Abstract
AbstractPrevious studies have repeatedly shown that all‐cause mortality is subject to spatial variation within countries and that acculturation of migrant mortality to native patterns occurs gradually with increasing duration of residence. This suggests that spatial variation in mortality is likely to differ between migrants and natives and that the migrant mortality advantage may be subject to strong variation between local settings. Using longitudinal microdata from the Belgian census, the population register, and the tax registers for 2011–2015, this article contributes to our understanding of migrant‐native mortality differentials by considering subnational spatial variation in the mortality advantage, settlement patterns of migrant groups, and varying degrees of acculturation by duration of residence. Consistent with the health selection hypothesis and the migration as a rapid health transition hypothesis, spatial variation in all‐cause mortality is limited among migrants with durations of residence under 30 years, resulting in strong variation of the mortality advantage between districts. Partial convergence to the spatial pattern of natives emerges among first generation migrants with durations of residence exceeding 30 years, as well as the intermediate and second generation. In Belgium, the country‐level mortality advantage can be partially accounted for by the settlement pattern of the migrant population in districts characterised by high native mortality and large migrant‐native differentials in all‐cause mortality.
Highlights
Significant mortality advantages have repeatedly been documented for migrants compared to native born populations, migrants in many cases face socio-economic deprivation, show higher morbidity levels, and experience barriers in health care use relative to natives (Jervelund et al, 2017; Urquia et al, 2012; Wallace & Darlington-Pollock, 2020)
We consider spatial variation in the migrant mortality advantage and test whether the overall mortality advantage in Belgium can be partially accounted for by the settlement pattern of the migrant population and their concentration in local settings characterised by high native mortality and large migrant-native differentials in all-cause mortality (Hypothesis 3)
Þ βk:SEPkij þ βk:HCki, where h0ðtjÞ is the unspecified baseline hazard function of all-cause mortality by age, Mki is a set of dummy variables distinguishing migrant groups from natives by migrant generation and duration of residence, Dki is a set of dummy variables comparing the mortality risk between districts, LAkij is a set of dummyvariables denoting the living arrangement on January 1 in each observation year t, SEPkij is a vector of time-constant and time-varying indicators of socio-economic position, and HCki denotes a vector of housing characteristics as measured in the 2011 Census
Summary
Significant mortality advantages have repeatedly been documented for migrants compared to native born populations, migrants in many cases face socio-economic deprivation, show higher morbidity levels, and experience barriers in health care use relative to natives (Jervelund et al, 2017; Urquia et al, 2012; Wallace & Darlington-Pollock, 2020). Local variation in the migrant mortality advantage is expected to diminish with duration of residence due to waning of selection effects and exposure to local conditions, but the theory of migration as a rapid health transition suggests that convergence to the spatial pattern of all-cause mortality in natives may only emerge gradually in migrant groups with extended durations of residence.
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