Interface Demography, Department of Social Research, Faculty of Economic and Social Sciences & Solvay Business School, Vrije Universiteit Brussel, Pleinlaan 2, 1050, Brussels, Belgium.
BMC Public Health. 2019 Apr 16;19(1):410. doi: 10.1186/s12889-019-6724-2.
Belgium has a large migrant community that is increasingly ageing. As migrants may have faced environmental and social exposures before, during and after migration, they may have experienced an accelerated epidemiological transition. Studying mortality differentials between the migrant and native population may therefore allow for a better understanding of the aetiology of diseases. While many studies have assessed migrant mortality, few have looked into the role of gender or the trend over time. Therefore, this study aims to probe into mortality differences between the native and migrant population for all major causes of death (COD) during the 1990s and 2000s. We will discriminate between all major migrant groups and men and women as they have different migration histories.
Individually linked data of the Belgian Census, the National Register and death certificates for the periods 1991-1997 and 2001-2008 were used. Migrant origin was based on both own and parents' origin, hereby maximizing the population with migrant roots. We included native Belgians and migrants from the largest migrant groups aged 25 to 65 years. Both absolute and relative mortality differences by migrant origin were calculated for the most common COD.
We generally observed a migrant advantage for overall, cause-specific and cancer-specific mortality, with infection-related cancer mortality being the only exception. The effect was particularly strong for lifestyle-related COD, non-western migrants, and men. Over time, mortality declined among native Belgian men and women, yet remained stable for several migrant groups. This converging trend was largely due to smoking and reduced reproductive behaviour among migrants.
The migrant mortality advantage stresses that there is room for improvement in the area of health in Belgium. Since the largest differences between native Belgians and migrants were observed for lifestyle-related diseases, and there is a tendency towards convergence of mortality over time, primary prevention tackling the most vulnerable groups remains crucial. Moreover, efforts should be made to ensure equal access to health care among the social and cultural strata.
比利时拥有庞大的移民社区，且移民社区正逐渐老龄化。由于移民在迁移前后可能面临环境和社会暴露，他们可能经历了加速的流行病学转变。因此，研究移民和本地人口之间的死亡率差异可以更好地了解疾病的病因。虽然许多研究都评估了移民的死亡率，但很少有研究关注性别差异或随时间的趋势。因此，本研究旨在探讨 1990 年代和 2000 年代所有主要死因（COD）的本地人口和移民人口之间的死亡率差异。我们将区分所有主要移民群体以及男性和女性，因为他们有不同的移民历史。
使用了比利时人口普查、国家登记册和死亡证明的个体链接数据，时间范围为 1991-1997 年和 2001-2008 年。移民原籍国基于自身和父母的原籍国，从而最大限度地扩大了有移民背景的人口。我们包括了 25 至 65 岁的本地比利时人和来自最大移民群体的移民。对于最常见的 COD，计算了移民原籍国的绝对和相对死亡率差异。
我们普遍观察到整体、特定病因和癌症特定死亡率的移民优势，感染相关癌症死亡率是唯一的例外。这种影响在与生活方式相关的 COD、非西方移民和男性中尤为强烈。随着时间的推移，本地比利时男性和女性的死亡率下降，但几个移民群体的死亡率仍然稳定。这种趋同趋势主要归因于移民的吸烟和生育行为减少。
移民的死亡率优势强调比利时在健康领域仍有改进的空间。由于本地比利时人和移民之间最大的差异是与生活方式相关的疾病，而且随着时间的推移死亡率有趋同的趋势，因此针对最脆弱群体的初级预防仍然至关重要。此外，应努力确保社会和文化阶层之间平等获得医疗保健。
