International Journal of Public Health

, Volume 60, Issue 1, pp 21–31 | Cite as

Self-perceived health among Eastern European immigrants over 50 living in Western Europe

  • D. Lanari
  • O. Bussini
  • L. Minelli
Original Article



This paper examines whether Eastern European immigrants aged 50 and over living in Northern and Western Europe face a health disadvantage in terms of self-perceived health, with respect to the native-born. We also examined health changes over time (2004–2006–2010) through the probabilities of transition among self-perceived health states, and how they vary according to nativity status and age group.


Data were obtained from the Survey of Health, Ageing and Retirement in Europe (SHARE). Logistic regressions and probabilities of transition were used.


Results emphasise the health disadvantage of Eastern European immigrants living in Germany, France and  Sweden with respect to the native-born, even after controlling for socio-economic status. Probabilities of transition also evidenced that people born in Eastern Europe were more likely to experience worsening health and less likely to recover from sickness.


This paper suggests that health inequalities do not affect immigrant groups in equal measure and confirm the poorer and more steeply deteriorating health status of Eastern European immigrants.


Self-perceived health Eastern European immigrants Europe SHARE Probabilities of transition 



This paper uses data from SHARE wave 4 release 1.1.1, as of March 28th 2013 and SHARE wave 1 and 2 release 2.5.0, as of May 24th 2011. The SHARE data collection has been primarily funded by the European Commission through the 5th Framework Programme (project QLK6-CT-2001-00360 in the thematic programme Quality of Life), through the 6th Framework Programme (projects SHARE-I3, RII-CT-2006-062193, COMPARE, CIT5- CT-2005-028857, and SHARELIFE, CIT4-CT-2006-028812) and through the 7th Framework Programme (SHARE-PREP, N° 211909, SHARE-LEAP, N° 227822 and SHARE M4, N° 261982). Additional funding from the U.S. National Institute on Aging (U01 AG09740-13S2, P01 AG005842, P01 AG08291, P30 AG12815, R21 AG025169, Y1-AG-4553-01, IAG BSR06-11 and OGHA 04-064) and the German Ministry of Education and Research as well as from various national sources is gratefully acknowledged (see for a full list of funding institutions). We thank the two anonymous reviewers for their useful comments on earlier draft of this paper.


  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. Public Health 120(6):543–550PubMedCrossRefGoogle Scholar
  2. Ai C, Norton EC (2003) Interaction terms in logit and probit models. Econ Lett 80(1):123–129CrossRefGoogle Scholar
  3. Boback M, Marmot M (1996) East-West mortality divide and its potential explanations: proposed research agenda. BMJ 312(7028):421–425CrossRefGoogle Scholar
  4. Börsch-Supan A, Jürges H (2005) The Survey of Health, Ageing and Retirement in Europe—Methodology. Mannheim, Germany: Mannheim Research Institute for the Economics of Aging (MEA). Available at:
  5. Carlson P (1998) Self-perceived health in East and West Europe: another European health divide. Soc Sci Med 46(10):1355–1366PubMedCrossRefGoogle Scholar
  6. Chandola T, Jenkinson C (2000) Validating self-rated health in different ethnic groups. Ethn Health 5(2):151–159PubMedCrossRefGoogle Scholar
  7. Diehr P, Patrick DL (2001) Probabilities of transition among health states for older adults. Qual Life Res 10(5):431–442PubMedCrossRefGoogle Scholar
  8. Fassmann H, Münz R (1992) Patterns and trends of international migration in Western Europe. Popul Dev Rev 18(3):457–480CrossRefGoogle Scholar
  9. Frejka T, Iglicka-Okolska K, Jazwinska E, Kanopiene V, Macura M, Malinovskaya E, Mullan B, Okolski M, Pyrozhkov S, Sipaviciene A (1995) Changing international migration patterns in Central and Eastern Europe in the early 1990s. In: Evolution or revolution in European population vol. 2, European population conference, Franco Angeli, Milan, pp 213–226 4–8 Sept 1995Google Scholar
  10. Fylkesnes K (1993) Determinants of health care utilization–visits and referrals. Scand J Soc Med 21(1):40–50PubMedGoogle Scholar
  11. Huijts T, Kraaykamp G (2012) Immigrants’ health in Europe: a cross-classified multilevel approach to examine origin country, destination country, and community effects. Int Migr Rev 46(1):101–137PubMedCrossRefGoogle Scholar
  12. Idler EL, Benyamini Y (1997) Self-rated health and mortality: a review of twenty-seven community studies. J Health Soc Behav 38(1):21–37PubMedCrossRefGoogle Scholar
  13. Jung J (2006) Estimating Markov transition probabilities between health states in the HRS dataset. Working Paper, Indiana University: Bloomington. Available at:
  14. 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(2):259–265PubMedCrossRefGoogle Scholar
  15. Lanari D, Bussini O (2012) International migration and health inequalities in later life. Ageing Soc 32(6):935–962CrossRefGoogle Scholar
  16. Leibfried S (1992) Towards a European welfare state. In: Ferge Z, Kolberg JE (eds) Social policy in a changing Europe. Campus-Verlag, Frankfurt, pp 245–279Google Scholar
  17. Leon DA, Chenet L, Shkolnikov VM, Zakharov S, Shapiro J, Rakhmanova G, Vassin S, McKee M (1997) Huge variation in Russian mortality rates 1984–1994: artefact, alcohol, or what? Lancet 350(9075):383–388PubMedCrossRefGoogle Scholar
  18. Lindstrom M, Sundquist J, Ostergren P (2001) Ethnic differences in self reported health in Malmö in southern Sweden. J Epidemiol Community Health 55(2):97–103PubMedCentralPubMedCrossRefGoogle Scholar
  19. Lundberg O, Manderbacka K (1996) Assessing reliability of a measure of self-rated health. Scand J Soc Med 24(3):218–224PubMedGoogle Scholar
  20. Mitrushina MN, Satz P (1991) Correlates of self-rated health in the elderly. Aging 3(1):73–77PubMedGoogle Scholar
  21. Münz R (1995) Where did they all come from? Typology and geography of European mass migration in the twentieth century. In: Evolution or revolution in European population vol. 1, European population conference, Franco Angeli, Milan, pp 95–154 4–8 Sept 1995Google Scholar
  22. Nielsen SS, Krasnick A (2010) Poorer self-perceived health among migrants and ethnic minorities versus the majority population in Europe: a systematic review. Int J Public Health 55(5):357–371PubMedCrossRefGoogle Scholar
  23. Peto R, Lopez AD, Boreham J, Thun M, Heath C Jr (1992) Mortality from tobacco in developed countries: indirect estimation from national vital statistics. Lancet 339(8804):1268–1278PubMedCrossRefGoogle Scholar
  24. 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(12):2493–2503PubMedCrossRefGoogle Scholar
  25. Ronellenfitsch U, Razum O (2004) Deteriorating health satisfaction among immigrants from Eastern Europe to Germany. Int J Equity Health 3(1):4PubMedCentralPubMedCrossRefGoogle Scholar
  26. Salt J (1989) A comparative overview of international trends and types, 1950–80. Int Migr Rev 23(3):431–456PubMedCrossRefGoogle Scholar
  27. SHARE (2004–2006–2010).
  28. Solé-Auró A, Crimmins EM (2008) Health of immigrants in European countries. Int Migr Rev 42(4):861–876PubMedCentralPubMedCrossRefGoogle Scholar
  29. UNESCO (1997) Institute for Statistics, International Standard Classification of Education. Available at:
  30. United Nations (2008) Population division: the standard country or area codes for statistical use, Revision 4. Available at:
  31. Vaillant N, Wolff FC (2010) Origin differences in self-reported health among older migrants living in France. Public Health 124(2):90–98PubMedCrossRefGoogle Scholar
  32. Weziak-Bialowolska D (2014) Health conditions in regions of Eastern and Western Europe. Int J Public Health 59(3):529–539PubMedCrossRefGoogle Scholar
  33. Witvliet M, Arah OA, Stronks K, Kunst AE (2014) Examining self-rated health of young central and eastern Europeans in the context of other world regions. Eur J Public Health 24(2):314–321PubMedCrossRefGoogle Scholar

Copyright information

© Swiss School of Public Health 2014

Authors and Affiliations

  1. 1.University of PerugiaPerugiaItaly

Personalised recommendations