Documentation status, gender, and health selection of immigrants: Evidence from Mexican–US migration

Recent research has revealed an epidemiologic paradox within immigrants: undocumented immigrants often exhibit similar or even better health outcomes than documented immigrants despite their socio‐economic disadvantages. The present study examines whether this paradox partly reflects heterogeneity in immigrant health selection by documentation status and gender. We examine the case of Mexico–US immigration using data from the Mexican Migration Project, which provides premigration health and detailed migration histories. Results demonstrate notable diversity in immigrant health selection. Undocumented Mexican immigrant men are especially positively selected on health. Better premigration health also increases recurrent undocumented migration trips. Documented Mexican immigrant men, in contrast, do not exhibit a significant level of positive health selection. For Mexican women, both documented and undocumented migrants are positively selected on the basis of health, and the degree of health selection is irrespective of their documentation status. These findings suggest that immigrant health selection can operate differently depending on the risks and maturity of migration. Taking into account both documentation status and gender is essential for a more accurate understanding of immigrant health selection and has important implications for investigating the impact of undocumented status on immigrant health.