Is there a Mediterranean migrants mortality paradox in Europe?

Myriam Khlat · Nicole Darmon

102 citations0/0 files storedInternational Journal of Epidemiology

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Migration, Health and Trauma Health disparities and outcomes Migration, Identity, and Health

Abstract

Sirs—Compared with non-Hispanic Whites, Hispanics in the US are poorer and less educated, and yet they enjoy a lower all-cause mortality rate. This so-called ‘Hispanic Paradox’ has received much attention over the past 20 years, both in the epidemiological and demographic literature. Besides artefactual explanations (i.e. possible under-reporting of Hispanic deaths on death certificates), competing theories fall into two categories: the ‘salmon bias hypothesis’, according to which migrants are likely to return to their country of origin after they retire or become seriously ill, and, the ‘healthy migrant hypothesis’, according to which those who migrate and remain in the host country are the healthiest and strongest members of their population of origin. To date, two reviews have documented extensively the wealth of literature on the Hispanic paradox. One, which is very critical of the concept, focuses on low birthweight and infant mortality;1 the other, which is relatively supportive, covers all the different health components involved in the paradox (mortality, infant mortality, violence, AIDS, coronary heart disease, stroke, cancer, and diabetes).2 The first concludes that the evidence supporting the paradox is fragile and highlights the potential role of selective processes in explaining the migrants’ advantage, while the second puts forward the complexity of the picture, with variations by age, gender, type of Hispanic group, degree of acculturation, and specific disease or cause of death.

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References

1999The Latino mortality paradox: a test of the "salmon bias" and healthy migrant hypotheses.2001Understanding the Hispanic paradox.2001Interpreting the Paradoxical in the Hispanic Paradox 1994Latino Outlook: Good Health, Uncertain Prognosis 1998Low overall mortality of Turkish residents in Germany persists and extends into a second generation: merely a healthy migrant effect?*2000The ‘healthy migrant effect’–not merely a fallacy of inaccurate denominator figures 2002Life expectancy and mortality differences between migrant groups living in Amsterdam, the Netherlands 2001Population health and aging : strengthening the dialogue between epidemiology and demography

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