Mortality in adult immigrants in the 2000s in Belgium: a test of the ‘healthy‐migrant’ and the ‘migration‐as‐rapid‐health‐transition’ hypotheses

Abstract

Abstractobjective Firstly, to map out and compare all-cause and cause-specific mortality patterns by migrant background in Belgium; and secondly, to probe into explanations for the observed patterns, more specifically into the healthy-migrant, acculturation and the migration-as-rapid-health-transition theories.methods Data comprise individually linked Belgian census-mortality follow-up data for the period 2001-2011. All official inhabitants aged 25-54 at time of the census were included. To delve into the different explanations, differences in all-cause and chronic-and infectious-disease mortality were estimated using Poisson regression models, adjusted for age, socioeconomic position and urbanicity.results First-generation immigrants have lower all-cause and chronic-disease mortality than the host population. This mortality advantage wears off with length of stay and is more marked among non-Western than Western first-generation immigrants. For example, Western and non-Western male immigrants residing 10 years or more in Belgium have a mortality rate ratio for cardiovascular disease of 0.72 (95% CI 0.66-0.78) and 0.59 (95% CI 0.53-0.66), respectively (vs host population). The pattern of infectious-disease mortality in migrants is slightly different, with rather high mortality rates in first-generation sub-Saharan Africans and rather low rates in all other immigrant groups. As for second-generation immigrants, the picture is gloomier, with a mortality disadvantage that disappears after control for socioeconomic position.conclusion Findings are largely consistent with the healthy-migrant, acculturation and the migration-as-rapid-health-transition theories. The convergence of the mortality profile of secondgeneration immigrants towards that of the host population with similar socioeconomic position indicates the need for policies simultaneously addressing different areas of deprivation.

Cancer mortality by migrant background in Belgium during the 2000s: Patterns and social determinants

“…Mortality from cancer of the digestive tract was lower for Sub-Saharan Africans, Italians, Spaniards, and Moroccans. A recent study taking into account duration of residence and immigrant generation shows increased all-cancer and lung cancer mortality with longer residence in Belgium and in the second generation (SG) [12]. Additionally, socio-economic position (SEP) and urbanisation contribute to site-specific cancer mortality levels for all groups [12].…”

Cancer through black eyes - The views of UK based black men towards cancer: A constructivist grounded theory study

“…Hence, there is an argument for strongly targeting health promotion campaigns at first generation individuals to discourage uptake of high-risk health behaviours and encourage cessation of unhealthy behaviours such as unhealthy eating and smoking (Vandenheede et al, 2015). 22 Our findings indicated that cancer-related information provided by large government and charitable organisations was not specifically focused on black men; current information formats were unappealing even when they featured black men.…”

“…For example, our study indicated differences between the views of first and second generation participants. Other studies have reported a 'healthy migrant' advantage for first generation immigrants to a host country, regardless of socioeconomic position (Anson, 2004;Tarnutze et al, 2012;Vandenheede et al, 2015).…”

“…However, migrant health and mortality tend to converge to the levels of the host country with increasing duration of stay over subsequent generations (Parkin and Khlat, 1996;Vandenheede et al, 2015). Hence, there is an argument for strongly targeting health promotion campaigns at first generation individuals to discourage uptake of high-risk health behaviours and encourage cessation of unhealthy behaviours such as unhealthy eating and smoking (Vandenheede et al, 2015).…”

Health and mortality patterns among migrants in France

“…Shortly, the hypothesis of migration as 'accelerated health transition' predicts a fast decline of the initially high infectious-disease mortality of migrants and a progressive reduction of their advantage in terms of chronic disease mortality over time. Very few studies have investigated this hypothesis to date (Vandenheede et al, 2015;Wallace and Kulu, 2015).…”