The Healthy Immigrant Effect and Immigrant Selection: Evidence from Four Countries

TLDR

The healthy immigrant effect, where immigrants are on average healthier than native‑born, is well accepted, yet explanations such as health screening, behavior adoption, and self‑selection remain contested. The study aims to investigate the role of health screening, behavior adoption, and self‑selection in explaining the healthy immigrant effect by analyzing health outcomes, behaviors, and socioeconomic characteristics of immigrants from the US, Canada, UK, and Australia. The authors examine health outcomes, behaviors, and socioeconomic characteristics of immigrants from these countries to test the last two explanations. Strong positive selection in education is observed for immigrants from all regions, and unobservable self‑selection factors also significantly contribute to the better health of recent immigrants.

Abstract

The existence of a healthy immigrant effect – where immigrants are on average healthier than the native-born – is now a well accepted phenomenon. There are many competing explanations for this phenomenon including health screening by recipient countries, healthy behaviour prior to migration followed by the steady adoption of new country (less) healthy behaviours, and immigrant self-selection where healthier and wealthier people tend to be migrants. We explore the last two of these explanations for the healthy immigrant effect by examining the health outcomes, health behaviours, and socio-economic characteristics of immigrants from a range of source countries in the US, Canada, UK and Australia. We find evidence of strong positive selection effects for immigrants from all regions of origin in terms of education. However, we also find evidence that self-selection in terms of unobservable factors is an important determinant of the better health of recent immigrants.