Abstract
This paper investigates age variations in foreign-born vs. native-born mortality ratios in an international comparative perspective, with the purpose of gaining insight into the mechanisms underlying the so-called migrant mortality advantage. We examine the four main explanations that have been proposed in the literature for the migrant mortality advantage (i.e., in-migration selection effects, out-migration selection effects, cultural effects, and data artifacts), and formulate expectations as to whether they should generate an increase, a decrease, or no change in relative mortality over the life course. Using data from France, the US and the UK for periods around 2010, we then examine typical age patterns of foreign-born vs. native-born mortality ratios in light of this theoretical framework. We find that these mortality ratios vary greatly by age, with important similarities across migrant groups and host countries. The most systematic age pattern we find is a U-shape pattern: at the aggregate level, migrants often experience excess mortality at young ages, then exhibit a large advantage at adult ages (with the largest advantage around age 45), and finally experience mortality convergence with natives at older ages. The explanation most consistent with this pattern is the “in-migration selection effects” explanation. By contrast, the “out-migration selection effects” explanation is poorly supported by the observed patterns. Our age disaggregation also shows that migrants at mid-adult ages experience mortality advantages that are often far greater than typically documented in this literature. Overall, these results reinforce the notion that migrants are a highly-selected population exhibiting mortality patterns that poorly reflect their living conditions in host countries.
Highlights
In the context of growing international mobility, health and mortality patterns among migrants are playing an increasingly-important role in many receiving countries, with implications for health care, health insurance schemes, and pension systems [1,2]
The only exception is foreign-born females in France, for whom the risk ratio is close to 1. These age-adjusted risk ratios, hide a huge amount of age-specific variation, including ages at which there is excess mortality, and ages at which the advantage is far greater than what would be indicated by the age-adjusted risk ratio
Not always statistically significant, the risk ratio starts above one at ages 5–9, followed by a steep decline in the ratio until a minimum somewhere around age 45. This minimum value, which varies in each host country, can sometimes be as low as .5, showing an advantage at these mid-adult ages that is far greater than typically documented in this literature
Summary
In the context of growing international mobility, health and mortality patterns among migrants are playing an increasingly-important role in many receiving countries, with implications for health care, health insurance schemes, and pension systems [1,2]. In the literature on mortality among migrants, the most pervasive finding is that migrants tend to exhibit lower mortality than the non-migrant population of their host countries This phenomenon, termed the Migrant Mortality Advantage (MMA), has been observed in a wide variety of receiving countries, including Australia [3,4], Belgium [5,6], Canada [7,8], France [9,10], Germany [11,12], the Netherlands [13], Switzerland [14], the United Kingdom [15,16,17], and the United States [18,19,20,21,22,23]. The relative contribution of each of these hypotheses in various contexts remains highly debated in the literature
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