Healthy migrants? Health selection of internal migrants in Germany

Christina Westphal, Universität Rostock and Fraunhofer IZI, Project Group EXIM

Background and Aim of the Study: In Germany, internal migration streams have substantially reshaped the population structure since reunification. Although selective migration can have substantial effects on the geographical distribution of health and associated risk factors, so far, only a few studies have analysed the link between internal migration processes and health. Aim of this study was to analyse whether internal migrants in Germany are selected with regard to their health status. Data and Methods: The analysis is based on the German Socio Economic Panel (GSOEP) for the years 2002-2010. Self-rated contentment with health was used as a health measure, while smoking and overweight were included in the analysis as indicators of an increased susceptibility to ill health. Applying event history analysis, this paper investigates how far migrants differ in their health satisfaction and risk factors from non-migrants when controlling for other covariates. Results: The findings show that health satisfaction has only little impact on internal migration. Men who were rather satisfied with their health, were more likely to migrate then unsatisfied men (HR=1,46; CI 1,074-1,984). A similar, but non-significant trend was observed for women (HR=1,15, CI=0,92-1,478). The risk factors smoking and overweight were significantly associated with internal migration. Non-smokers were more likely to migrate, and the propensity to migrate decreased with increasing weight. Obese people had the lowest migration risk (men: HR=0,62 CI=0,418-0,935; women: HR=0,52 CI=0,350-0,764). Discussion: Internal migrants in Germany are selected regarding their health status, i.e. they are possibly healthier and have a better risk factor profile. The population left behind is consequently potentially older, less productive and more prone to the development of chronic conditions. This may reinforce the consequences of population aging and have an impact on the demand for medical care.