The seminar is part of The Migration Seminar; a multidisciplinary forum for researchers from all faculties at Malmö University with an interest in migration, integration, diversity and related issues. Maarten Vink is currently Willy Brandt Guest Professor at the Malmö Institute for Studies of Migration, Diversity and Welfare (MIM) at Malmö University.
Frailty quantifies the risk of adverse health outcomes and is superior to chronological age in predicting mortality. Examining 96,698 Europeans in the Survey of Health, Aging and Retirement in Europe, we investigated cross-sectional and longitudinal associations between migration status and frailty at ages >50 years old. We tested mediation by migrant home ownership and citizenship and examined whether associations differed by the countries’ level of healthcare coverage and access for migrants. Cross-sectionally, all migrants >50 years old were, on average, 15-18 % frailer than non-migrants, even after adjusting for confounders. This association decreased after adjustment for potential mediation by citizenship. The magnitude of the association between migrant status and frailty was greater in migrants from low or middle-income countries, compared with migrants from high income countries. Northern, Eastern and Western European migrants were a respective 33-41, 3-15 and 10-15 % frailer than non-migrants, but Southern European migrants were no frailer than non-migrants. The magnitude of the association between migrant status and frailty was also greater in countries with lower healthcare coverage and access for migrants, however, this difference was largely explained by citizenship. In longitudinal analyses, migrants were frailer than non-migrants at baseline (ages >50 years) and trajectories converged over time until migrants and non-migrants were equally frail by 80-90 years. Our work discounts the ‘healthy migrant effect’ outside of Southern Europe at ages where expanding migrant populations may place their greatest demands on healthcare systems and suggests that acculturation is a key determinant of migrant health.