The ambiguous socioeconomic gradient in immigrants’ health in the context of the ‘healthy migrant paradox’

The empirical evidence on pervasive and persistent socioeconomic inequalities in health is exhaustive.

Existing studies, mostly from outside Sweden, have shown rather unexpected weak associations between health outcomes and education, social class or income-based measures among immigrants.

Yet the extent to which these flattened social gradients in health are related to the frequently observed ‘healthy migrant paradox’, whereby immigrants show health advantages upon arrival in settlement, remains unclear.

Although this health advantage has been shown to diminish with increasing duration of residence, there is a paucity of research about the adjacent development of immigrants’ health inequalities, and the extent to which socioeconomically determined health inequalities may alter by migration background characteristics (i.e., country of origin, duration of residence, age at arrival).

This project aims to address these gaps by exploring how the health gradient in immigrant health is shaped by the presence or absence of a health advantage.

We will investigate how income-related inequalities in health and mortality develop over the course of immigrants’ settlement in Sweden.

We will also study to what extent the frequently observed status incongruences in immigrants, e.g. mismatch between immigrants’ educational level and occupational status contribute to the flattened health gradient demonstrated in previous research.

The use of high-quality Swedish register data will allow us to account for heterogeneity of migration background characteristics, in terms of origin, reason for migration, age at arrival, and duration of residence, and thus help to understand the mechanisms that mitigate or fuel health inequalities in this growing Swedish population group.