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A 'healthy immigrant effect' or a 'sick immigrant effect'? Selection and policies matter

Amelie Constant, Teresa García-Muñoz, Shoshana Neuman & Tzahi Neuman

Previous literature in a variety of countries has documented a "healthy immigrant effect" (HIE). Accordingly, immigrants arriving in the host country are, on average, healthier than comparable natives. However, their health status dissipates with additional years in the country. HIE is explained through the positive self-selection of the healthy immigrants as well as the positive selection, screening and discrimination applied by host countries. In this paper we study the health of immigrants within the context of selection and migration policies. Using SHARE data we examine the HIE comparing Israel and sixteen countries in Europe that have fundamentally different migration policies. Israel has virtually unrestricted open gates for Jewish people around the world, who in turn have ideological rather than economic considerations to move. European countries have selective policies with regards to the health, education and wealth of migrants, who also self-select themselves. Our results provide evidence that a) immigrants to Israel have compromised health and suffer from many health ailments, making them less healthy than comparable natives. Their health does not improve for up to 20 years of living in Israel, after which they become similar to natives; b) immigrants to Europe have better health than natives and their health advantage persists up to six years from their arrival, after which they are not significantly different than natives except in one case in which the health of immigrants became worse than that of natives after 21 years. Our results are important for migration policy and relevant for domestic health policy.

Keywords: self-reported health status, immigration, Europe, Israel, older population, multilevel regression, SHARE

JEL Classification: C22, J11, J12, J14, O12, O15, O52