Migration and geographical inequalities in health in the Netherlands: an investigation of age patterns
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ORIGINAL ARTICLE
Migration and geographical inequalities in health in the Netherlands: an investigation of age patterns Birthe Jongeneel-Grimen • Marie¨l Droomers • Karien Stronks J. A. M. van Oers • Anton E. Kunst
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Received: 3 November 2011 / Revised: 10 February 2013 / Accepted: 14 March 2013 Ó Swiss School of Public Health 2013
Abstract Objectives This paper estimates, for six different age groups, whether and how migration influences inequalities in health between deprived and non-deprived neighbourhoods in the Netherlands. Methods Data were accessed from the Netherlands Housing Survey 2006. Using multi-level logistic regression analyses, we compared the health of migrants with that of nonmigrants in the area of origin and assessed the role of demographic and socioeconomic characteristics. Next, we assessed the magnitude of health differences between deprived versus non-deprived areas among migrants and non-migrants. Results For many age groups, migrants into non-deprived areas were healthier and migrants into deprived areas had similar levels of health compared with non-migrant populations in the area of origin. These differences in health were not explained by demographic and socio-economic characteristics. For all ages and for people aged 25–34 years we found smaller area inequalities in health
B. Jongeneel-Grimen (&) M. Droomers K. Stronks A. E. Kunst Department of Public Health, Academic Medical Centre, University of Amsterdam, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands e-mail: [email protected] J. A. M. van Oers Centre for Public Health Status and Forecasting, National Institute for Public Health and the Environment, Bilthoven, The Netherlands J. A. M. van Oers Academic Collaborative Centre for Public Health Brabant, Tranzo, Faculty of Social Sciences, University of Tilburg, Tilburg, The Netherlands
among migrants compared with non-migrants. For most other age groups, about equally large differences were observed. Conclusions For most age groups, the results do not provide empirical support to the expectation that migration would enlarge health differences between deprived and non-deprived neighbourhoods. Keywords The Netherlands Health inequalities Selective migration Age patterns Socioeconomic factors Morbidity
Introduction An extensive amount of research has shown that people living in deprived areas have higher mortality and poorer physical health. This relationship largely but not entirely disappears once individual-level characteristics are controlled for (Chaix et al. 2006; Curtis et al. 2009; JongeneelGrimen et al. 2011). Inequalities in health between deprived and non-deprived areas may have been growing in recent years (Shaw et al. 2000; Davey Smith et al. 2002; Norman et al. 2005; Pearce and Dorling 2006; Leyland et al. 2007; Connolly et al. 2007). The mechanisms that might explain area inequalities in health are not yet fully clear. One factor that may contribute to the existing area inequalities in health is selective internal migration (Brimblecombe et al
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