Healthy Migrants in an Unhealthy City? The Effects of Time on the Health of Migrants Living in Deprived Areas of Glasgow

Ade Kearns,Carol Tannahill,Elise Whitley,Matt Egan,Catherine Tabbner

doi:10.1007/s12134-016-0497-6

Abstract

This paper examines the healthy immigrant effect in Glasgow, a post-industrial city where the migrant population has more than doubled in the last decade. Using data from a community survey in 15 communities across the city, the paper compares four health outcomes for the following three groups: British-born, social and economic migrants and asylum seekers and refugees. Migrants were found to be healthier than the indigenous population on all four measures, particularly in the case of adult households in both migrant groups and for older asylum seeker and refugee households. Health declines for social and economic migrants with time spent in the UK, but there is no clear pattern for asylum seekers and refugees. Health declined for refugees according to time spent awaiting a decision, whilst their health improved after a leave-to-remain decision. Indigenous and social and economic migrant health declines with time spent living in a deprived area; this was true for three health indicators for the former and two indicators for the latter. Asylum seekers and refugees who had lived in a deprived area for more than a year had slightly better self-rated health and well-being than recent arrivals. The study’s findings highlight the role of destination city and neighbourhood in the health immigrant effect, raise concerns about the restrictions placed upon asylum seekers and the uncertainty afforded to refugees and suggest that spatial concentration may have advantages for asylum seekers and refugees.

Highlights

The notion of the healthy immigrant effect has the following two distinct elements: first, that new immigrants are healthier than the indigenous population on arrival and second, that this health advantage deteriorates over time as the health of immigrants converges towards that of the host population (Halli and Anchan 2005; Rechel et al 2013)
The fact that this healthy migrant effect is seen in asylum seekers and refugees as well as amongst social and economic migrants suggests that the effect is not solely a consequence of self-selection on the part of migrants, nor of screening processes instituted by the receiving country, since under Home Office arrangements, Scotland does not select those asylum seekers arriving north of the border
In contrast to previous explanations for the healthy migrant effect which focus on characteristics of the country of origin (e.g. Dunn and Dyck 2000), our results highlight the importance of the country of destination; if migrants arrive or settle in an unhealthy city, and, in the more deprived parts of that city, a healthy migrant effect may become apparent as a consequence

Summary

Introduction

From earlier concerns in Western countries that immigrants either represented a health risk to the host population, or were merely heavy users of health care services (Hyman 2001), there is a growing recognition that immigrants are often healthier than the receiving population. This has been reported for example in respect of Canada (Newbold and Danforth 2003; McDonald and Kennedy 2004), the USA (Antecol and Bedard 2006) and Australia (Biddle et al 2007). One would expect that economic migrants would be likely to have a health advantage and that asylum seekers and refugees who are forced to leave their home country, for example due to conflict, would be less likely to exhibit healthier characteristics

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