Differences in Healthy Life Expectancy between Migrants and Natives in Germany: a Multistate Life Table Approach

Adrian Kunz, Tilburg University
Adrien Remund , Rijksuniversiteit Groningen
Tim Riffe, University of Basque Country

In many countries, migrants outlive natives in life expectancy (LE), but simultaneously display poorer levels of health, resulting paradoxically in shorter migrant healthy life expectancy (HLE). This contradiction has been observed in Belgium, the Netherlands, and England and Wales, but these prior studies rely on the Sullivan method, which may introduce bias due to its strong assumptions. Multistate life tables provide a way around this limitation and allow a finer understanding of the mechanisms at play. Our study aims to assess differences in LE and HLE at age 50 between migrants and natives in Germany, and to analyse how transitions between health states and death contribute to these disparities. We use data from waves 4 to 7 of SHARE and exploit self-reported health, dichotomised into “good” and “bad” health. We fit GAM multinomial logistic models with age splines to predict transition probabilities between health states and death by age, sex, and migration status. We then use them to compute multistate life tables and derive LE and HLE by sex and migration status. Finally, we use decomposition analysis to identify the contribution of each transition to LE and HLE differences. Our findings confirm that, in Germany, migrants live longer than natives (males: +0.75 years; females: +0.8 years) but have shorter HLE (males: -2.28 years; females: -2.8 years). Decompositions show that about two-thirds of the HLE gap is due to morbidity incidence, and half comes from recovery, while the MMA only slightly compensates these migrants’ health disadvantages.

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 Presented in Session P4. Migration, Migrants, and Mobility