Are all immigrants equally healthy? Examining the healthy immigrant paradox across age groups and education levels in Spain

Abstract

Immigration has changed the demographic composition and social structure of many Western European countries, which has increased interest in how immigrants age. This chapter examines the health of immigrants versus Spanish-born for individuals aged ≥30 years old using cross-sectional Spanish data from 2014 and 2020. I used descriptive and multivariate models to examine the association between migration status and health outcomes (e.g., chronic health conditions, self-perceived health, Global Activity Limitation Indicator, cognitive impairment, smoking, and overweight). In particular, I explored how the association between immigration status and health varies according to age groups and education levels. I further investigated two separate interactions: the interaction between immigration status and education on health and the interaction between immigration status and age on health. My findings support the existence of the healthy immigrant paradox in Spain, wherein both short- and long-term immigrants generally have much better health conditions than Spanish-born. Considering the diversity of the immigrant population in terms of their countries of origin and educational attainment, future research should focus on understanding the role of educational selectivity in contributing to the observed health inequalities among the considered outcomes over the life course.