Migrants’ health and mortality. Evidence from the italian context

Migration represents a challenge for every European country as the continent shifts towards a multi-ethnic and multi-cultural reality. Health particularly plays an important role in migrant integration. Italy was a late-comer to the club of European immigration countries. The country has experienced, in the last years, a rapid increase in migrant numbers, reaching more than five million in 2019. Thus, promoting health and improving health programming, both at the national and at the local level, requires a complex strategy. Evidence on migrant health and on the effect of migration on health, healthcare use and mortality is, unfortunately, limited and recent for Italy. The present thesis aims to analyse migrant health issues from a holistic point of view. To accomplish this aim, the first chapter, performing a cross-sectional study at national level and using survey data, is the first study in Italy to examine gendered health disparities between natives and migrants by duration of stay. In the second chapter, using an eleven-year longitudinal study and administrative data for all residents in Rome, the goal is to provide new evidence on the migrant healthcare use, analysing differences between Italians and migrants in the Emergency Department usage rates by comparing the pre-2008 and the post-2008 time-periods. Finally, the last contribution of this thesis regards migrant mortality. Adopting a longitudinal cohort approach, the study analyses, first, mortality differences between Italians and migrants residing in Rome and mortality changes before and during the Great Recession. Second, it analyses mortality variations among birth-cohorts to examine whether the migrant mortality advantage is verified across all birth-cohorts. This thesis belongs to the classic tradition of demographic studies that looks at the micro-level, in this case examining the association between migrant status and health, healthcare use and mortality. By using survey data and administrative data and by filling some gaps in the research on the relationship between migration and health, the present study shows that migrant health and mortality are changing, with significant differences in terms of gender and origin area. Results yield important findings which underscore the complexity of the relationship between migration and health, results which might help improve or develop health policy for migrants.