Going 'beyond the mean' in analysing immigrant health disparities

BACKGROUND On arrival, immigrants are on average healthier than natives, but their health advantage tends to dissipate over time. This constitutes a relevant public health issue for the hosting societies, as it implies higher health care costs, lower immigrants’ participation to the labour market, and lower tax revenues. OBJECTIVE This study is the first to take a ‘beyond the mean’ perspective in analysing health differences between between Italians and short-say immigrants, as well as between short-stay and long-stay immigrants. It highlights whether health differences are concentrated in specific parts of the distributions, and what observed or unobserved factors contribute to these differences. This knowledge helps policy makers in preventing the detrimental effect of those factors that worsen especially the left tail of the health distribution, which is associated with larger individual and societal costs. METHODS We use unconditional quantile regressions combined with Oaxaca-Blinder decompositions on data from the Italian Health Condition Survey. RESULTS We find that the health advantage of short-stay immigrants over both Italians and long-stay immigrants is concentrated in the lower part of the health distributions, and that, in both cases, this is mainly due to some unobserved factors. Our results are consistent with immigrants’ difficulties in accessing the health care system. CONTRIBUTION We examine immigrant health disparities across the entire health distribution. This helps in shaping effective health policies. Policy interventions should be tailored to immigrants with poor health conditions, improving their access to the health care system.