contacts or 

more. (Differences were not significant for persons 45 years 

of age and over.) 

Comparing foreign-born persons of Mexican origin 

with the U.S.-born population, the same general pattern of 

differences is found, but the differences are larger. Foreignborn persons of Mexican origin were less likely than comparable U.S.-born persons to have had six physician contacts or more, although differences in several additional 

categories were not statistically significant —45-64 years of 

Table 6. Percent of persons 16 years of age and over who had 

6 or more physician contacts in the last year, by age, sex, 

education, and annual family income, according to birthplace 

and Hispanic origin: United States, 1985-86 

[Data are based on household interviews of the civilian nonlnslilullonallzed 

populafiin. The survey design, general qualification, and information on the 

rellabiltty of the estimates are given In Teohnical notes.] 

U.S. born Foreign born 

Hispanic Hispanic 

Characterktb Total’ Total 2 Mexican Tofal’ Total 2 Mex[can 

Age 

18yesrs andover . . . . . 18.5 16.7 18.1 16.2 16.0 12.4 

18-44 years. . . . . . . . . . 15.2 14.7 14.2 12.2 12.1 9.0 

45-64 years. . . . . . . . . . 19.4 20.3 19.3 17.2 20.2 16.0 

65 years and over . . . . . 29.1 30.1 33.0 29.2 35.3 40.2 

Sex 

Male . . . . . . . . . . . . . . 13.3 10.4 9.7 10.6 9.4


Female . . . . . . . . . . . . 23.1 22.1 21.6 21.2 22.5 1::


Educalion 

Less than 12 years . . . . . 23.2 19.4 19.1 19.8 18.1 13.1 

12years . . . . . . . . . . . . 17.3 15.3 14.5 14.8 14.4 *9.7 

More than 12 years. . . . . 16.8 15.6 14.3 13.4 12.5 *I 1.5 

Annual famiiy Income 

Lessthan $20,000 . . . . . 21.9 19.2 18.6 18.6 17.9 12.2 

$20,0000rmore . . . . . . 16.5 14.5 13.6 14.2 13.3 12.0 

‘Includes persons of unkncwn Hispanic origin. 

‘Includes persons of unknwn Mexican origin. 

age, females, persons with more than 12 years of education, 

and those with more than $20,000 annual family income, 

There was one reversal of that pattern Among persons 65 

years of age and over, foreign-born persons of Mexican 

origin were more likely than U.S.-born persons to have had 

six physician contacts or more. 
---

advancedata 5 

References 

National Center for Health Statistics, M.G. Kovar, and G.S. Poe. 

1985. The National Health Interview Survey Design, 1973-84, and 

Procedures, 1975-83. V7taland Health Statistics. Series 10, No. 18. 

DHHS Pub. No. (PHS) $5-1320. Public Health Service. Washington: U.S. Government Printing Office. 

National Center for Health Statistics, A.J. Moss, and V.L. Parsons. 1986, Current estimates from the National Health Interview 

Survey, United States, 1985. Vital and Health Statistics. Series 10, 

No. 160, DHHS Pub. No. (PHS) 86-1588. Public Health Service. 

Wmhington: U.S. Government Printing Office. 

National Center for Health Statistics, D.A. Dawson, and P.F. 

Adams. 1987. Current estimates from the National Health Interview Survey, United States, 1986. Vital and Health Statistics. Series 

10, No. 164. DHHS Pub. No. (PHS) S7-1592. Public Health 

Semite. Washington: U.S. Government Printing Office. 

U.S. Bureau of the Census. 1980. U.S. Census of Population, 

Vol. 1, chapter D (PC80)-1-01. 

Symbols 

Data not available 

. . . Categoty not applicable 

Quantity zero 

0.0 Quantity more than zero but less than 

0.05 

z	 Quantity more than zero but less than 

500 where numbers are rounded to 

thousands 

* Figure does not meet standard of 

reliability or precision 

#	 Figure suppressed to comply with 

confidentiality requirements 
6 advancedata 

Technical notes 

The estimates shown in this report are based on data 

obtained in household interviews during a continuing nationwide survey. Each week a probability sample of households is interviewed by personnel of the U.S. Bureau of the 

Census to obtain information about the health and other 

characteristics of the civilian noninstitutionalized population of the United States. 

During 1985 and 1986, interviews were conducted in 

58,682 households containing 153,583 family members and 

unrelated individuals. The total noninterview rate was 

about 3.8 percent. The weights of interviewed persons in 

the segments containing sample households for which data 

were not obtained were inflated to compensate for household nonresponse. 

All persons 17 years of age and over were asked to 

participate in the interview. When this was not possible, 

proxy responses were accepted from family members meeting the NHIS respondent rules. About two-thirds of all 

adult family members responded for themselves. 

Because the estimates shown in this report are based 

on a sample, they are subject to sampling error. A measure 

of the sampling error is given by the standard error. 

Approximate standard errors for estimated percents in this 

report are given by the formula 

sE=­

where SE is the standard error, p is the estimated percent, 

and y is the estimated base of the percent. The bases of the 

percents in table 1 are shown in its first line, and the bases 

of percents shown in tables 2-6 can be calculated from the 

data in table 1. 

The approximate standard error of a difference between percents is given by the formula 

SE (xl –xz) = ~SE (X1)2 + SE (X2)2 

where xl and X2 are the two percents being compared, 

xl –X2 is the difference between them, and SE(XI) and 

SE(X2) are the standard errors of the two percents. In this 

report, a difference was considered statistically significant 

at the 5- percent level if the difference (xl -xJ was at least 

twice as large as its standard error. 

More detailed discussions of the sample design, estimating procedures, procedures for estimating standard errors, nonsampling errors, and definitions of terms used in 

this report have been published in Vital and Health Statistics, Series 10, Nos. 160 and 164, and in Series 1, No, 18 

(NCHS, 1985,1986, 1987). 

NOTE A list of referencesfollowsthe text. 
8 advancedata 

Recent Issues of Advance Data From Vital and Health Statistics 

No. 156. Utilization of Short-Stay Hospitals by Patients 

With AIDS: United States, 1984-1986. (Issued May 24, 

19ss) 

No. 155. Prevalence of Selected Chronic Conditions, United 

States, 19 S3-$5. (Issued May 24, 1988) 

No. 154. Relationship Between Smoking and Other Unhealthy Habits: United States, 1985. (Issued May 27, 19S8) 

Suggested citation 

National Center for Health Statistics, G. E. 

Hendershot, 1988, Health of the foreign-born 

population: United States, 1985-86. Advance Dai% 

From VW and Hea/th Statistics. No. 157.DHHS 

Pub. No. (PHS) 88-1250. Public Heaith Service. 

Hyattsvilie, Md. 

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HUMAN SERVICES 

Public Health Service 

Centers for Disease Control 

Natlonai Center for Health Statistics 

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Hyattsviile, Maryland 20782


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