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Healthy Migrants? Health Selection of Internal Migrants in Germany

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Abstract

In Germany, internal migration streams have shaped the population structure quite notably during the past two decades. As selective migration can have a substantial impact on the geographical distribution of health, this paper examines whether internal migrants in Germany are selected regarding their health status. To capture health selection, one measure—i.e. self-rated contentment with health—and two established risk factors for poor health—i.e. smoking and BMI—were included. Applying event history analysis, the health status of migrants was compared to non-migrants, controlling for other individual characteristics. The analyses were based on the German Socio-Economic Panel, a retrospective data set representative of the German population. Results for self-rated health and smoking were inconclusive. While self-rated health was only related to migration in men, smoking was only linked to migration in women. However, there was a clear association between BMI and migration, i.e. the propensity to migrate decreased significantly with increasing weight. The results suggest that BMI is an important indicator of increased susceptibility to ill health, which prevent people from migration. Leaving behind a population who has a greater susceptibility to chronic conditions, selective migration is likely to reinforce the consequences of population ageing and healthcare demand, in particular in regions characterized by outmigration.

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Fig. 1

Source GSOEP 2002–2010

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Acknowledgments

The author thanks the European Regional Development Fund (EFRE) and European Social Fund (ESF), Grant No. AU 09 046:ESF/IV-BM-B35-0005/12, for financial support.

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Authors and Affiliations

  1. Rostock Center for the Study of Demographic Change, Konrad-Zuse-Str. 1, 18057, Rostock, Germany

    Christina Westphal

  2. Fraunhofer Institute for Cell Therapy and Immunology IZI, Project Group Extracorporeal Immunomodulation, Schillingallee 68, 18057, Rostock, Germany

    Christina Westphal

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Correspondence to Christina Westphal.

Appendix

Appendix

See Tables 4 and 5.

Table 4 Cox proportional hazard ratios for the risk of migration and competing risk regression for the population lost to attrition and lost to mortality, men
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Table 5 Cox proportional hazard ratios for the risk of migration and competing risk regression for the population lost to attrition and lost to mortality, women
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Westphal, C. Healthy Migrants? Health Selection of Internal Migrants in Germany. Eur J Population 32, 703–730 (2016). https://doi.org/10.1007/s10680-016-9397-x

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