Tropical Medicine and International Health
Volume 19, Issue 8, 2014, Pages 958-967

Duration of residence and disease occurrence among refugees and family reunited immigrants: Test of the 'healthy migrant effect' hypothesis (Article)

Norredam M.* , Agyemang C. , Hoejbjerg Hansen O.K. , Petersen J.H. , Byberg S. , Krasnik A. , Kunst A.E.
  • a Danish Research Centre for Migration, Ethnicity and Health, Section of Health Services Research, Department of Public Health, University of Copenhagen, Copenhagen, Denmark, Section of Immigrant Medicine, Department of Infectious Disease, University Hospital Copenhagen, Hvidovre, Denmark
  • b Department of Social Medicine, Amsterdam Medical Centre, Amsterdam University, Amsterdam, Netherlands
  • c Section for Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
  • d Section for Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
  • e Danish Research Centre for Migration, Ethnicity and Health, Section of Health Services Research, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
  • f Danish Research Centre for Migration, Ethnicity and Health, Section of Health Services Research, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
  • g Department of Social Medicine, Amsterdam Medical Centre, Amsterdam University, Amsterdam, Netherlands

Abstract

Objectives: The 'healthy migrant effect' (HME) hypothesis postulates that health selection has a positive effect on migrants' health outcomes, especially in the first years after migration. We examined the potential role of the HME by assessing the association between residence duration and disease occurrence. Methods: We performed a historical prospective cohort study. We included migrants who obtained residence permits in Denmark between 1 January 1993 and 31 December 2010 (n = 114 331). Occurrence of severe conditions was identified through linkage to the Danish National Patient Register. Hazard Ratios (HRs) were modelled for disease incidence by residence duration since arrival (0-5 years; 0-10 years; 0-18 years) adjusting for age and sex. Results: Compared with Danish-born individuals, refugees and family reunited immigrants had lower HRs of stroke and breast cancer within 5 years after arrival; however, HRs increased at longer follow-up. For example, HRs of stroke among refugees increased from 0.77 (95% CI: 0.66; 0.91) to 0.96 (95% CI: 0.88; 1.05). For ischaemic heart disease (IHD) and diabetes, refugees and family reunited migrants had higher HRs within 5 years after arrival, and most HRs had increased by end of follow-up. For example, HRs of IHD among family reunited migrants increased from 1.29 (95% CI: 1.17; 1.42) to 1.43 (95% CI: 1.39; 1.52). In contrast, HRs for TB and HIV/AIDS showed a consistent decrease over time. Conclusion: Our analyses of the effect of duration of residence on disease occurrence among migrants imply that, when explaining migrants' advantageous health outcomes, the ruling theory of the HME should be used with caution, and other explanatory models should be included. © 2014 John Wiley & Sons Ltd.

Author Keywords

Migration immigrants Refugees Communicable disease Non-communicable disease Duration of residence

Index Keywords

prospective study immigrant breast cancer refugee Registries Human immunodeficiency virus infection Stroke cerebrovascular accident lung cancer Follow-Up Studies follow up Prospective Studies human emigrantes Refugees middle aged Denmark diabetes mellitus health status hypothesis testing hazard ratio cancer Human immunodeficiency virus Residence Characteristics asylum seeker Humans family cardiovascular disease male Diseases Emigrants and Immigrants female tuberculosis residence time Article communicable disease adult major clinical study migration diabetes ischemic heart disease cohort analysis Emigration and Immigration non-communicable disease Transients and Migrants maladies non transmissibles enfermedades transmisibles duration of residence duración de residencia maladies transmissibles refugiados disease incidence acquired immune deficiency syndrome citizenship inmigración réfugiés durée de résidence public health immigrants
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84903595308&doi=10.1111%2ftmi.12340&partnerID=40&md5=4b11ffe9c2a145d71942c73b21514795
DOI: 10.1111/tmi.12340
ISSN: 13602276
Cited by: 54
Original Language: English