Journal of Epidemiology and Community Health
Volume 71, Issue 9, 2017, Pages 863-869

Do cardiometabolic, behavioural and socioeconomic factors explain the 'healthy migrant effect' in the UK? Linked mortality follow-up of South Asians compared with white Europeans in the Newcastle Heart Project (Article)

Hayes L.* , White M. , McNally R.J.Q. , Unwin N. , Tran A. , Bhopal R.
  • a Health and Society, Institute of Health and Society, Newcastle University, Newcastle upon Tyne, United Kingdom
  • b Health and Society, Institute of Health and Society, Newcastle University, Newcastle upon Tyne, United Kingdom, MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
  • c Health and Society, Institute of Health and Society, Newcastle University, Newcastle upon Tyne, United Kingdom
  • d Health and Society, Institute of Health and Society, Newcastle University, Newcastle upon Tyne, United Kingdom, MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom, Chronic Disease Research Centre, University of the West Indies, Bridgetown, Barbados
  • e Health and Society, Institute of Health and Society, Newcastle University, Newcastle upon Tyne, United Kingdom
  • f Edinburgh Migration, Ethnicity and Health Research Group, Centre for Population Health Sciences, Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom

Abstract

Background Immigrants are sometimes found to have better health than locally born populations. We examined the mortality experience of South Asian origin and white European origin individuals living in Newcastle upon Tyne, UK. Methods A linked 17-21 year mortality follow-up of a cross-sectional study of European (n=825) and South Asian (n=709) men and women, aged 25-74 years, recruited between 1993 and 1997. Poisson regression was used to estimate mortality rate ratios (MRRs) for allcause mortality. Sensitivity analysis explored the possible effect of differences between ethnic groups in loss to follow-up. The impact of adjustment for established risk factors on MRRs was studied. Results South Asians had lower all-cause age-adjusted and sex-adjusted mortality than Europeans (MRR 0.70; 95% CI 0.58 to 0.85). There was higher loss to follow-up in South Asians. Sensitivity analyses demonstrated that this did not account for the observed lower mortality. Adjustment for cardiometabolic, behavioural and socioeconomic characteristics attenuated but did not eliminate the mortality differences between South Asians and Europeans, although CIs now cross 1 (MRR 0.79; 95% CI 0.55 to 1.13). Conclusions South Asians had lower all-cause mortality compared with European origin individuals living in Newcastle upon Tyne that were not accounted for by incomplete mortality data. It is possible that such migrants to the UK have the resources and motivation to move in search of better opportunities and may be healthier and wealthier than those who remain in their country of origin. These findings challenge us to better understand and measure the factors contributing to their survival advantage. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017.

Author Keywords

[No Keywords available]

Index Keywords

immigrant regression analysis heart South Asian European follow up motivation human ethnic group controlled study health status sensitivity analysis socioeconomic status cross-sectional study South Asia migrant ethnic difference male England female risk factor Behavior socioeconomics cardiology major clinical study adult Newcastle upon Tyne [England] mortality rate Newcastle upon Tyne [Newcastle upon Tyne (DST)] United Kingdom mortality
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85027245393&doi=10.1136%2fjech-2017-209348&partnerID=40&md5=8c30757524b0fe2615869b3085fa3d3a
DOI: 10.1136/jech-2017-209348
ISSN: 0143005X
Cited by: 3
Original Language: English