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Writer's pictureMonica Pineider

A Double-Edged Sword: The Health Implications of Dual Citizenship


The American Dream beckons outside of the U.S. border. Thousands of people from other countries worldwide want to become naturalized U.S. citizens and explore the benefits of Dual Citizenship. Naturalized citizens are not American citizens by birth. They do not have parents who are U.S. citizens.


They may have had a green card for many years and met the requirements of Congress.


A person raises their right hand to take the Oath of Allegiance, to get dual citizenship.

Naturalized citizens must swear allegiance to the United States, a declaration of loyalty to the country. Most people see this as the start of their American journey. Others with dual citizenship may worry about how swearing allegiance impacts their citizenship.


Understanding the long-term implications is critical if you call more than one country home.

This becomes especially important if you are requested to swear allegiance.



What Is the Oath of Allegiance?


The Oath of Allegiance means making promises to the U.S. It is the final step in the U.S. naturalization process, whereby you promise to uphold, support, and defend the Constitution and laws of America.


You also commit to renouncing allegiance to any other ‘sovereignty, state, foreign prince, or potentate.’


It's important to note this: when you take the Oath of Allegiance, you also promise to ‘bear arms’ on behalf of the U.S. if required by law. Furthermore, you promise to perform ‘noncombatant service’ in the U.S. military if required by law.


For many people, taking the Oath of Allegiance is a proud moment that signifies their official transformation into U.S. citizens.



What Is Dual Citizenship?


You have dual citizenship or nationality if you are legally recognized as a citizen of two or more countries simultaneously. Each country sees you as a citizen who must uphold their laws.


For instance, you may have citizenship in Mexico and the U.S., which means you enjoy rights in both countries. However, you must also fulfill legal obligations such as paying taxes and following the law in both countries.


You may have obtained your dual citizenship in one of many ways. These include:


  • Birth. You were born in a country that granted automatic citizenship by birth (like the U.S.) and inherited another citizenship from one or both parents.

  • Naturalization. You become a citizen of a second country while retaining the original citizenship.

  • Marriage. You gained citizenship by marrying someone from another country in that country.



Does Taking the Oath of Allegiance Mean Losing Your Original Citizenship?


You may assume that taking the Oath of Allegiance to be a U.S. citizen automatically revokes your original citizenship. It does not, since U.S. law does not prohibit dual citizenship. However, this process also depends on the laws of your home country.


Dual Citizenship in the U.S.


As mentioned, the U.S. allows dual citizenship. Becoming an American citizen does not require you to give up your original citizenship. This means that renouncing foreign allegiances should be viewed symbolically.


Foreign Country Laws


Some countries do not permit dual citizenship. If you decide to become a U.S. citizen, you may automatically lose your citizenship in your country of origin.

These countries include:


  • India: This country does not allow dual citizenship. Indian nationals who naturalize in the U.S. lose their Indian citizenship. However, they may apply for OCI (Overseas Citizen of India) status. This allows them specific privileges.


  • China: If you are a Chinese national and naturalize in the U.S., you will automatically be revoked from your Chinese citizenship.


  • Germany: Germany is slightly more lenient, allowing for dual citizenship in certain cases. This is often true for EU or Swiss citizens or those who receive government permission. Germany introduced a new nationality law in June 2024. Under this law, foreigners can become naturalized citizens after five years of legal residence. Those who are well-integrated can become naturalized after three years.


If you want to pursue U.S. citizenship, it is critical to research the dual citizenship policies of your home country.



Navigating Health as a Dual Citizen


Dual citizenship offers a world of opportunities, but it also presents unique health considerations. Being proactive and informed can ensure your well-being in both countries.


Understanding Healthcare Systems


  • Insurance Coverage: Ensure your health insurance plan covers you in both countries, especially when travelling.


  • Emergency Care: Familiarize yourself with emergency procedures and contact numbers in both countries.


  • Chronic Conditions: If you have chronic conditions such as hip osteoarthritis, coordinate with healthcare providers in both countries. This will help maintain seamless treatment.


Mental Health and Cultural Adjustment


The emotional toll of dual citizenship cannot be overlooked. Cultural differences, language barriers, and the stress of adapting to multiple cultures can impact mental health.


  • Stress Management: Dual citizenship can be emotionally demanding. Practice stress-management techniques like meditation, yoga, or spending time in nature. If you need inspiration, try these eight ways to relax in an unexpected way.


  • Cultural Differences: Be mindful of cultural differences and their impact on your mental and emotional well-being.


  • Seek Support: Some people struggle with culture shock, homesickness, or other mental health issues. Build strong social connections with people from both cultures. Seek professional help from a mental health team when needed. These actions can provide invaluable support.


Proactively addressing these health considerations is crucial for dual citizens. They can effectively manage the complexities of their lifestyle. This approach safeguards their physical and emotional well-being.



Benefits of Dual Citizenship


Despite potential hurdles, there are several advantages to holding dual citizenship. For instance, if you are a U.S. citizen and a Canadian citizen, you can travel easily between the two without a visa.


You will also likely have access to more work opportunities and be able to buy property in both countries. If you are an immigrant planning to live in the U.S. and become a citizen, maintaining your original citizenship means you can preserve your cultural connections.


You can embrace the dream that is American life while remembering your roots. Plus, you will have access to legal rights and protections in both countries. For example, if you are a U.S. and Italian citizen, you can vote in both countries and receive the consular support you need.



Challenges of Dual Citizenship


The challenges of dual citizenship are also important for anyone to consider. If you are a U.S. citizen, you must file taxes on worldwide income, even if you live abroad. Several countries have the same rules, so you may sometimes pay double tax.


There are treaties between the U.S. and certain other countries that can help prevent this.

Furthermore, if you are expected to perform mandatory military service in one country, it may conflict with the laws and pose challenges in another. This is because these laws often conflict depending on the countries you are a citizen of.


Depending on where you are, you may also not receive consular support. If you are a U.S.–Brazil citizen visiting Brazil, the U.S. Embassy there may not help you for various reasons.


It is also essential to understand the political climate in both countries. You may become a subject of scrutiny concerning national security or politics.



How to Get Dual Citizenship Successfully


The best way to navigate dual citizenship is to get help and advice from an immigration lawyer. You can also consult a tax attorney who can guide in managing tax obligations in both countries.


Staying current on laws that affect your dual citizenship in both countries is crucial. Moreover, you must ensure that your passports, visas, and other legal documents are always valid.


The overall impact of dual citizenship when taking the Oath of Allegiance in the U.S. depends on both countries' policies and foreign laws, as well as on individual circumstances.


When you get an immigration attorney to give expert advice, you can ensure a smooth transition between citizenship.

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