Health Outcomes Among MENA Populations in the United States: A Comparative Analysis of Foreign-Born and Native-Born...

Using pooled 2018-2022 American Community Survey microdata on 94,381 Middle East and North Africa (MENA) ancestry adults aged 25 and older, this study examines how nativity, socioeconomic status, acculturation, and country of origin are associated with disability in a population that is typically classified as White in U.S. racial data systems. We construct a composite disability indicator from six functional domains and estimate weighted logistic regression models across four analytic stages: the full MENA-ancestry sample, U.S.-born MENA-ancestry adults, all foreign-born MENA-ancestry adults, and MENA-country-born adults with country-of-origin distinctions. All estimates are interpreted as associations rather than causal effects. Overall disability prevalence is 13.57%. Education and income are strongly protective across models. Contrary to a simple immigrant-disadvantage expectation, MENA-country-born adults exhibit lower odds of disability than U.S.-born counterparts (OR = 0.559, p < 0.001), a pattern consistent with positive health selection among immigrants. Among U.S.-born MENA adults, socioeconomic gradients are especially steep. Among the foreign-born, English proficiency is strongly protective, whereas naturalized citizenship and longer U.S. residence are positively associated with disability, a pattern consistent with possible cohort composition, selective survival, health-related selection into citizenship, and cumulative exposure to structural disadvantage. Country-of-origin differences persist net of covariates, with Iraqi immigrants showing significantly higher odds of disability than Egyptians (OR = 1.401, p < 0.001). These findings indicate layered disability inequalities within MENA populations and underscore the need for language access, trauma-informed care, and policies addressing structural barriers to health.