Loneliness as a pathway to immigrant health decline: a longitudinal mediation analysis in Germany

Objectives Despite often having better health at arrival, and at young ages, there is evidence that immigrants age at a faster pace than non-immigrants over the life course. One potential mediator in the relationship between migration background and health deterioration is loneliness. This study examines the direct impact of migration-related factors on mental and physical health trajectories, as well as their indirect effects through loneliness in the German context. Methods Using data from the 2012–2020 German Socio-Economic Panel (SOEP), we apply a parallel process latent growth curve model (PPM) with mediation analysis to examine the long-term impact of migration background and age at migration on physical and mental health trajectories. We also explore the mediating role of loneliness in this relationship. The analysis is stratified by gender. Results Loneliness fully mediates the relationship between migration background and mental health, as immigrants are more likely to experience loneliness, which in turn leads to worse mental health. Immigrants who moved to Germany after age 18 are more likely to experience loneliness, resulting in poorer mental health. This mechanism is particularly pronounced among women. Discussion Loneliness contributes to mental health disparities between immigrants and non-immigrants. Women who migrated after age 18 are particularly vulnerable. This study presents an innovative approach to examining the mechanisms behind health disparities by migration background. Interventions targeted at reducing loneliness may help to reduce health disparities between immigrants and non-immigrants.