Abstract
BackgroundMigrant studies in France revealed that Mediterranean migrant men have lower mortality and morbidity than local-born populations for non-communicable diseases (NCDs). We studied overweight and NCDs among Tunisian migrants compared to the population of the host country and to the population of their country of origin. We also studied the potential influence of socio-economic and lifestyle factors on differential health status.MethodsA retrospective cohort study was conducted to compare Tunisian migrant men with two non-migrant male groups: local-born French and Tunisians living in Tunisia, using frequency matching. We performed quota sampling (n = 147) based on age and place of residence. We used embedded logistic regression models to test socio-economic and lifestyle factors as potential mediators for the effect of migration on overweight, hypertension and reported morbidity (hypercholesterolemia, type-2 diabetes, cardiovascular diseases (CVD)).ResultsMigrants were less overweight than French (OR = 0.53 [0.33–0.84]) and had less diabetes and CVD than Tunisians (0.18 [0.06–0.54] and 0.25 [0.07–0.88]). Prevalence of hypertension (grade-1 and -2) and prevalence of hypercholesterolemia were significantly lower among migrants than among French (respectively 0.06 [0.03–0.14]; 0.04 [0.01–0.15]; 0.11 [0.04–0.34]) and Tunisians (respectively OR = 0.07 [0.03–0.18]; OR = 0.06 [0.02–0.20]; OR = 0.23 [0.08–0.63]).The effect of migration on overweight was mediated by alcohol consumption. Healthcare utilisation, smoking and physical activity were mediators for the effect of migration on diabetes. The effect of migration on CVD was mediated by healthcare utilisation and energy intake. No obvious mediating effect was found for hypertension and hypercholesterolemia.ConclusionOur study clearly shows that lifestyle (smoking) and cultural background (alcohol) are involved in the observed protective effect of migration.
Highlights
IntroductionIntroduction to regression modelingIn Modern epidemiology 2nd edition. Edited by: Rothman KJ, Greenland S
Introduction to regression modelingIn Modern epidemiology 2nd edition
This study suggests that migrants are better protected from some non-communicable diseases (NCDs) than their counterparts in Tunisia
Summary
Introduction to regression modelingIn Modern epidemiology 2nd edition. Edited by: Rothman KJ, Greenland S. Massive migration has taken place from southern countries to industrialised countries where migrants usually experience radical changes in lifestyle Besides their importance for public health, studies of migrants' health provide good models to study the importance of the environment of populations for health [1]. In 1986, an epidemiologic paradox was revealed in the USA: compared with the non-Hispanic 'white' population, the Hispanic population had lower death rates for cancer, cardiovascular diseases, and allcause mortality [6] This paradox is currently theorized in a wider geographical and cultural context [7,8,9,10] and several hypotheses have been proposed to elucidate this effect [11], which could be related to the "healthy migrant effect", i.e. the selection, at entry, of applicants for immigration who are healthier than their average compatriots [12]. Powles [13] proposed an attractive hypothesis: "the best of both worlds"; the continuation, even the preservation, of traditional behaviours favourable to health, more important family support, and a better access to a health care system could protect migrants, and in particular from non-communicable diseases (NCDs)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
