Skip to main content

Advertisement

Log in

Association between cultural distance and migrant self-rated health

  • Original Paper
  • Published:
The European Journal of Health Economics Aims and scope Submit manuscript

Abstract

We study whether migrant health in Europe is associated with the cultural distance between their host country and country of origin. To this end, we run multilevel regression models on data merging self-rated health and social background of ≥3800 migrants from the European Social Survey with an index of cultural distance based on country differences in values, norms and attitudes measured in the World Values Survey. We find that higher levels of cultural distance are associated with worse migrant health. This association is comparable in size with the negative association between health and female (compared with male) gender but less important than the association between health and education level. In addition, this association is less significant among second-generation than first-generation migrants.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Cunningham, S.A., Ruben, J.D., Narayan, K.M.V.: Health of foreign-born people in the United States: a review. Health Place 14, 623–635 (2008)

    Article  Google Scholar 

  2. Rubalcava, L.N., Teruel, G.M., Thomas, D., Goldman, N.: The healthy migrant effect: new findings from the Mexican family life survey. Am. J. Public Health 98, 78–84 (2008)

    Article  PubMed  PubMed Central  Google Scholar 

  3. Singh, G.K., Siahpush, M.: Ethnic-immigrant differentials in health behaviors, morbidity, and cause-specific mortality in the United States: an analysis of two national data bases. Hum. Biol. 74, 83–109 (2002)

    Article  PubMed  Google Scholar 

  4. Wengler, A.: The health status of first- and second-generation Turkish immigrants in Germany. Int. J. Public Health 56, 493–501 (2011)

    Article  PubMed  Google Scholar 

  5. Lorant, V., Van Oyen, H., Thomas, I.: Contextual factors and immigrants’ health status: double jeopardy. Health Place 14, 678–692 (2008)

    Article  PubMed  Google Scholar 

  6. Ljunge, M.: Migrants, health, and happiness: evidence that health assessments travel with migrants and predict well-being. Econ. Hum. Biol. 22, 35–46 (2016)

    Article  PubMed  Google Scholar 

  7. Nesterko, N., Braehler, E., Grande, G., Glaesmer, H.: Life satisfaction and health-related quality of life in immigrants and native-born Germans: the role of immigration-related factors. Qual. Life Res. 22, 1005–1013 (2013)

    Article  PubMed  Google Scholar 

  8. Dinesen, C., Nielsen, S.S., Mortensen, L.H., Krasnik, A.: Inequality in self-rated health among immigrants, their descendants and ethnic Danes: examining the role of socioeconomic position. Int. J. Public Health 56, 503–514 (2011)

    Article  PubMed  Google Scholar 

  9. Kuehne, A., Huschke, S., Bullinger, M.: Subjective health of undocumented migrants in Germany—A mixed methods approach. BMC Public Health 15, 926 (2015)

    Article  PubMed  PubMed Central  Google Scholar 

  10. Nielsen, S.S., Krasnik, A.: Poorer self-perceived health among migrants and ethnic minorities versus the majority population in Europe: a systematic review. Int. J. Public Health 55, 357–371 (2010)

    Article  PubMed  Google Scholar 

  11. Sardadvar, S.: How migrant status affects health beyond socioeconomic status: evidence from Austria. Int. Migr. Rev. 49, 843–877 (2015)

    Article  Google Scholar 

  12. Wiking, E., Johansson, S.-E., Sundquist, J.: Ethnicity, acculturation, and self reported health. A population based study among immigrants from Poland, Turkey, and Iran in Sweden. J. Epidemiol. Community Health 58, 574–582 (2004)

    Article  PubMed  PubMed Central  Google Scholar 

  13. Assaf, S., Campostrini, S., Di Novi, C., Xu, F., Gotway Crawford, C.: Analyzing disparity trends for health care insurance coverage among non-elderly adults in the US: evidence from the behavioral risk factor surveillance system, 1993–2009. Eur. J. Health Econ. doi:10.1007/s10198-016-0806-1. (1993–2009, In press)

  14. Egede, L.E.: Race, ethnicity, culture, and disparities in health care. J. Gen. Intern. Med. 21, 667–669 (2006)

    Article  PubMed  PubMed Central  Google Scholar 

  15. Hesketh, T., Jun, Y.X., Lu, L., Wang, H.M.: Health status and access to health care of migrant workers in China. Public Health Rep. 123, 189–197 (2008)

    Article  PubMed  PubMed Central  Google Scholar 

  16. Malmusi, D.: Immigrants’ health and health inequality by type of integration policies in European countries. Eur. J. Public Health 25, 293–299 (2015)

    Article  PubMed  Google Scholar 

  17. Malmusi, D., Borrell, C., Benach, J.: Migration-related health inequalities: showing the complex interactions between gender, social class and place of origin. Soc. Sci. Med. 71, 1610–1619 (2010)

    Article  PubMed  Google Scholar 

  18. Norredam, M., Nielsen, S.S., Krasnik, A.: Migrants’ utilization of somatic healthcare services in Europe—A systematic review. Eur. J. Public Health 2010, 555–563 (2010)

    Article  Google Scholar 

  19. Solé-Auró, A., Guillén, M., Crimmins, E.M.: Health care usage among immigrants and native-born elderly populations in eleven European countries: results from SHARE. Eur. J. Health Econ. 13, 741–754 (2012)

    Article  PubMed  Google Scholar 

  20. Antoñanzas, F., Juárez-Castelló, C.A., Rodríguez-Ibeas, R.: Improving health care systems by building ‘more Europe’. Eur. J. Health Econ. 17, 787–789 (2016)

    Article  PubMed  Google Scholar 

  21. Mladovsky, P., Rechel, B., Ingleby, D., McKee, M.: Responding to diversity: an exploratory study of migrant health policies in Europe. Health Policy 105, 1–9 (2012)

    Article  PubMed  Google Scholar 

  22. Rechel, B., Mladovsky, P., Ingleby, D., Mackenbach, J.P., McKee, M.: Migration and health in an increasingly diverse Europe. Lancet 381, 1235–1245 (2013)

    Article  PubMed  Google Scholar 

  23. Dias, S.F., Severo, M., Barros, H.: Determinants of health care utilization by immigrants in Portugal. BMC Health Serv. Res. 8, 207 (2008)

    Article  PubMed  PubMed Central  Google Scholar 

  24. Hanssens, L., Detollenaere, J., Van Pottelberge, A., Baert, S., Willems, S.: Perceived discrimination in primary health care in Europe: evidence from the cross-sectional QUALICOPC-Study. Health Soc. Care Community 25, 641–651 (2017)

    Article  PubMed  Google Scholar 

  25. Reijneveld, S.A.: Reported health, lifestyles, and use of health care of first generation immigrants in The Netherlands: do socioeconomic factors explain their adverse position? J. Epidemiol. Community Health 52, 298–304 (1998)

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Scheppers, E., van Dongen, E., Dekker, J., Geertzen, J., Dekker, J.: Potential barriers to the use of health services among ethnic minorities: a review. Fam. Prac. 23, 325–348 (2006)

    Article  Google Scholar 

  27. Williams, D.R., Collins, C.: US socioeconomic and racial differences in health: patterns and explanations. Annu. Rev. Sociol. 21, 349–386 (1995)

    Article  Google Scholar 

  28. Williams, D.R., Yu, Y., Jackson, J.S., Anderson, N.B.: Racial differences in physical and mental health. J. Health Psychol. 2, 335–351 (1997)

    Article  CAS  PubMed  Google Scholar 

  29. Salabarria-Pena, Y., Trout, P.T., Gill, J.K., Morisky, D.E., Muralles, A.A., Ebin, V.J.: Effects of acculturation and psychosocial factors in Latino adolescent’s TB-related behaviors. Ethn. Dis. 11, 661–675 (2001)

    CAS  PubMed  Google Scholar 

  30. Betancourt, J.R., Green, A.R., Carrillo, J.E., Ananeh-Firempong, O.: Defining cultural competence: a practical framework for addressing racial/ethnic disparities in health and health care. Public Health Rep. 118, 293–302 (2003)

    Article  PubMed  PubMed Central  Google Scholar 

  31. Salant, T., Lauderdale, D.S.: Measuring culture: a critical review of acculturation and health in Asian immigrant populations. Soc. Sci. Med. 57, 71–90 (2003)

    Article  PubMed  Google Scholar 

  32. Arnold, M., Razum, O., Coebergh, J.W.: Cancer risk diversity in non-western migrants to Europe: an overview of the literature. Eur. J. Cancer 46, 2647–2659 (2010)

    Article  PubMed  Google Scholar 

  33. Harding, S., Rosato, M., Teyhan, A.: Trends in cancer mortality among migrants in England and Wales, 1979–2003. Eur. J. Cancer 45, 2168–2179 (2009)

    Article  PubMed  Google Scholar 

  34. Lara, M., Gamboa, C., Kahramanian, M.I., Morales, L.S., Hayes-Bautista, D.E.: Acculturation and latino health in the United States: a review of the literature and its sociopolitical context. Annu. Rev. Public Health 26, 367–397 (2005)

    Article  PubMed  Google Scholar 

  35. Tang, T.S., Solomon, L.J., McCracken, L.M.: Cultural barriers to mammography, clinical breast exam, and breast self-exam among Chinese-American women 60 and older. Prev. Med. 31, 575–583 (2000)

    Article  CAS  PubMed  Google Scholar 

  36. Abouguendia, M., Noels, K.A.: General and acculturation-related daily hassles and psychological adjustment in first- and second-generation South Asian immigrants to Canada. Int. J. Psychol. 36, 163–173 (2001)

    Article  Google Scholar 

  37. Leonetti, D.L., Tsunehara, C.H., Wahl, P.W., Fujimoto, W.Y.: Education attainment and the risk of non-insulin-dependent diabetes or coronary heart disease in Japanese-American men. Ethn. Dis. 2, 326–336 (1992)

    CAS  PubMed  Google Scholar 

  38. Matsumoto, D., Pun, K.K., Nakatani, M., Kadowaski, D., Weissman, M., McCarter, L., Fletcher, D., Takeuchi, S.: Cultural differences in attitudes, values, and beliefs about osteoporosis in first and second generation Japanese-American women. Women Health 23, 39–56 (1995)

    Article  CAS  PubMed  Google Scholar 

  39. Spolaore, E., Wacziarg, R.: Ancestry, language and culture. In: Ginsburgh, V., Weber, S. (eds.) The Palgrave handbook of economics and language, pp. 174–211. Palgrave Macmillan, London (2016)

    Google Scholar 

  40. Islam, M.K., Gerdtham, U.G., Gullberg, B., Lindstrom, M., Merlo, J.: Social capital externality and mortality in Sweden. Econ. Hum. Biol. 6, 19–42 (2008)

    Article  PubMed  Google Scholar 

  41. Ljunge, M.: Social capital and health: evidence that ancestral trust promotes health among children of immigrants. Econ. Hum. Biol. 15, 165–186 (2014)

    Article  PubMed  Google Scholar 

  42. Yamamura, E.: Different effects of social capital on health status among residents: evidence from modern Japan. J. Soc. Econ. 40, 475–479 (2011)

    Article  Google Scholar 

  43. Rumbaut, R.G.: On the past and future of American immigration and ethnic history: a sociologist’s reflections on a silver jubilee. J. Am. Ethn. Hist. 25, 160–167 (2006)

    Google Scholar 

  44. Idler, E.L., Benyamini, Y.: Self-rated health and mortality: a review of twenty-seven community studies. J. Health Soc. Behav. 38, 21–37 (1997)

    Article  CAS  PubMed  Google Scholar 

  45. Kaplan, G.A., Goldberg, D.E., Everson, S.A., Cohen, R.D., Salonen, R., Tuomilehto, J., Salonen, J.: Perceived health status and morbidity and mortality: evidence from the Kuopio ischaemic heart disease risk factor study. Int. J. Epidemiol. 25, 259–265 (1996)

    Article  CAS  PubMed  Google Scholar 

  46. McDowell, I.: Measuring health: a guide to rating scales and questionnaire. Oxford University Press, Oxford (2006)

    Book  Google Scholar 

  47. Fang, J., Madhavan, S., Alderman, M.H.: The association between birthplace and mortality from cardiovascular causes among black and white residents of New York City. N. Engl. J. Med. 335, 1545–1551 (1996)

    Article  CAS  PubMed  Google Scholar 

  48. Mayer, T., Zignago, S.: Notes on CEPII’s distances measures: the GeoDist Database. CEPII Working Paper 2011, 25 (2011)

  49. Bollen, K.A., Barb, K.H.: Pearson’s R and Coarsely categorized measures. Am. Sociol. Rev. 46, 232–239 (1981)

    Article  Google Scholar 

  50. Johnson, D.R., Creech, J.C.: Ordinal measures in multiple indicator models: a simulation study of categorization error. Am. Sociol. Rev. 48, 398–407 (1983)

    Article  Google Scholar 

  51. Heine, S.J., Lehman, D.R., Peng, K., Greenholtz, J.: What’s wrong with cross-cultural comparisons of subjective Likert scales?: the reference-group effect. J. Pers. Soc. Psychol. 82, 903–918 (2002)

    Article  PubMed  Google Scholar 

  52. Sadana, R., Mathers, C.D., Lopez, A.D., Murray, C.J.L., Moesgaard, I.K.: Comparative analyses of more than 50 household surveys on health status. In: Murray, C.J.L., Solomon, J.A., Mathers, C.D., Lopez, A.D. (eds.) Summary measures of population health: concepts, ethics, measurements and applications, pp. 369–386. WHO, Geneva (2002)

    Google Scholar 

  53. Levecque, K., Van Rossem, R.: Depression in Europe: does migrant integration have mental health payoffs? A cross-national comparison of 20 European countries. Ethn. Health 20, 49–65 (2015)

    Article  PubMed  Google Scholar 

  54. Baert, S., Vujić, S.: Immigrant volunteering: a way out of labour market discrimination? Econ. Lett. 146, 95–98 (2016)

    Article  Google Scholar 

  55. Bisin, A., Patacchini, E., Verdier, T., Zenou, Y.: Ethnic identity and labour market outcomes of immigrants in Europe. Econ. Policy 65, 57–92 (2011)

    Article  Google Scholar 

  56. Constant, A.F., Zimmermann, K.F.: Measuring ethnic identity and its impact on economic behavior. J. Eur. Econ. Assoc. 6, 424–433 (2008)

    Article  Google Scholar 

  57. Plunkett, S.W., Bámaca-Gómez, M.Y.: The relationship between parenting, acculturation, and adolescent academics in Mexican-Origin immigrant families in Los Angeles. Hisp. J. Behav. Sci. 25, 222–239 (2003)

    Article  Google Scholar 

  58. Roche, K.M., Ghazarian, S.R., Fernandez-Esquer, M.A.: Unpacking acculturation: cultural orientations and educational attainment among Mexican-origin youth. J. Youth Adolesc. 41, 920–931 (2012)

    Article  PubMed  Google Scholar 

  59. McBain-Rigg, K.E., Veitch, C.: Cultural barriers to health care for Aboriginal and Torres Strait Islanders in Mount Isa. Aust. J. Rural Health 19, 70–74 (2011)

    Article  PubMed  Google Scholar 

  60. McCormick, W.C., Uomoto, J., Young, H., Graves, A.B., Vitaliano, P., Mortimer, J.A., Edland, S.D., Larson, E.B.: Attitudes toward use of nursing homes and home care in older Japanese-Americans. J. Am. Geriatr. Soc. 44, 769–777 (1996)

    Article  CAS  PubMed  Google Scholar 

  61. Schulman, K.A., Berlin, J.A., Harless, W., Kerner, J.F., Sistrunk, S., Gersh, B.J., Dubé, R., Taleghani, C.K., Burke, J.E., Williams, S., Eisenberg, J.M., Escarce, J.J.: The effect of race and sex on physician’s recommendations for cardiac catheterization. N. Engl. J. Med. 340, 618–626 (1999)

    Article  CAS  PubMed  Google Scholar 

  62. West, C.M., Kantor, G.K., Jasinski, J.L.: Sociodemographic predictors and cultural barriers to help-seeking behavior by Latina and Anglo American battered women. Violence Vict. 13, 361–375 (1998)

    CAS  PubMed  Google Scholar 

  63. Powel Sears, K.: Improving cultural competence education: the utility of an intersectional framework. Med. Educ. 46, 545–551 (2012)

    Article  Google Scholar 

  64. McLean, M.: Broadening our perceptions of diversity in medical education: using multifocal lenses. Med. Educ. 46, 534–544 (2012)

    Article  Google Scholar 

  65. Muntinga, M.E., Krajenbrink, V.Q.E., Peerdeman, S.M., Croiset, G., Verdonk, P.: Toward diversity-responsive medical education: taking an intersectionality approach to a curriculum evaluation. Adv. Health Sci. Educ. 21, 1–19 (2015)

    Google Scholar 

  66. Verdonk, P.: When I say … reflexivity. Med. Educ. 49, 147–148 (2015)

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jens Detollenaere.

Appendix

Appendix

Tables 3, 4, and 5 illustrate the model-building process.

Table 3 Step-by-step building of the multilevel linear regression model for cultural distance as reflected in subjective general health of all migrants
Table 4 Step-by-step building of the multilevel linear regression model of cultural distance on subjective general health of first-generation migrants
Table 5 Step-by-step building of the multilevel linear regression model of cultural distance on subjective general health of second-generation migrants

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Detollenaere, J., Baert, S. & Willems, S. Association between cultural distance and migrant self-rated health. Eur J Health Econ 19, 257–266 (2018). https://doi.org/10.1007/s10198-017-0881-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10198-017-0881-y

Keywords

JEL Classification

Navigation