From Gateways to New Destinations: How Arrival Cohorts and Country of Origin Shape Asian American Health Disparities in the United States

Asian Americans are the fastest-growing racial or ethnic group in the United States, having experienced an 81% increase since 2000. 71% of adult Asian Americans are immigrants (Pew Research Center 2022). Meanwhile, the sociohistorical experiences of Asian immigrants vary across countries of origin, and the incorporation process and health consequences among the Asian subgroups are largely understudied. Accordingly, this research examines the health disparities of six Asian ethnic groups in traditional gateways and new destinations. Using the 2000, 2010, and 2020 decennial census data, we first identified three types of Asian settlement areas in U.S. metropolitan areas: traditional Asian gateways, new Asian destinations, and minor Asian destinations. Then, drawing on the 2009-2019 American Community Survey (ACS), we disaggregated Asian Americans by nativity. Among those foreign-born, we disaggregated by the six most populous Asian immigrant groups—Chinese, Indian, Filipino, Vietnamese, Japanese, and Korean—and their arrival cohorts and duration to investigate the physical health disparities of Asian Americans in different settlement destinations. The results suggest that the settlement patterns, country of origins, and arrival cohorts interweave to shape the health disparities of Asian Americans. Specifically, six ethnic groups showed distinct, widely varying health patterns across arrival cohorts. Challenging the view that the traditional gateway provides protective effects on immigrants’ health, our results suggest that immigrants in new destinations have health advantages compared to native-born peers, while some arrival cohorts in traditional gateways are comparatively disadvantaged. These disparities are shaped not only by the socioeconomic conditions, healthcare systems, and health behaviors in the sending countries of these immigrants, but also by major historical events and immigrant policy.