Skip to main content

Poorer self-perceived health among migrants and ethnic minorities versus the majority population in Europe: a systematic review

Abstract

Objectives

Knowledge about self-perceived health can help us understand the health status and needs among migrants and ethnic minorities in the European Union (EU) which is essential to improve equity and integration. The objective was to examine and compare self-perceived health among migrant and ethnic minority groups in the EU countries.

Methods

Publications were ascertained by a systematic search of PUBMED and EMBASE. Eligibility of studies was based on the abstracts and the full texts. Additional articles were identified via the references. The final number of studies included was 17.

Results

Publications were identified in 5 out of the 27 EU countries. In regard to self-perceived health, most migrants and ethnic minority groups appeared to be disadvantaged as compared to the majority population even after controlling for age, gender, and socioeconomic factors. Only limited cross-country comparisons could be carried out, still they revealed a parallel pattern of self-perceived health among similar migrant/ethnic minority groups.

Conclusions

Policies to improve social and health status, contextual factors, and access to healthcare among migrants and ethnic minorities are essential to reduce ethnic inequalities in health.

This is a preview of subscription content, access via your institution.

Fig. 1

References

  1. Agyemang C, Denktas S, Bruijnzeels M, Foets M (2006) Validity of the single-item question on self-rated health status in first generation Turkish and Moroccans versus native Dutch in the Netherlands. Pub Health 120:543–550

    Article  Google Scholar 

  2. Bhopal R (2004) Glossary of terms relating to ethnicity and race: for reflection and debate. J Epidemiol Community Health 58:441–445

    CAS  Article  PubMed  Google Scholar 

  3. Borrell C, Muntaner C, Sola J, Artazcoz L, Puigpinos R, Benach J, Noh S (2008) Immigration and self-reported health status by social class and gender: the importance of material deprivation, work organisation and household labour. J Epidemiol Community Health 62:e7

    CAS  Article  PubMed  Google Scholar 

  4. Bos V, Kunst AE, Keij-Deerenberg IM, Garssen J, Mackenbach JP (2004) Ethnic inequalities in age- and cause-specific mortality in the Netherlands. Int J Epidemiol 33:1112–1119

    Article  PubMed  Google Scholar 

  5. Burstrom B, Fredlund P (2001) Self-rated health: is it as good a predictor of subsequent mortality among adults in lower as well as in higher social classes? J Epidemiol Community Health 55:836–840

    CAS  Article  PubMed  Google Scholar 

  6. Cagney KA, Browning CR, Wen M (2005) Racial disparities in self-rated health at older ages: what differences does the neighborhood make? J Gerontol B Psychol Sci Soc Sci 60:S181–S190

    PubMed  Google Scholar 

  7. Chandola T (2001) Ethnic and class differences in health in relation to British South Asians: using the new National Statistics Socio-Economic Classification. Soc Sci Med 52:1285–1296

    CAS  Article  PubMed  Google Scholar 

  8. Chandola T, Jenkinson C (2000) Validating self-rated health in different ethnic groups. Ethn Health 5:151–159

    CAS  Article  PubMed  Google Scholar 

  9. Cooper H (2002) Investigating socio-economic explanations for gender and ethnic inequalities in health. Soc Sci Med 54:693–706

    Article  PubMed  Google Scholar 

  10. Desesquelles AF, Egidi V, Salvatore MA (2009) Why do Italian people rate their health worse than French people do? An exploration of cross-country differentials of self-rated health. Soc Sci Med 68:1124–1128

    Article  PubMed  Google Scholar 

  11. European Community Health Indicators Monitoring (2008) Self-perceived health—definition of indicator

  12. Fang J, Madhavan S, Alderman MH (1996) The association between birthplace and mortality from cardiovascular causes among black and white residents of New York City. N Engl J Med 335:1545–1551

    CAS  Article  PubMed  Google Scholar 

  13. Fylkesnes K (1993) Determinants of health care utilization—visits and referrals. Scand J Soc Med 21:40–50

    CAS  PubMed  Google Scholar 

  14. Hjern A, Haglund B, Persson G, Rosen M (2001) Is there equity in access to health services for ethnic minorities in Sweden? Eur J Pub Health 11:147–152

    CAS  Article  Google Scholar 

  15. Idler EL, Benyamini Y (1997) Self-rated health and mortality: a review of twenty-seven community studies. J Health Soc Behav 38:21–37

    CAS  Article  PubMed  Google Scholar 

  16. Iglesias E, Robertson E, Johansson SE, Engfeldt P, Sundquist J (2003) Women, international migration and self-reported health. A population-based study of women of reproductive age. Soc Sci Med 56:111–124

    Article  PubMed  Google Scholar 

  17. Jurges H (2007) True health vs response styles: exploring cross-country differences in self-reported health. Health Econ 16:163–178

    Article  PubMed  Google Scholar 

  18. Jylha M, Guralnik JM, Ferrucci L, Jokela J, Heikkinen E (1998) Is self-rated health comparable across cultures and genders? J Gerontol B Psychol Sci Soc Sci 53:S144–S152

    CAS  PubMed  Google Scholar 

  19. Kaplan GA, Goldberg DE, Everson SA, Cohen RD, Salonen R, Tuomilehto J, Salonen J (1996) Perceived health status and morbidity and mortality: evidence from the Kuopio ischaemic heart disease risk factor study. Int J Epidemiol 25:259–265

    CAS  Article  PubMed  Google Scholar 

  20. Konig HH, Bernert S, Angermeyer MC, Matschinger H, Martinez M, Vilagut G, Haro JM, de Girolamo G, de Graaf G, Kovess V, Alonso J (2009) Comparison of population health status in six European countries: results of a representative survey using the EQ-5D questionnaire. Med Care 47:255–261

    Article  PubMed  Google Scholar 

  21. Koochek A, Montazeri A, Johansson SE, Sundquist J (2007) Health-related quality of life and migration: a cross-sectional study on elderly Iranians in Sweden. Health Qual Life Outcomes 5:60

    Article  PubMed  Google Scholar 

  22. Leao TS, Sundquist J, Johansson SE, Sundquist K (2009) The influence of age at migration and length of residence on self-rated health among Swedish immigrants: a cross-sectional study. Ethn Health 14:93–105

    Article  PubMed  Google Scholar 

  23. Lindstrom M, Sundquist J, Ostergren PO (2001) Ethnic differences in self-reported health in Malmo in southern Sweden. J Epidemiol Community Health 55:97–103

    CAS  Article  PubMed  Google Scholar 

  24. Lorant V, Van OH, Thomas I (2008) Contextual factors and immigrants’ health status: double jeopardy. Health Place 14:678–692

    Article  PubMed  Google Scholar 

  25. MEHO (2009) Migrant and Ethnic Minority Health Observatory. http://www.meho.eu.com

  26. Mohseni M, Lindstrom M (2008) Ethnic differences in anticipated discrimination, generalised trust in other people and self-rated health: a population-based study in Sweden. Ethn Health 13:417–434

    Article  PubMed  Google Scholar 

  27. Padilla B, Miguel JP (2007) Health and migration in the EU: building a shared vision for action. Lisbon

  28. Pudaric S, Sundquist J, Johansson SE (2003) Country of birth, instrumental activities of daily living, self-rated health and mortality: a Swedish population-based survey of people aged 55–74. Soc Sci Med 56:2493–2503

    Article  PubMed  Google Scholar 

  29. Robertson E, Iglesias E, Johansson SE, Sundquist J (2003) Migration status and limiting long-standing illness: a longitudinal study of women of childbearing age in Sweden. Eur J Pub Health 13:99–104

    Article  Google Scholar 

  30. Singhammer J (2008) Ethnic minorities’ health. The Partnership, Region Midtjylland, pp 30–43

  31. Stirbu I, Kunst AE, Bos V, Mackenbach JP (2006) Differences in avoidable mortality between migrants and the native Dutch in The Netherlands. BMC Pub Health 6:78

    CAS  Article  Google Scholar 

  32. Stronks K, Ravelli AC, Reijneveld SA (2001) Immigrants in the Netherlands: equal access for equal needs? J Epidemiol Community Health 55:701–707

    CAS  Article  PubMed  Google Scholar 

  33. Sungurova Y, Johansson SE, Sundquist J (2006) East-west health divide and east-west migration: self-reported health of immigrants from Eastern Europe and the former Soviet Union in Sweden. Scand J Pub Health 34:217–221

    Article  Google Scholar 

  34. Taloyan M, Johansson LM, Johansson SE, Sundquist J, Kocturk TO (2006) Poor self-reported health and sleeping difficulties among Kurdish immigrant men in Sweden. Transcult Psychiatry 43:445–461

    Article  PubMed  Google Scholar 

  35. Taloyan M, Johansson SE, Sundquist J, Kocturk TO, Johansson LM (2008) Psychological distress among Kurdish immigrants in Sweden. Scand J Pub Health 36:190–196

    Article  Google Scholar 

  36. United Nations (2009) World Migrant Stock: The 2005 Revision Population Database

  37. Villadsen SF, Mortensen LH, Andersen AM (2009) Ethnic disparity in stillbirth and infant mortality in Denmark 1981–2003. J Epidemiol Community Health 63:106–112

    Article  PubMed  Google Scholar 

  38. Wiking E, Johansson SE, Sundquist J (2004) Ethnicity, acculturation, and self-reported health. A population based study among immigrants from Poland, Turkey, and Iran in Sweden. J Epidemiol Community Health 58:574–582

    Article  PubMed  Google Scholar 

  39. Wild S, McKeigue P (1997) Cross sectional analysis of mortality by country of birth in England and Wales, 1970–92. BMJ 314:705–710

    CAS  PubMed  Google Scholar 

  40. World Health Organisation (1946) WHO Constitution. http://www.who.int/governance/eb/constitution/en/index/html

Download references

Acknowledgments

This paper is a product of the EU-funded project Migrant and Ethnic Minority Health Observatory (MEHO) (http://www.meho.eu.com) from the work package “Healthcare utilization and self-perceived health”. Therefore, we would like to thank the project leader Marleen Foets, co-project leader Gerrit Koopmanns, and former leader Semiha Denktas (Erasmus Medical Centre, The Netherlands). Thanks also to Laura Cacciani, Emanuela Forcella, and Aldo Rosano (Agenzia di Sanità Pubblica della Regiona Lazio, Italy) for preparing a general survey for identification of registers and surveys in Europe. Also thanks to the other participants in the MEHO-project: Anton Kunst (University of Amsterdam), Johan Mackenbach and Irina Stirbu (Eramus Medical Centre, The Netherlands), Raj Bhopal and Snorri Bjorn Rafnsson (University of Edinburgh, Scotland), Oliver Razum, Jacob Spallek, and Anna Reeske (University of Bielefeld, Germany), Alexander Krämer, Manas Akmatov (University of Bielefeld, Germany), Kvetoslava Rimarova (University of Slovenia), and Dineke Zeegers (EUPHA).

Conflict of interest statement

The authors declare that they have no competing interests.

Author information

Affiliations

Authors

Corresponding author

Correspondence to Signe Smith Nielsen.

Additional information

This paper belongs to the special issue “Health of ethnic minorities in Europe”.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Nielsen, S.S., Krasnik, A. Poorer self-perceived health among migrants and ethnic minorities versus the majority population in Europe: a systematic review. Int J Public Health 55, 357–371 (2010). https://doi.org/10.1007/s00038-010-0145-4

Download citation

Keywords

  • Migrants
  • Ethnic minorities
  • Self-perceived health
  • Health status
  • Europe
  • Review