Healthy Migrants in an Unhealthy City?

Over the last fifteen years, Glasgow has experienced a lot of change as a result of ‘new migration’.  Many of the neighbourhoods that GoWell is studying became ethnically diverse over this period, many for the first time.  Diversity is generally held to be good for a city in many respects, including in terms of the economy, educational outcomes and health.  The ‘healthy immigrant effect’ has been described to explain the positive impacts of immigration upon health, with migrants having better general health and healthier lifestyle behaviours than the indigenous population, either due to cultural differences, or as a result of self-selection and screening to ensure that only healthier people migrate.   
However, a second element of the ‘healthy immigrant’ thesis is that the immigrants’ health advantage declines over time as they become acculturated to their new society, adopt unhealthier behaviours, or become stressed through living in poor conditions and experiencing poverty.  Since many migrants live in deprived parts of Glasgow, some of which are subject to regeneration activity, what happens to migrants’ health over time may have an effect upon overall changes in community health, which we are looking at to see the impacts of  regeneration programmes. 

For this reason, we used GoWell survey data from 2008 and 2011 to examine the two elements of the healthy immigrant thesis, using four health indicators: self-rated health; a physical health score; a mental health score; and a mental wellbeing score.  Migrants were divided into social and economic migrants, and asylum seekers and refugees.   With regard to the first element of the healthy migrant thesis, we found that migrants tended to be healthier than their equivalent UK-born residents on all four measures, particularly migrants of both types living in adult households (below retirement age, without dependent children), and older migrants (above retirement age) who were asylum seekers and refugees.  

In relation to the second element of the healthy migrant thesis, we found that the health of social and economic migrants was worse, the longer they had lived in the UK, but that no clear pattern emerged for asylum seekers and refugees.   However, we found indications that the health of asylum seekers was worse the longer they had been waiting for a decision on their status, especially those who had been waiting five  years or more, and that the health of refugees improved in the first few years after their leave-to-remain decision had been received.   Furthermore, those asylum seekers and refugees who had been living in a deprived area for more than a year, had slightly better self-rated health and mental wellbeing than recent arrivals, whereas the health of the UK-born and of social and economic migrants deteriorated the longer they had lived in a deprived area.  

The results of our analysis suggest that the deterioration of migrants’ health over time may be the result of social integration and acculturation via employment and education for social and economic migrants (although we have not studied the health effects of low status employment and poverty itself), and that the spatial concentration of asylum seekers and refugees may be beneficial for protecting their health over time. 

The research is available in this open access article in the Journal of International Migration and Integration: Healthy Migrants in an Unhealthy City?  The Effects of Time on the Health of Migrants Living in Deprived Areas of Glasgow.