Association between Integration Policies and Immigrants' Mortality: An Explorative Study across Three European Countries
To integrate immigrants into their societies, European countries have adopted different types of policies, which may influence health through both material and psychosocial determinants. Recent studies have suggested poorer health outcomes for immigrants living in countries with poorly rated integra...
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| creator | Ikram, Umar Z Malmusi, Davide Juel, Knud Rey, Grégoire Kunst, Anton E |
| description | To integrate immigrants into their societies, European countries have adopted different types of policies, which may influence health through both material and psychosocial determinants. Recent studies have suggested poorer health outcomes for immigrants living in countries with poorly rated integration policies.
To analyse mortality differences of immigrants from the same country of origin living in countries with distinct integration policy contexts.
From the mortality dataset collected in the Migrant Ethnic Health Observatory (MEHO) project, we chose the Netherlands (linked data from 1996-2006), France (unlinked; 2005-2007) and Denmark (linked; 1992-2001) as representatives of the inclusive, assimilationist and exclusionist policy models, respectively, based on the Migrant Integration Policy Index. We calculated for each country sex- and age-standardized mortality rates for Turkish-, Moroccan- and local-born populations aged 20-69 years. Poisson regression was used to estimate the mortality rate ratios (MRRs) for cross-country and within-country comparisons. The analyses were further stratified by age group and cause of death.
Compared with their peers in the Netherlands, Turkish-born immigrants had higher all-cause mortality in Denmark (MRR men 1.92; 95% CI 1.74-2.13 and women 2.11; 1.80-2.47) but lower in France (men 0.64; 0.59-0.69 and women 0.58; 0.51-0.67). A similar pattern emerged for Moroccan-born immigrants. The relative differences between immigrants and the local-born population were also largest in Denmark and lowest in France (e.g., Turkish-born men MRR 1.52; 95% CI 1.38-1.67 and 0.62; 0.58-0.66, respectively). These patterns were consistent across all age groups, and more marked for cardiovascular diseases.
Although confounders and data comparability issues (e.g., French cross-sectional data) may affect the findings, this study suggests that different macro-level policy contexts may influence immigrants' mortality. Comparable mortality registration systems across Europe along with detailed socio-demographic information on immigrants may help to better assess this association. |
| doi_str_mv | 10.1371/journal.pone.0129916 |
| format | Article |
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To analyse mortality differences of immigrants from the same country of origin living in countries with distinct integration policy contexts.
From the mortality dataset collected in the Migrant Ethnic Health Observatory (MEHO) project, we chose the Netherlands (linked data from 1996-2006), France (unlinked; 2005-2007) and Denmark (linked; 1992-2001) as representatives of the inclusive, assimilationist and exclusionist policy models, respectively, based on the Migrant Integration Policy Index. We calculated for each country sex- and age-standardized mortality rates for Turkish-, Moroccan- and local-born populations aged 20-69 years. Poisson regression was used to estimate the mortality rate ratios (MRRs) for cross-country and within-country comparisons. The analyses were further stratified by age group and cause of death.
Compared with their peers in the Netherlands, Turkish-born immigrants had higher all-cause mortality in Denmark (MRR men 1.92; 95% CI 1.74-2.13 and women 2.11; 1.80-2.47) but lower in France (men 0.64; 0.59-0.69 and women 0.58; 0.51-0.67). A similar pattern emerged for Moroccan-born immigrants. The relative differences between immigrants and the local-born population were also largest in Denmark and lowest in France (e.g., Turkish-born men MRR 1.52; 95% CI 1.38-1.67 and 0.62; 0.58-0.66, respectively). These patterns were consistent across all age groups, and more marked for cardiovascular diseases.
Although confounders and data comparability issues (e.g., French cross-sectional data) may affect the findings, this study suggests that different macro-level policy contexts may influence immigrants' mortality. Comparable mortality registration systems across Europe along with detailed socio-demographic information on immigrants may help to better assess this association.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0129916</identifier><identifier>PMID: 26067249</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Acculturation ; Adult ; Age ; Aged ; Aliens ; Cardiovascular disease ; Cardiovascular diseases ; Citizenship ; Community Integration - statistics & numerical data ; Cultural differences ; Demographics ; Emigrants and Immigrants - statistics & numerical data ; Europe ; Female ; Heart diseases ; Humans ; Immigrants ; Immigration ; Integration ; Male ; Men ; Middle Aged ; Migration ; Minority & ethnic groups ; Mortality ; Mortality - ethnology ; Multiculturalism & pluralism ; Noncitizens ; Poisson density functions ; Policies ; Politics ; Public health ; Regression analysis ; Statistical analysis ; Systematic review</subject><ispartof>PloS one, 2015-06, Vol.10 (6), p.e0129916-e0129916</ispartof><rights>2015 Ikram et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2015 Ikram et al 2015 Ikram et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c592t-f1704b2a3a994aa1007eda1d1a43fcb01328c3c95c4f60f7451e73d67ac571643</citedby><cites>FETCH-LOGICAL-c592t-f1704b2a3a994aa1007eda1d1a43fcb01328c3c95c4f60f7451e73d67ac571643</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4466572/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4466572/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793,79600,79601</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26067249$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Ciccozzi, Massimo</contributor><creatorcontrib>Ikram, Umar Z</creatorcontrib><creatorcontrib>Malmusi, Davide</creatorcontrib><creatorcontrib>Juel, Knud</creatorcontrib><creatorcontrib>Rey, Grégoire</creatorcontrib><creatorcontrib>Kunst, Anton E</creatorcontrib><title>Association between Integration Policies and Immigrants' Mortality: An Explorative Study across Three European Countries</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>To integrate immigrants into their societies, European countries have adopted different types of policies, which may influence health through both material and psychosocial determinants. Recent studies have suggested poorer health outcomes for immigrants living in countries with poorly rated integration policies.
To analyse mortality differences of immigrants from the same country of origin living in countries with distinct integration policy contexts.
From the mortality dataset collected in the Migrant Ethnic Health Observatory (MEHO) project, we chose the Netherlands (linked data from 1996-2006), France (unlinked; 2005-2007) and Denmark (linked; 1992-2001) as representatives of the inclusive, assimilationist and exclusionist policy models, respectively, based on the Migrant Integration Policy Index. We calculated for each country sex- and age-standardized mortality rates for Turkish-, Moroccan- and local-born populations aged 20-69 years. Poisson regression was used to estimate the mortality rate ratios (MRRs) for cross-country and within-country comparisons. The analyses were further stratified by age group and cause of death.
Compared with their peers in the Netherlands, Turkish-born immigrants had higher all-cause mortality in Denmark (MRR men 1.92; 95% CI 1.74-2.13 and women 2.11; 1.80-2.47) but lower in France (men 0.64; 0.59-0.69 and women 0.58; 0.51-0.67). A similar pattern emerged for Moroccan-born immigrants. The relative differences between immigrants and the local-born population were also largest in Denmark and lowest in France (e.g., Turkish-born men MRR 1.52; 95% CI 1.38-1.67 and 0.62; 0.58-0.66, respectively). These patterns were consistent across all age groups, and more marked for cardiovascular diseases.
Although confounders and data comparability issues (e.g., French cross-sectional data) may affect the findings, this study suggests that different macro-level policy contexts may influence immigrants' mortality. Comparable mortality registration systems across Europe along with detailed socio-demographic information on immigrants may help to better assess this association.</description><subject>Acculturation</subject><subject>Adult</subject><subject>Age</subject><subject>Aged</subject><subject>Aliens</subject><subject>Cardiovascular disease</subject><subject>Cardiovascular diseases</subject><subject>Citizenship</subject><subject>Community Integration - statistics & numerical data</subject><subject>Cultural differences</subject><subject>Demographics</subject><subject>Emigrants and Immigrants - statistics & numerical data</subject><subject>Europe</subject><subject>Female</subject><subject>Heart diseases</subject><subject>Humans</subject><subject>Immigrants</subject><subject>Immigration</subject><subject>Integration</subject><subject>Male</subject><subject>Men</subject><subject>Middle Aged</subject><subject>Migration</subject><subject>Minority & ethnic groups</subject><subject>Mortality</subject><subject>Mortality - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ikram, Umar Z</au><au>Malmusi, Davide</au><au>Juel, Knud</au><au>Rey, Grégoire</au><au>Kunst, Anton E</au><au>Ciccozzi, Massimo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association between Integration Policies and Immigrants' Mortality: An Explorative Study across Three European Countries</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2015-06-12</date><risdate>2015</risdate><volume>10</volume><issue>6</issue><spage>e0129916</spage><epage>e0129916</epage><pages>e0129916-e0129916</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>To integrate immigrants into their societies, European countries have adopted different types of policies, which may influence health through both material and psychosocial determinants. Recent studies have suggested poorer health outcomes for immigrants living in countries with poorly rated integration policies.
To analyse mortality differences of immigrants from the same country of origin living in countries with distinct integration policy contexts.
From the mortality dataset collected in the Migrant Ethnic Health Observatory (MEHO) project, we chose the Netherlands (linked data from 1996-2006), France (unlinked; 2005-2007) and Denmark (linked; 1992-2001) as representatives of the inclusive, assimilationist and exclusionist policy models, respectively, based on the Migrant Integration Policy Index. We calculated for each country sex- and age-standardized mortality rates for Turkish-, Moroccan- and local-born populations aged 20-69 years. Poisson regression was used to estimate the mortality rate ratios (MRRs) for cross-country and within-country comparisons. The analyses were further stratified by age group and cause of death.
Compared with their peers in the Netherlands, Turkish-born immigrants had higher all-cause mortality in Denmark (MRR men 1.92; 95% CI 1.74-2.13 and women 2.11; 1.80-2.47) but lower in France (men 0.64; 0.59-0.69 and women 0.58; 0.51-0.67). A similar pattern emerged for Moroccan-born immigrants. The relative differences between immigrants and the local-born population were also largest in Denmark and lowest in France (e.g., Turkish-born men MRR 1.52; 95% CI 1.38-1.67 and 0.62; 0.58-0.66, respectively). These patterns were consistent across all age groups, and more marked for cardiovascular diseases.
Although confounders and data comparability issues (e.g., French cross-sectional data) may affect the findings, this study suggests that different macro-level policy contexts may influence immigrants' mortality. Comparable mortality registration systems across Europe along with detailed socio-demographic information on immigrants may help to better assess this association.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>26067249</pmid><doi>10.1371/journal.pone.0129916</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Acculturation Adult Age Aged Aliens Cardiovascular disease Cardiovascular diseases Citizenship Community Integration - statistics & numerical data Cultural differences Demographics Emigrants and Immigrants - statistics & numerical data Europe Female Heart diseases Humans Immigrants Immigration Integration Male Men Middle Aged Migration Minority & ethnic groups Mortality Mortality - ethnology Multiculturalism & pluralism Noncitizens Poisson density functions Policies Politics Public health Regression analysis Statistical analysis Systematic review |
| title | Association between Integration Policies and Immigrants' Mortality: An Explorative Study across Three European Countries |
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