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BMC Medicine
Published in: BMC Medicine 1/2018

Open Access 01-12-2018 | Research article

Differences in the health transition patterns of migrants and non-migrants aged 50 and older in southern and western Europe (2004–2015)

Authors: Matias Reus-Pons, Clara H. Mulder, Eva U. B. Kibele, Fanny Janssen

Published in: BMC Medicine | Issue 1/2018

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Abstract

Background

Most previous research on migrant health in Europe has taken a cross-sectional perspective, without a specific focus on the older population. Having knowledge about inequalities in health transitions over the life course between migrants and non-migrants, including at older ages, is crucial for the tailoring of policies to the demands of an ageing and culturally diverse society. We analyse differences in health transitions between migrants and non-migrants, specifically focusing on the older population in Europe.

Methods

We used longitudinal data on migrants and non-migrants aged 50 and older in 10 southern and western European countries from the Survey of Health, Ageing and Retirement in Europe (2004–2015). We applied multinomial logistic regression models of experiencing health deterioration among individuals in good health at baseline, and of experiencing health improvement among individuals in poor health at baseline, separately by sex, in which migrant status (non-migrant, western migrant, non-western migrant) was the main explanatory variable. We considered three dimensions of health, namely self-rated health, depression and diabetes.

Results

At older ages, migrants in Europe were at higher risk than non-migrants of experiencing a deterioration in health relative to remaining in a given state of self-rated health. Western migrants had a higher risk than non-migrants of becoming depressed, while non-western migrants had a higher risk of acquiring diabetes. Among females only, migrants also tended to be at lower risk than non-migrants of experiencing an improvement in both overall and mental health. Differences in the health transition patterns of older migrants and non-migrants remained robust to the inclusion of several covariates, including education, job status and health-related behaviours.

Conclusions

Our findings indicate that, in addition to having a health disadvantage at baseline, older migrants in Europe were more likely than older non-migrants to have experienced a deterioration in health over the study period. These results raise concerns about whether migrants in Europe are as likely as non-migrants to age in good health. We recommend that policies aiming to promote healthy ageing specifically address the health needs of the migrant population, thereby distinguishing migrants from different backgrounds.
Appendix
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Footnotes
1
Although this is not completely accurate, we use the term “married” to denote both respondents that were married and living with their spouse, and respondents who were in a registered partnership. Registered partnership is a rare category in the data, which was found mainly in Sweden, the Netherlands, and Belgium (5–10% of cases). No information was available on whether those in a registered partnership were actually living with their partner. Neither was information available on informal cohabitation.
 
Literature
1.
Lanzieri G. Fewer, older and multicultural?: projections of the EU populations by foreign/national background. Luxemburg: Eurostat; 2011.
2.
International Organization for Migration. Migrant health: better health for all in Europe. Geneva: International Organisation for Migration; 2009.
3.
Nørredam M, Krasnik A. Migrants’ access to health services. In: Rechel B, Mladovsky P, Devillé W, Rijks B, Petrova-Benedict R, McKee M, editors. Migration and health in the European Union. Berkshire: Open University Press; 2011. p. 67–80.
4.
Carnein M, Milewski N, Doblhammer G, Nusselder WJ. Health inequalities of immigrants: patterns and determinants of health expectancies of Turkish migrants living in Germany. In: Doblhammer G, editor. Health among the elderly in Germany: new evidence on disease, disability and care need. Leverkusen: Barbara Budrich; 2014. p. 157–90.
5.
Reus-Pons M, Vandenheede H, Janssen F, Kibele EUB. Differences in mortality between groups of older migrants and older non-migrants in Belgium, 2001-09. Eur J Pub Health. 2016;26:992–1000.CrossRef
6.
Reus-Pons M, Kibele EUB, Janssen F. Differences in healthy life expectancy between older migrants and non-migrants in three European countries over time. Int J Public Health. 2017;62:531–40.CrossRefPubMedPubMedCentral
7.
8.
Aichberger MC, Schouler-Ocak M, Mundt A, Busch MA, Nickels E, Heimann HM, Ströhle A, Reischies FM, Heinz A, Rapp MA. Depression in middle-aged and older first generation migrants in Europe: results from the Survey of Health, Ageing and Retirement in Europe (SHARE). Eur Psychiat. 2010;25:468–75.CrossRef
9.
Lanari D, Bussini O. International migration and health inequalities in later life. Ageing Soc. 2012;32:935–62.CrossRef
10.
Newbold KB. Self-rated health within the Canadian immigrant population: risk and the healthy immigrant effect. Soc Sci Med. 2005;60:1359–70.CrossRefPubMed
11.
De Maio FG, Kemp E. The deterioration of health status among immigrants to Canada. Glob Public Health. 2010;5:462–78.CrossRefPubMed
12.
So L, Quan H. Coming to Canada: the difference in health trajectories between immigrants and native-born residents. Int J Public Health. 2012;57:893–904.CrossRefPubMed
13.
Kim I-H, Carrasco C, Muntaner C, McKenzie K, Noh S. Ethnicity and postmigration health trajectory in new immigrants to Canada. Am J Public Health. 2013;103:96–104.CrossRef
14.
Gubernskaya Z. Age at migration and self-rated health trajectories after age 50: understanding the older immigrant health paradox. J Gerontol Ser B-Psychol Sci Soc Sci. 2015;70:279–90.CrossRef
15.
16.
17.
18.
Lanari D, Bussini O, Minelli L. Self-perceived health among eastern European immigrants over 50 living in western Europe. Int J Public Health. 2015;60:21–31.CrossRefPubMed
19.
Razum O, Twardella D. Time travel with Oliver Twist–towards an explanation for a paradoxically low mortality among recent immigrants. Tropical Med Int Health. 2002;7:4–10.CrossRef
20.
Lindström M, Sundquist J, Östergren PO. Ethnic differences in self reported health in Malmö in southern Sweden. J Epidemiol Community Health. 2001;55:97–103.CrossRefPubMedPubMedCentral
21.
Hosper K, Nierkens V, Nicolaou M, Stronks K. Behavioural risk factors in two generations of non-western migrants: do trends converge towards the host population? Eur J Epidemiol. 2007;22:163–72.CrossRefPubMedPubMedCentral
22.
Arnold M, Razum O, Coebergh JW. Cancer risk diversity in non-western migrants to Europe: an overview of the literature. Eur J Cancer. 2010;46:2647–59.CrossRefPubMed
23.
Vandenheede H, Willaert D, de Grande H, Simoens S, Vanroelen C. Mortality in adult immigrants in the 2000s in Belgium: a test of the ‘healthy-migrant’ and the ‘migration-as-rapid-health-transition’ hypotheses. Tropical Med Int Health. 2015;20:1832–45.CrossRef
24.
Börsch-Supan A, Brandt M, Hunkler C, Kneip T, Korbmacher J, Malter F, Schaan B, Stuck S, Zuber S, on behalf of the SHARE Central Coordination Team. Data resource profile: the Survey of Health, Ageing and Retirement in Europe (SHARE). Int J Epidemiol. 2013;42:992–1001.CrossRefPubMedPubMedCentral
25.
Castles S, Miller MJ. The age of migration. 5th ed. Basingstoke: Palgrave Macmillan; 2014.CrossRef
26.
27.
28.
29.
30.
31.
Seo S, Chung S, Shumway M. How good is “very good”? Translation effect in the racial/ethnic variation in self-rated health status. Qual Life Res. 2014;23:593–600.CrossRefPubMed
32.
Kunst AE, Bos V, Lahelma E, Bartley M, Lissau I, Regidor E, Mielck A, Cardano M, Dalstra JA, Geurts JJ, Helmert U, Lennartsson C, Ramm J, Spadea T, Stronegger WJ, Mackenbach JP. Trends in socioeconomic inequalities in self-assessed health in 10 European countries. Int J Epidemiol. 2005;34:295–305.CrossRefPubMed
33.
Prince MJ, Reischies F, Beekman AT, Fuhrer R, Jonker C, Kivela SL, Lawlor BA, Lobo A, Magnusson H, Fichter M, van Oyen H, Roelands M, Skoog I, Turrina C, Copeland JR. Development of the EURO-D scale - a European Union initiative to compare symptoms of depression in 14 European centres. Bri J Psychiat. 1999;174:330–8.CrossRef
34.
Dewey ME, Prince MJ. Mental health. In: Börsch-Supan A, Brugiavini A, Jürges H, Mackenbach J, Siegrist J, Weber G, editors. Health, ageing and retirement in Europe - first results from the Survey of Health, Ageing and Retirement in Europe. Mannheim: Mannheim Research Institute for the Economics of Ageing (MEA); 2005. p. 108–17.
35.
Gorodzeisky A, Semyonov M. Terms of exclusion: public views towards admission and allocation of rights to immigrants in European countries. Ethnic Racial Stud. 2009;32:401–23.CrossRef
36.
Carr D, Springer KW. Advances in families and health research in the 21st century. J Marriage Fam. 2010;72:743–61.CrossRef
37.
Nazroo JY. The structuring of ethnic inequalities in health: economic position, racial discrimination, and racism. Am J Public Health. 2003;93:277–84.CrossRefPubMedPubMedCentral
38.
Mackenbach JP, Stirbu I, Roskam AR, Schaap MM, Menvielle G, Leinsalu M, Kunst AE. Socioeconomic inequalities in health in 22 European countries. N Engl J Med. 2008;358:2468–81.CrossRefPubMed
39.
Bhopal R, Hayes L, White M, Unwin N, Harland J, Ayis S, Alberti G. Ethnic and socio-economic inequalities in coronary heart disease, diabetes and risk factors in Europeans and south Asians. J Public Health Med. 2002;24:95–105.CrossRefPubMed
40.
World Health Organization. Joint WHO/FAO expert consultation on diet, nutrition and the prevention of chronic diseases. WHO technical report series 916. Geneva: WHO; 2003.
41.
Chen L, Pei JH, Kuang J, Chen HM, Chen Z, Li ZW, Yang H. Effect of lifestyle intervention in patients with type 2 diabetes: a meta-analysis. Metabolism. 2015;64:338–47.CrossRefPubMed
42.
Huber PJ. The behavior of maximum likelihood estimates under nonstandard conditions. Proceedings of the Fifth Berkeley Symposium on Mathematical Statistics and Probability. 1967;1:221–33.
43.
White H. A heteroskedasticity-consistent covariance matrix estimator and a direct test for heteroskedasticity. Econometrica. 1980;48:817–38.CrossRef
44.
Goldman N, Pebley AR, Creighton MJ, Teruel GM, Rubalcava LN, Chung C. The consequences of migration to the United States for short-term changes in the health of Mexican immigrants. Demography. 2014;51:1159–73.CrossRefPubMedPubMedCentral
45.
Angel JL, Buckley CJ, Sakamoto A. Duration or disadvantage? Exploring nativity, ethnicity, and health in midlife. J Gerontol Ser B-Psychol Sci Soc Sci. 2001;56:S275–84.CrossRef
46.
Dannefer D. Cumulative advantage/disadvantage and the life course: cross-fertilizing age and social science theory. J Gerontol Ser B-Psychol Sci Soc Sci. 2003;58:S327–37.CrossRef
47.
Gushulak B, Pace P, Weekers J. Migration and health of migrants. In: Koller T, editor. Poverty and social exclusion in the WHO European region: health systems respond. Copenhagen: WHO Regional Office for Europe; 2010. p. 257–81.
48.
Alcántara C, Chen C, Alegría M. Do post-migration perceptions of social mobility matter for Latino immigrant health? Soc Sci Med. 2014;101:94–106.CrossRefPubMed
49.
Rechel B, Mladovsky P, Ingleby D, Mackenbach JP, McKee M. Migration and health in an increasingly diverse Europe. Lancet. 2013;381:1235–45.CrossRefPubMed
50.
Deboosere P, Gadeyne S. Adult migrant mortality advantage in Belgium: evidence using census and register data. Population. 2005;60:655–98.CrossRef
51.
Anthamatten P, Hazen H. An introduction to the geography of health. Abingdon (Oxford): Routledge; 2011.
52.
Huschek D, de Valk HAG, Liefbroer AC. Gender-role behavior of second-generation Turks: the role of partner choice, gender ideology and societal context. Adv Life Course Res. 2011;16:164–77.CrossRef
53.
54.
Norredam M, Agyemang C, Hoejbjerg-Hansen OK, Petersen JH, Byberg S, Krasnik A, Kunst AE. Duration of residence and disease occurrence among refugees and family reunited immigrants: test of the ‘healthy migrant effect’ hypothesis. Tropical Med Int Health. 2014;19:958–67.CrossRef
55.
Hales CN, Barker DJP. Type 2 (non-insulin-dependent) diabetes mellitus: the thrifty phenotype hypothesis. Diabetologia. 1992;35:595–601.CrossRefPubMed
56.
Sniderman AD, Bhopal R, Prabhakaran D, Sarrafzadegan N, Tchernof A. Why might South Asians be so susceptible to central obesity and its atherogenic consequences? The adipose tissue overflow hypothesis. Int J Epidemiol. 2007;36:220–5.CrossRefPubMed
57.
58.
Malmusi D. Immigrants’ health and health inequality by type of integration policies in European countries. Eur J Pub Health. 2015;25:293–9.CrossRef
59.
60.
Abraído-Lanza AF, Dohrenwend BP, Ng-Mak DS, Turner JB. The Latino mortality paradox: a test of the “salmon bias” and healthy migrant hypotheses. Am J Public Health. 1999;89:1543–8.CrossRefPubMedPubMedCentral
61.
Uitenbroek DG, Verhoeff AP. Life expectancy and mortality differences between migrant groups living in Amsterdam, the Netherlands. Soc Sci Med. 2002;54:1379–88.CrossRefPubMed
62.
Nazroo JY. Genetic, cultural or socio-economic vulnerability? Explaining ethnic inequalities in health. Sociol Health Ill. 1998;20:710–30.CrossRef
63.
Nielsen SS, Hempler NF, Krasnik A. Issues to consider when measuring and applying socioeconomic position quantitatively in immigrant health research. Int J Environ Res Public Health. 2013;10:6354–65.CrossRefPubMedPubMedCentral
Metadata
Title
Differences in the health transition patterns of migrants and non-migrants aged 50 and older in southern and western Europe (2004–2015)
Authors
Matias Reus-Pons
Clara H. Mulder
Eva U. B. Kibele
Fanny Janssen
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Medicine / Issue 1/2018
Electronic ISSN: 1741-7015
DOI
https://doi.org/10.1186/s12916-018-1044-4

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