Gendering health differences between nonmigrants and migrants by duration of stay in Italy

Abstract

BACKGROUNDGender and migrant status are important factors for health. A common finding is that women report poorer health than men and that migrants' health converges with nonmigrants' health as the duration of stay in the host country increases. However, little is known about whether gender differences in health persist within migrant groups and whether the migrant-native health convergence differs by gender, especially in the Italian context. OBJECTIVEThis study aims to include the gender dimension in the analysis of the health differences between Italians and migrants by duration of stay, focusing on how gender interacts with duration of stay in determining migrants' health. METHODSWe performed multivariate logistic regression on a sample of 70,154 residents in Italy aged 20-64, using the 2013 Italian Health Survey. We modelled the association between duration of stay and three health dimensions by gender and computed predicted probabilities to show the interaction effect of gender and duration of stay. RESULTSWe found evidence of a migrant health advantage among recent migrant men and women that becomes weaker among long-term migrants. After a long duration of stay, differences in health between migrants and nonmigrants are slightly more pronounced among women than among men. CONTRIBUTIONThis is the first study in Italy that contributes to a more comprehensive understanding of the role played by gender in determining the health differences observed. The study

Mortality differences between migrants and Italians residing in Rome before, during, and in the aftermath of the great recession. A longitudinal cohort study from 2001 to 2015

“…It could also be explained by the economic downturn compounding precarious employment conditions and low socioeconomic status. Certainly, there is evidence that migrant health worsens with longer residence in the host country [44,[75][76][77]. However, in the absence of information about the length of stay, we cannot confirm this hypothesis.…”

“…This trend could be related to EU membership for Poland and the Czech Republic in 2004 and for Romania and Bulgaria in 2007. This modified the composition of migration flows to Italy, helped along by strong Italian demand for domestic workers and caregivers [77,78]. Finally, further studies are needed to investigate the socio-structural drivers of the differences in mortality that emerged in the analysis.…”

Going "beyond the mean" in analysing immigrant health disparities

“…3 The first insight into the presence of an HIE in Italy was provided by Moullan and Jusot (2014), who showed that immigrants' self-assessed health is better compared to natives. Subsequent studies that compare mortality rates or other physical and mental health outcomes between immigrants and Italians confirm the existence of an HIE (Fedeli et al 2015;Pacelli et al 2016) and suggest that it decreases over time (Petrelli et al 2017;Caselli, Loi, and Strozza 2017;Loi et al 2018;Loi and Hale 2019;Campostrini et al 2019;Trappolini and Giudici 2021). Studies on immigrants' health care use report mixed results.…”

“…The main explanation for the HIE in the Italian context is generally a positive selection effect in the country of origin (Pacelli et al 2016;Loi et al 2018;Trappolini and Giudici 2021). Some authors suggest that the salmon bias, which generally concerns the re-emigration to the country of origin of elderly and unhealthy immigrants, can also play a role (Pacelli et al 2016;Di Napoli et al 2021).…”

“…Italy, one of the leading countries harboring international migrants worldwide (UN 2019), has a vested interest in shedding light on the determinants of these differences, as the share of documented immigrants residing in Italy grew from about 2% at the turn of the century to almost 9% in the most recent figures (ISTAT 2020). Previous studies investigating the HIE in Italy also focused on mean differences (see, e.g., Petrelli et al 2017;Caselli, Loi, and Strozza 2017;Loi et al 2018;Loi and Hale 2019;Campostrini et al 2019;Trappolini and Giudici 2021). Hence, they do not permit us to assess whether factors contributing to health differences between Italians and immigrants, as well as among immigrants themselves, have differentiated effects across the health distribution.…”