Living longer in poorer health? Understanding the immigrant morbidity-mortality paradox

If the global foreign-born population all lived in single country, it would be the fifth largest country in the world. The rapid rise and diversification of contemporary worldwide migration has no precedent in history. There is clear evidence that immigrants are healthier than native-born populations are.

Although this health advantage is pervasive for mortality (i.e., death), it is regularly absent, or even reversed, for morbidity (i.e., diseases and medical conditions). This is alarming because it suggests that migrants are living long lives in poor overall health.

With immigrants ageing in place, this should constitute one of the most highly relevant social and public health concerns today.

Yet, beyond evidence from disparate data sources of variable quality and coverage, there is a distinct absence of direct, coherent, empirical knowledge of this morbidity-mortality paradox.To address this gap, I aim to establish the existence, extent, and causes of this immigrant morbidity-mortality paradox.

I will use cutting-edge techniques to analyse longitudinal micro-level data on morbidity and mortality from the same source of information: the population registers of Denmark, Finland, Norway and Sweden.Work Package A will reveal how prevalent an immigrant morbidity-mortality paradox is within the Nordic region and evaluate the role that this paradox plays in our understanding of wider population health.

Work Package B will identify the intricate disease spectrum, causes-of-death, and granular immigrant origins essential to understanding the paradox. Work Package C will identify the mechanisms that can explain the paradox.

This research has the potential to (1) transform the limited way in which the health of immigrants is currently conceptualised and understood, (2) revolutionise how researchers analyse immigrant health, (3) highlight immigrant health and its role in wider population health, and (4) directly inform national and international policy.