The healthy migrant effect: role of selection and late entry bias

Das Gesundheitswesen
Oliver Razum, S Rohrmann

Abstract

First-generation immigrants frequently have a lower mortality than the host population, in spite of a low socio-economic status. This is usually explained by (self-) selection into migration. If this were the case, the immigrants' mortality risk would increase with time under observation. A persistently low mortality could be due to a late entry bias: if migrants are enrolled in a study years after immigration, sick or socio-economically unsuccessful individuals may already have returned to their countries of origin. Mortality risk would then be inversely associated with length of stay in the host country before enrollment. We assessed the mortality risk of immigrants from Mediterranean countries to Germany in the German Socio-economic Panel, in relation to time under observation (1-15 years) and length of stay in Germany before enrollment (0-34 years), using the Cox regression. In 1984-98, 2624 immigrants aged 16-83 years accrued 21,858 person years; 59 died. The hazard ratio, adjusted for age, sex and marital status, for each additional year under observation was 0.93 (95 % CI: 0.87-0.99); and for each additional 10 years in Germany before enrollment 0.49 (95 % CI: 0.27-0.89) in the age group >/= 50 years. We found no evidenc...Continue Reading

Citations

Aug 29, 2006·Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz·H Zeeb, O Razum
Nov 20, 2004·Der Nervenarzt·O Razum, H Zeeb
Jun 15, 2004·International Journal for Equity in Health·Ulrich Ronellenfitsch, Oliver Razum
Sep 17, 2010·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·Melina ArnoldJan-Willem Coebergh
Jul 10, 2009·Health Policy·Philipa Mladovsky
Mar 24, 2010·American Journal of Human Biology : the Official Journal of the Human Biology Council·Ashwin A Kotwal
Apr 11, 2015·Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz·Martin Kohls
Nov 6, 2003·Psychological Bulletin·Nicholas B Allen, Paul B T Badcock
Mar 6, 2019·International Journal of Gynecological Cancer : Official Journal of the International Gynecological Cancer Society·Yael RazDan Grisaru
Jul 30, 2019·Frontiers in Public Health·Ronny Westerman, Michael Mühlichen

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