The definition of immigrant status matters: impact of nationality, country of origin, and length of stay in host country on mortality estimates
Abstract Background Mortality is a robust indicator of health and offers valuable insight into the health of immigrants. However, mortality estimates can vary significantly depending on the manner in which immigrant status is defined. Here, we assess the impact of nationality, country of origin, and...
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doaj-eed0005679754531a48a5b286d7265122020-11-25T01:27:48ZengBMCBMC Public Health1471-24582019-02-011911810.1186/s12889-019-6555-1The definition of immigrant status matters: impact of nationality, country of origin, and length of stay in host country on mortality estimatesLuis Andrés Gimeno-Feliu0Amaia Calderón-Larrañaga1Esperanza Díaz2Clara Laguna-Berna3Beatriz Poblador-Plou4Carlos Coscollar-Santaliestra5Alexandra Prados-Torres6EpiChron Research Group on Chronic Diseases, Aragón Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University HospitalEpiChron Research Group on Chronic Diseases, Aragón Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University HospitalDepartment of Global Public Health and Primary Care, Research Group for General Practice, University of BergenEpiChron Research Group on Chronic Diseases, Aragón Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University HospitalEpiChron Research Group on Chronic Diseases, Aragón Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University HospitalEpiChron Research Group on Chronic Diseases, Aragón Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University HospitalEpiChron Research Group on Chronic Diseases, Aragón Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University HospitalAbstract Background Mortality is a robust indicator of health and offers valuable insight into the health of immigrants. However, mortality estimates can vary significantly depending on the manner in which immigrant status is defined. Here, we assess the impact of nationality, country of origin, and length of stay in the host country on mortality estimates in an immigrant population in Aragón, Spain. Methods Cross-sectional retrospective study of all adult subjects from the EpiChron Cohort in 2011 (n = 1,102,544), of whom 146,100 were foreign-born (i.e., according to place of birth) and 127,213 were non-nationals (i.e., according to nationality). Directly standardized death proportions between years 2012–2015 were calculated, taking into account the age distribution of the European population in 2013. Binary logistic regression was used to compare the four-year probability of death. Results The age- and sex-standardized number of deaths per 1000 subjects were 45.1 (95%CI 44.7–45.2) for the Spanish-born population, 29.3 (95%CI 26.7–32.1) for the foreign-born population, and 18.4 (95%CI 15.6–21.6) for non-Spanish nationals. Compared with the Spanish-born population, the age- and sex-adjusted likelihood of dying was equally reduced in the foreign-born and non-national populations (OR 0.6; 95%CI 0.5–0.7) when the length of stay was less than 10 years. No significant differences in mortality estimates were detected when the length of stay was over 10 years. Conclusions Mortality estimates in immigrant populations were lower than those of the native Spanish population, regardless of the criteria applied. However, the proportion of deaths was lower when immigrant status was defined using nationality instead of country of birth. Age- and sex-standardized death proportions tended to increase with increased length of stay in the host country.http://link.springer.com/article/10.1186/s12889-019-6555-1Emigration and immigrationMortalityPopulation groupsHealth inequalitiesInternational healthSpain |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Luis Andrés Gimeno-Feliu Amaia Calderón-Larrañaga Esperanza Díaz Clara Laguna-Berna Beatriz Poblador-Plou Carlos Coscollar-Santaliestra Alexandra Prados-Torres |
spellingShingle |
Luis Andrés Gimeno-Feliu Amaia Calderón-Larrañaga Esperanza Díaz Clara Laguna-Berna Beatriz Poblador-Plou Carlos Coscollar-Santaliestra Alexandra Prados-Torres The definition of immigrant status matters: impact of nationality, country of origin, and length of stay in host country on mortality estimates BMC Public Health Emigration and immigration Mortality Population groups Health inequalities International health Spain |
author_facet |
Luis Andrés Gimeno-Feliu Amaia Calderón-Larrañaga Esperanza Díaz Clara Laguna-Berna Beatriz Poblador-Plou Carlos Coscollar-Santaliestra Alexandra Prados-Torres |
author_sort |
Luis Andrés Gimeno-Feliu |
title |
The definition of immigrant status matters: impact of nationality, country of origin, and length of stay in host country on mortality estimates |
title_short |
The definition of immigrant status matters: impact of nationality, country of origin, and length of stay in host country on mortality estimates |
title_full |
The definition of immigrant status matters: impact of nationality, country of origin, and length of stay in host country on mortality estimates |
title_fullStr |
The definition of immigrant status matters: impact of nationality, country of origin, and length of stay in host country on mortality estimates |
title_full_unstemmed |
The definition of immigrant status matters: impact of nationality, country of origin, and length of stay in host country on mortality estimates |
title_sort |
definition of immigrant status matters: impact of nationality, country of origin, and length of stay in host country on mortality estimates |
publisher |
BMC |
series |
BMC Public Health |
issn |
1471-2458 |
publishDate |
2019-02-01 |
description |
Abstract Background Mortality is a robust indicator of health and offers valuable insight into the health of immigrants. However, mortality estimates can vary significantly depending on the manner in which immigrant status is defined. Here, we assess the impact of nationality, country of origin, and length of stay in the host country on mortality estimates in an immigrant population in Aragón, Spain. Methods Cross-sectional retrospective study of all adult subjects from the EpiChron Cohort in 2011 (n = 1,102,544), of whom 146,100 were foreign-born (i.e., according to place of birth) and 127,213 were non-nationals (i.e., according to nationality). Directly standardized death proportions between years 2012–2015 were calculated, taking into account the age distribution of the European population in 2013. Binary logistic regression was used to compare the four-year probability of death. Results The age- and sex-standardized number of deaths per 1000 subjects were 45.1 (95%CI 44.7–45.2) for the Spanish-born population, 29.3 (95%CI 26.7–32.1) for the foreign-born population, and 18.4 (95%CI 15.6–21.6) for non-Spanish nationals. Compared with the Spanish-born population, the age- and sex-adjusted likelihood of dying was equally reduced in the foreign-born and non-national populations (OR 0.6; 95%CI 0.5–0.7) when the length of stay was less than 10 years. No significant differences in mortality estimates were detected when the length of stay was over 10 years. Conclusions Mortality estimates in immigrant populations were lower than those of the native Spanish population, regardless of the criteria applied. However, the proportion of deaths was lower when immigrant status was defined using nationality instead of country of birth. Age- and sex-standardized death proportions tended to increase with increased length of stay in the host country. |
topic |
Emigration and immigration Mortality Population groups Health inequalities International health Spain |
url |
http://link.springer.com/article/10.1186/s12889-019-6555-1 |
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