Does nativity affect health status? Health disparities in middle-aged and older migrants in Europe

Background. As various studies have shown, middle-aged and older migrants living in Europe generally have worse health than the native population. Thus, the health of this subgroup will have a significant impact on the health care system in terms of increasing demands for health care and social support. Aims The aim of this paper is to go beyond examining the main effects of immigration status on self-perceived and mental health to the extent to which social, structural and behavioural contexts explain any disparities. We examine health differences between immigrants and native-born populations aged 50 and older in eleven European countries, using data from the Survey on Health, Ageing and Retirement in Europe (SHARE) database. Our hypothesis is that, according to the “multiple jeopardy” theory, health inequalities among elders of migrant groups may be explained by nativity (“being an immigrant” as opposed to being a native) in addition to ageing itself and the socio-demographic and economic factors. We also consider the role of duration of residence and country-fixed effects play in accounting for observed health disparities. Results As logistic regression reveals, foreign-born individuals are more likely to have worse health status in terms of self-perceived and mental health than their native-born counterparts, even when demographic and socio-economic variables are taken into account. Nativity is a strong independent risk factor, especially for self-perceived health. This study also highlights the importance of age at arrival in examining health status among immigrants. Estimations show decreasing health satisfaction among foreign-born people who have migrated in the host country during mature and young adulthood, while those who migrated during childhood can be assimilated to natives.