There have been consistent reports in several countries that some adult migrant populations tend to have lower mortality than the host population despite a lower socioeconomic status. The most frequently proposed hypotheses for this paradox are selection mechanisms, dietary intake variations and cultural or lifestyle factors.
Belgium is well suited to explore these explanations thanks to the presence of large migrant communities and the existence of a national population register. The present analysis compares cause-specific mortality patterns for the largest migrant communities (Italian, Spanish, Moroccan and Turkish) with those of migrants from neighbouring countries with a similar lifestyle and dietary intake as the Belgian population.
Cause-specific mortality is an important clue for explaining the diversity of health outcomes. The mortality patterns of migrant communities and the native Belgian population were analysed by decomposition techniques and multinomial logistic regressions. The study of cause-specific mortality by subpopulations is useful for identifying factors that make some populations healthier than others. The reasons for the paradox appear to be multifactorial, resulting from a combination of lifestyle, dietary intake variations and the health infrastructure of the host country.