Income and Mental Well-Being of Middle-Aged and Older Americans: Immigrants’ Diminished Returns

Introduction: although income is among the major social determinants of mental health of middle-aged and older individuals, socially marginalized groups gain less health from their income and other socioeconomic status (ses) resources compared to socially privileged groups. this pattern is called marginalization-related diminished returns (mdrs). most of the existing knowledge on mdrs, however, has been derived from studies that have defined marginalization based on race, ethnicity, or sexual orientation. as a result, very limited information exists on whether similar mdrs can be observed for middle-aged and older immigrants or not. building on the mdrs framework, this study compared a national sample of immigrants and non-immigrants for the effects of income on the mental well-being of middle-aged and older adults in the united states.methods: this is a cross-sectional study. the 2015 national health interview survey (nhis) enrolled 14 149 middle-aged and older individuals who were either immigrants (n=1977; 14.0%) or non-immigrants (n=12 166; 86.0%). the independent variable (iv) was income that was treated as a continuous variable. the dependent variable was mental well-being, also treated as a continuous variable. age, gender, race, ethnicity, education, marital status, employment, self-rated health, obesity, and region were confounders. immigration (nativity status) was the moderator. logistic regression was applied for data analysis.results: high income was associated with higher odds of good mental well-being in middle-aged and older adults. however, immigration showed a significant statistical interaction with income, which was suggestive of a smaller protective effect of high income on mental well-being for immigrant than non-immigrant middle-aged and older adults.conclusion: in line with mdrs, the association between income and mental well-being is weaker for immigrant than non-immigrant middle-aged and older adults. there is a need to help high income immigrants secure health outcomes similar to those of non-immigrants. such changes may require bold and innovative economic, public, and social policies that help immigrants more effectively translate their income and socioeconomic resources into tangible outcomes such as mental well-being.