Drawing on public health critical race praxis and acculturation theory, this study examines how racialization and immigration status shape the self-reported health of Latinx adults using 2021 California Health Interview Survey (CHIS) data for adult Californians (n = 17,345) and multivariate logistic regression analyses.

Findings: Naturalized and U.S.-born Latinxs have higher odds of being in worse health than U.S.-born white citizens. A key determinant of Latinx health is how long individuals have been in the U.S. Among Latinx naturalized citizens, only those who have been in the U.S. for at least 15 years have worse health than U.S.-born white citizens. Among Latinx noncitizens, those who have been in the U.S. for less than 15 years actually have better health than U.S.-born white citizens. The findings advance how we conceptualize the complexity of Latinx health by accounting for racialized health policy stratification and the pervasive role of institutionalized racism in shaping Latinx health outcomes.