Educational Selectivity and the Immigrant–Native Health Disparity

Selectivity is a key explanation for immigrant health advantage, yet evidence is often inferred from comparisons that bundle selection with post-migration processes and leave unspecified what is being selected. This study isolates educational selectivity by quantifying how predicted immigrant–native differences change when contextual attainment—immigrants’ education percentile within origin-country cohort-by-gender distributions—is introduced. Using pooled 2002–2018 National Health Interview Survey data linked to mortality follow-up through 2019, we examine mortality, smoking, and activity limitation among first-generation Asian and Latino adults from China, India, the Philippines, Mexico, Cuba, and the Dominican Republic. We benchmark immigrants against both native-born non-Hispanic Whites and U.S.-born coethnics and estimate gap compression on the outcome scale. Accounting for contextual attainment attenuates immigrant advantages across outcomes and origins, with larger and more consistent compression under coethnic than White benchmarks; attenuation also persists across duration-of-residence strata. In origin-specific analyses, contextual attainment eliminates the coethnic mortality gap for Chinese immigrants and shifts the coethnic gap toward an immigrant disadvantage for Cuban mortality and Dominican activity limitation. These findings show that origin-relative educational rank captures a measurable component of selectivity and that reference-group choice is consequential for interpreting immigrant–native disparities.