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Respiratory health research has rightfully focused on outcomes related to the diagnosis and hospitalization of asthma and COPD. However, it is unclear how everyday pulmonary challenges vary by race and ethnicity as well as nativity. Using data from the National Longitudinal Study of Adolescent Health (Add Health), I use Item Response Theory (IRT) to construct a latent measure of pulmonary distress by using indicators of respiratory discomfort that vary in severity among middle-aged participants (N=9,720). Results indicated that foreign-born persons exhibit the 'healthy immigrant' effect by having lower respiratory distress scores on average than native-born whites (θ= -0.13). When conducting multi-level regression and adding neighborhood characteristics, the 'immigrant effect' was attenuated, and the effect disappeared. More research needs to explore the interaction between nativity and immigrant composition. The form and content of this abstract are approved I recommend its publication.