Pinchas-Mizrachi Ronit, Naparstek Yaakov, Nirel Ronit, Kukia Ehud
The Israel Academic College in Ramat Gan, Ramat Gan, Israel.
Jerusalem College of Technology, Jerusalem, Israel.
SSM Popul Health. 2020 Nov 14;12:100694. doi: 10.1016/j.ssmph.2020.100694. eCollection 2020 Dec.
The "healthy immigrant" phenomenon finds that immigrants are in better health than natives, while the "sick immigrant" phenomenon finds the opposite. We examined this phenomenon using the relationship between immigration and mortality, stratified by income level, among Soviet immigrants to Israel in the 1990s, compared to veteran immigrants with similar ethnic origin. A retrospective cohort study of mortality during 1990-2016 was conducted among 63,847 immigrants born during 1940-1950 in the USSR or Eastern Europe, and who immigrated to Israel during 1990-1995. They were compared to a control group of 75,347 Israeli Jews born during the same period in the same countries or second-generation immigrants with parents from these countries and who immigrated by 1960. After adjusting for sex, age, income, and marital status, we found higher mortality rates among immigrants than non-immigrants for the total study population (adjusted hazard ratio (AHR) = 1.399, 99% confidence intervals (CI) = 1.341, 1.459) and among 19,033 men (AHR = 2.852, 99%CI = 2.619, 3.107) and 24,355 women (AHR = 1.705, 99%CI = 1.566, 1.857) with low incomes. The opposite relationship was found for 25,436 men (AHR = 0.710,99%CI = 0.617, 0.0.816) and for 12,922 women (AHR = 0.693,99%CI = 0.534, 0.900) with high incomes. When examining the total study population, we found evidence to support the "sick immigrant" phenomenon. However, both men and women in the high-income subgroup, and women in the middle-income subgroup, demonstrated the "healthy immigrant" phenomenon. Decision-makers in Israel should pay particular attention to immigrants from a low socioeconomic level. Our results emphasize the need for social stratification when examining the relationships between immigration and health outcomes.
“健康移民”现象表明移民的健康状况优于本土居民，而“患病移民”现象则相反。我们通过研究20世纪90年代前苏联移民到以色列的情况，并与具有相同种族背景的老移民进行比较，利用移民与死亡率之间的关系，按收入水平分层，来研究这一现象。对1940年至1950年出生在前苏联或东欧、并于1990年至1995年移民到以色列的63847名移民进行了一项关于1990年至2016年期间死亡率的回顾性队列研究。将他们与同期在相同国家出生的75347名以色列犹太人或父母来自这些国家且在1960年前移民的第二代移民组成的对照组进行比较。在调整了性别、年龄、收入和婚姻状况后，我们发现，在整个研究人群中，移民的死亡率高于非移民（调整后的风险比（AHR）=1.399，99%置信区间（CI）=1.341，1.459）；在19033名低收入男性中（AHR=2.852，99%CI=2.619，3.107）以及24355名低收入女性中（AHR=1.705，99%CI=1.566，1.857）也是如此。而在25436名高收入男性中（AHR=0.710，99%CI=0.617，0.816）以及12922名高收入女性中（AHR=0.693，99%CI=0.534，0.900）则发现了相反的关系。在研究整个研究人群时，我们发现有证据支持“患病移民”现象。然而，高收入亚组中的男性和女性，以及中等收入亚组中的女性，都表现出“健康移民”现象。以色列的决策者应特别关注社会经济水平较低的移民。我们的研究结果强调，在研究移民与健康结果之间的关系时，需要进行社会分层。
