The European Journal of Health Economics

, Volume 19, Issue 1, pp 103–121 | Cite as

A “healthy immigrant effect” or a “sick immigrant effect”? Selection and policies matter

  • Amelie F. ConstantEmail author
  • Teresa García-Muñoz
  • Shoshana Neuman
  • Tzahi Neuman
Original Paper


Previous literature on a variety of countries has documented a “healthy immigrant effect” (HIE). Accordingly, immigrants arriving in the host country are, on average, healthier than comparable natives. However, their health status dissipates with additional years in the country. HIE is explained through the positive self-selection of healthy immigrants as well as the positive selection, screening and discrimination applied by host countries. In this article we study the health trajectories of immigrants within the context of selection and migration policies. Using SHARE data we examine the HIE, comparing Israel and 16 European countries that have fundamentally different migration policies. Israel has virtually unrestricted open gates for Jewish people around the world, who in turn have ideological rather than economic considerations to move. European countries have selective policies with regards to the health, education and wealth of migrants, who also self-select themselves. Our results provide evidence that (1) immigrants who move to Israel have compromised health and are significantly less healthy than comparable natives. Their health disadvantage persists for up to 20 years of living in Israel, after which they become similar to natives; (2) immigrants who move to Europe have significantly better health than comparable natives. Their health advantage remains positive for many years. Even though during some time lapses they are not significantly different from natives, their health status never becomes worse than that of natives. Our results are important for migration policy and relevant for domestic health policy.


Self-reported health status Immigration Europe Israel Older population Multilevel regression SHARE 

JEL Codes

C22 J11 J12 J14 O12 O15 O52 



We are grateful for comments and suggestions by participants at the Annual Migration Meeting in Dakar, Senegal, and the Annual Meeting of the Southern Economic Association in New Orleans, LA, USA. We have also benefited from discussions with Maurice Schiff, James Smith and Klaus F. Zimmermann. Part of this study was conducted while Shoshana Neuman was visiting IZA (summer 2014 and summer 2015). She would like to thank IZA for their hospitality and excellent research facilities.

Teresa García-Muñoz would like to thank MICINN (ECO2013-44879-R) and Junta de Andalucía (SEJ-1436) for financial support.

The SHARE data collection has been primarily funded by the European Commission through FP5 (QLK6-CT-2001-00360), FP6 (SHARE-I3: RII-CT-2006-062193, COMPARE: CIT5-CT-2005-028857, SHARELIFE: CIT4-CT-2006-028812) and FP7 (SHARE-PREP: N°211909, SHARE-LEAP: N°227822, SHARE M4: N°261982). Additional funding from the German Ministry of Education and Research, the US National Institute on Aging (U01_AG09740-13S2, P01_AG005842, P01_AG08291, P30_AG12815, R21_AG025169, Y1-AG-4553-01, IAG_BSR06-11, OGHA_04-064) and various national funding sources is gratefully acknowledged (see


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Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • Amelie F. Constant
    • 1
    • 2
    Email author
  • Teresa García-Muñoz
    • 3
  • Shoshana Neuman
    • 4
    • 5
    • 6
  • Tzahi Neuman
    • 7
  1. 1.Office of Population ResearchPrinceton UniversityPrincetonUSA
  2. 2.UNU-Merit, Maastrich UniversityMaastrichtThe Netherlands
  3. 3.Department of Quantitative MethodsUniversity of GranadaGranadaSpain
  4. 4.Department of EconomicsBar-Ilan UniversityRamat-GanIsrael
  5. 5.School of EconomicsAcademic Ashkelon CollegeAshkelonIsrael
  6. 6.IZABonnGermany
  7. 7.Hadassah-Hebrew University Medical CenterJerusalemIsrael

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