The Immigrant Mortality Advantage Among Over-65 Middle Eastern and North African Immigrants to the United States

Immigrants to the United States often have longer life expectancies than their U.S.-born counterparts, however it is unclear whether a similar "immigrant advantage" exists for immigrants from the Middle East and North Africa (MENA). This study uses a novel machine-learning name classifier to offer one of the first national-level examinations of MENA mortality patterns by nativity in the United States. A recurrent neural network model was developed to identify MENA individuals based on given name and surname characteristics. The model was trained on more than 2.5 million mortality-linked social security records in the Berkeley Unified Numident Mortality Database (BUNMD). Mortality rates and life expectancy were estimated using a Gompertz distribution and maximum likelihood estimation, focusing on high-coverage years between 1988 and 2005 and deaths over age 65. Foreign-born MENA men over 65 showed a significant immigrant mortality advantage with a hazard ratio (HR) of 0.64 and an estimated 3.13 additional years of life expectancy at age 65 compared to U.S.-born counterparts. Foreign-born MENA women also exhibited an advantage, with a HR of 0.71 and an additional 2.24 years of life expectancy at age 65. This study is one of the first national-level analyses of mortality outcomes among the over-65 MENA population in the United States, finding a MENA immigrant mortality advantage. The results suggest further research is needed to identify and disaggregate the MENA population in health research.