Healthy immigrants, unhealthy ageing? Analysis of health decline among older migrants and natives across European countries

Immigrants face a particularly high risk of unhealthy ageing. It is well-known that the probability of having multiple chronic conditions simultaneously, or multimorbidity, tends to increase with age. This study investigates the immigrant-native disparities in age-related health decline, focusing on the number of chronic health conditions; and considers the heterogeneity of this decline within immigrant populations by origin and receiving country. We use data from the Survey of Health, Ageing and Retirement in Europe on adults aged 50 to 79 from 28 European countries, and employ fixed-effects regression models to account for the unobserved heterogeneity related to individual characteristics, including migration background. Our results indicate that immigrants have a higher number of chronic conditions at all ages relative to their native-born peers, but also that the immigrant-native differential in the number of chronic conditions decreases from age 65 onwards. When considering differences by origin country, we find that the speed of chronic disease accumulation is slower among immigrants from the Americas and the Asia and Oceania country groups than it among natives. When looking at differences by receiving country group, we observe that the speed of health decline is slower among immigrants in Eastern Europe than among natives, particularly at older ages. Our findings suggest that age-related trajectories of health vary substantially among immigrant populations by origin and destination country, which underscore that individual migration histories play a persistent role in shaping the health of ageing immigrant populations throughout the life course.