title: Survival differences among native-born and foreign-born older adults in the United States.
abstract: BACKGROUND
  Studies show that the U.S. foreign-born population has lower mortality than the native-born population before age 65. Until recently, the lack of data prohibited reliable comparisons of U.S. mortality by nativity at older ages. This study provides reliable estimates of U.S. foreign-born and native-born mortality at ages 65 and older at the end of the 20(th) century. Life expectancies of the U.S. foreign born are compared to other developed nations and the foreign-born contribution to total life expectancy (TLE) in the United States is assessed.
  
  
  METHODS
  Newly available data from Medicare Part B records linked with Social Security Administration files are used to estimate period life tables for nearly all U.S. adults aged 65 and older in 1995. Age-specific survival differences and life expectancies are examined in 1995 by sex, race, and place of birth.
  
  
  RESULTS
  Foreign-born men and women had lower mortality at almost every age from 65 to 100 compared to native-born men and women. Survival differences by nativity were substantially greater for blacks than whites. Foreign-born blacks had the longest life expectancy of all population groups (18.73 [95% confidence interval {CI}, 18.15-19.30] years at age 65 for men and 22.76 [95% CI, 22.28-23.23] years at age 65 for women). The foreign-born population increased TLE in the United States at older ages, and by international comparison, the U.S. foreign born were among the longest-lived persons in the world.
  
  
  CONCLUSIONS
  Survival estimates based on reliable Medicare data confirm that foreign-born adults have longer life expectancy at older ages than native-born adults in the United States.
authors.affiliation: Duke Clinical Research Institute, Duke University, Durham, North Carolina, United States of America. matthew.dupre@duke.edu
authors.forename: Matthew E
authors.initials: ME
authors.lastname: Dupre
authors.forename: Danan
authors.initials: D
authors.lastname: Gu
authors.forename: James W
authors.initials: JW
authors.lastname: Vaupel
mesh_terms: D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D004641:Emigration and Immigration; D005260:Female; D006801:Humans; D008017:Life Expectancy; D008297:Male; D006278:Medicare / Q000706:statistics & numerical data; D044382:Population Groups; D015996:Survival Rate; D014481:United States / Q000453:epidemiology