Foreign-born workers are exposed to increased vulnerability at the intersection of immigration and work, among other social determinants of health. The health impacts of these combined effects is not yet well understood. This is a priority population for public health science and advocacy, in individual locations and comparatively around the globe.

Two samples of foreign-born workers were studied separately in California and Spain, and their self-rated health status was collected in different ways. Statistical methods allow for a comparative analysis to be completed after assessing for health as a latent variable. The data was found to be consistent with health as a latent variable, and with better health among the sample of people born in Latin America who were working in Spain compared to California. The methodology used here can be applied to other comparative analyses when discrepant measures are used.

A longitudinal cohort study of foreign-born farmworker families in Mendota, CA, allowed for more specific exploration of the health effects of precarious employment and undocumented legal status. Self-rated health and depressive symptoms were used to assess health status. A profile of people in the sample with undocumented legal status is presented. Precarious employment was found to be associated with increased odds of experiencing depressive symptoms. No significant associations were found between legal status and precarious employment, between legal status and self-rated health, or between precarious employment and self-rated health. Interactions between the ‘healthy worker effect’ and the ‘healthy immigrant effect’ need to be considered in interpreting these findings.

Future studies are needed to continue to explore social determinants of health compounding the vulnerability of immigrant workers to complete the public health science and allow for optimal health promotion and appropriate structural protections.