Self-selection in physical and mental health among older intra-European migrants

The Healthy Immigrant Paradox found in the literature by comparing the health of immigrants with that of natives in the destination country, may suffer from serious social and cultural biases. Our study avoids such biases by utilizing an origin–destination framework, which compares the health of emigrants with compatriots who remain in the origin country. Isolating cultural effects can best gauge the effects of migration and of living abroad on the health of migrants. We study both the physical and mental dimensions of health among European-born emigrants over 50, who originate from seven European countries and live in fourteen different destination countries in Europe. We test three hypotheses concerning self-selection, adaptation, and compositional influences with data from the Survey of Health, Ageing and Retirement in Europe and apply multi-level modeling. For physical health we find positive self-selection, beneficial adaptation effects, and effects from other observables for some but not all countries. For mental health, we cannot confirm self-selection, with the notable exception of German émigrés, while additional years abroad and other characteristics have only weak effects. On balance, living abroad has a favorable impact on the health of older European emigrants. Free intra-European mobility and the economic similarity of European countries appear to reduce the role of self-selection in health and to improve the migration experience. Our results are robust to several tests.