Inequalities in Life Expectancy, Healthy Life Expectancy and Disability Free Life Expectancy by Country of Birth in England and Wales: A Total Population, Repeated Cross-Sectional Approach

Joseph Harrison , University of Salford
Matthew Wallace, University of Salford

Recent research suggests that while some immigrant groups live longer than native populations, they often experience poorer health and higher levels of disability. Yet, evidence linking health and longevity over time remains limited. This study provides the most detailed simultaneous analysis to date of life expectancy, healthy life expectancy, and disability-free life expectancy among immigrants in England and Wales, using the most granular countries of origin available across the 2001, 2011, and 2021 censuses. Using life table methods and the Sullivan method, we estimate these measures and compare each origin group with the native population. Groups are categorised based on whether they display a healthy migrant effect, an unhealthy migrant effect, a mortality-morbidity paradox, or a relationship that has shifted over time. Findings reveal marked heterogeneity in outcomes across origin groups. The healthy migrant effect remains prevalent; however, individuals born in Türkiye, Pakistan, Bangladesh, Iraq, and Somalia are found to live longer lives but with higher disability prevalence. This pattern is especially pronounced among women, though also observed among men. Variation across groups can be partly explained by differing migration pathways. Groups facing discrimination, socioeconomic disadvantage, or who have migrated via humanitarian routes tend to fare worse. The presence of a mortality-morbidity paradox in several origins suggests that accumulated stress, adversity, and structural disadvantage throughout the life course can compromise later-life health despite increased longevity.

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 Presented in Session P5. Health, Mortality, and Ageing 1