Health across the “Skills Spectrum”: Occupational Skill, U.S. Citizenship Status, and the Immigrant Health Advantage

Occupational attainment is central to the immigrant experience, yet little research has explored the role of occupational skill in shaping the immigrant health advantage (IHA). Furthermore, whether citizenship status - an increasingly critical structural determinant of immigrant health - moderates the effects of occupational attainment on health remains underexplored. Drawing on linked 2000–2018 National Health Interview Survey and O*NET job skills data, findings reveal that noncitizen immigrants employed in low- and mid-skill occupations demonstrate the largest self-rated and mental health advantages, whereas their same-skill U.S. citizen immigrant peers exhibit outcomes more similar to those of the U.S. born. Furthermore, noncitizen immigrants persistently report less healthcare access and lower likelihoods of having health insurance than the U.S. born, even at the highest occupational skill levels. Together, analyses suggest important heterogeneity in immigrant well-being by skill and citizenship status, adding important nuance to the existing IHA literature.