Although immigrants from Italy and their offspring form one of the largest demographic groups in Switzerland, there are hardly any studies on their state of health and risk of mortality. In a first for Switzerland, Silvan Tarnutzer and Matthias Bopp from the University of Zurich's Institute of Social and Preventative Medicine calculated unbiased mortality risks for people with an Italian migrant background.
Immigrants from Italy live longer than Swiss people
Compared to Swiss people born in Switzerland, immigrant Italians exhibit a mortality risk that is roughly ten percent lower. Younger male Italians especially fair better than the Swiss, although the differences become increasingly smaller the older they are. At first glance, this finding is astonishing as Italian immigrants often only have a low school education and below-average income -- both factors associated with higher risks of mortality. The greater prevalence of smoking and overweight people and poorer assessment of one's own health in Italy compared to Switzerland also point in the same direction. On a behavioral level, this is merely counteracted by the Mediterranean diet -- the frequent consumption of fish, fruit, vegetables and olive oil -- and the distinctive social network. First author of the study Silvan Tarnutzer thus assumes that the lower risks of mortality can primarily be put down to the so-called "healthy migrant effect," according to which particularly healthy and bold people often migrate while weaker and ill people do not even start looking for a job abroad in the first place or, in the event of illness, return to their country of origin.
Next generations at greater risk of mortality
As far as the offspring of migrants born in Switzerland are concerned, however, this head start disappears. The lifestyle of the host country influences Italians from subsequent generations during their personal development and they detach themselves from the healthy southern lifestyle and close-knit family network. For instance, Italians born in Switzerland display a 16 percent greater risk of mortality than locals. "Presumably as a result of the double burden of poorer educational opportunities and a more unfavorable lifestyle," says co-author Matthias Bopp. Interestingly, women seem to be affected by this unfavorable risk constellation to a lesser degree. "Due to their large number and on average younger age, the male offspring of Italian immigrants constitutes a special target group for prevention and the promotion of health," concludes Tarnutzer.
Many immigrants from Italy have a residence in Switzerland and Italy, which means that deaths abroad are often not registered in Switzerland. This leads to an underestimation of the actual mortality risks.
By using the "Swiss National Cohort," a combination of data from the 1990 census and the death and foreigner register from 1990 and 2008, however, Tarnutzer and Bopp were able to avoid this under-registration. In doing so, they distinguished between the immigrant generation and subsequent generations born in Switzerland.
- Silvan Tarnutzer, Matthias Bopp. Healthy migrants but unhealthy offspring? a retrospective cohort study among Italians in Switzerland. BMC Public Health, 2012; 12 (1): 1104 DOI: 10.1186/1471-2458-12-1104
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