Employment Prospects and Health Insurance Among Legal Permanent Residents: a Longitudinal Assessment of the Influence of Visa Type and Job Skill Level

Abstract Background Immigrants have disparate access to employment and health insurance, but it is unclear whether differences in access exist by visa types and job skill. We examined the relationship between visa type and employment, and the association between job skill and health insurance. Methods We conducted a retrospective cohort study using the 2003 to 2004 and 2007 to 2009 longitudinal data from the New Immigrant Survey. Using logistic regression, we compared the odds of employment by visa type (immediate relatives/family sponsored; diversity; refugee/asylee/parolee; and legalization) and the odds of insurance by job skill level (high, medium, and low), at each survey wave and assessed the change in each outcome over time. Results More immigrants were employed in wave 2 than in wave 1 (74% vs. 58%). Those with refugee/asylee/parolee visas had the highest rate of employment (82%) in wave 1 but decreased in wave 2 (76.4% ). Those with diversity visas had the highest increase in employment over time (56.6% in wave 1 vs. 85.5% in wave 2). The odds of insurance were consistently high among immigrants in high skill level jobs compared to those in lower skill level jobs over time. Conclusion Those with the diversity visa may be most vulnerable to unemployment and those in medium and low skill level jobs may be most vulnerable to uninsurance. They may benefit the most from job placement support in industries offering skill building, career advancement and health insurance to ensure best use of their human capital and continued upward mobility.