A Nonparametric Analysis of the Healthy Immigrant Effect

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A nonparametric analysis of the healthy immigrant effect. Antonio Fidalgoa b Alberto Hollyc Marco Pecoraroa Philippe Wannerb. Swiss Forum for Migration and Population Studies CH 2000 Neucha tel Switzerland. I De mo University of Geneva CH 1211 Geneva Switzerland. University of Lausanne CH 1015 Lausanne Switzerland. December 13 2016, This paper uses data from the Swiss Labour Force Survey to evaluate the existence. of the healthy immigrant effect hie which would translate in i a health advantage. of immigrants upon their arrival in Switzerland compared to individuals with similar. characteristics but Swiss born and ii an erosion of that advantage over the time of. residence until convergence in the levels of health between these two groups Our orig. inal contribution is to address this issue by taking a nonparametric approach in order. overcome any potential danger of misspecification that would preclude valid inference. We find little empirical support for the hie i no initial advantage and ii no conver. gence but the health status of immigrants is shown to deteriorate more than Swiss born. individuals with similar characteristics Significant differences appear when disaggre. gating among immigrants country of origin Interestingly we show that a standard. parametric approach in contrast to our findings would fully confirm the existence of. the hie with the same data set,1 Introduction, Concerns with the health of the migrant population have increased in the recent. decades with the growing number of immigrants in advanced countries The issue. has attracted a great deal of attention from various fields of research including social. sciences and epidemiology But its direct policy implications have also hit the headlines. as anxious voices question the burden on the public health system implied by high levels. of immigration especially from relatively poor countries. Guidance from the current literature however ought to be reassuring 1 The follow. We would like to thank Didier Ruedin for numerous invaluable suggestions and Sara Rellstab for. her help with the data We also gratefully acknowledge comments gathered at various conferences. including the 5th OECD CEPII Paris EHH2016 Lugano and 8th ICPDU Lausanne The research. leading to these results has received funding from the Swiss National Science Foundation under grant. agreement number 157027 and in the context of the NCCR on the move Possible remaining errors. are of our own responsibility, Email address fidalgo antonio gmail com Antonio Fidalgo. From the point of view of the host countries not necessarily the sending countries. ing regularity indeed emerges across studies Immigrants appear to be in better health. upon their arrival than a native born with similar socio economic characteristics a. fact coined healthy immigrant effect hie henceforth Yet this effect is also shown. to be temporary as the initial health advantage of immigrants diminishes till disappear. ing over the duration of the immigrant s stay in the host country. The present study offers new evidence by addressing the hie hypothesis2 in a way. not explored so far The main contribution of our analysis lies in the econometric. approach adopted To our knowledge we are the first to use nonparametric techniques. in order to analyze the functional relationship between locals vs immigrants measure. of health and a set of explanatory variables Parametric methods require prior to. estimation that researchers impose a functional form on the underlying unknown. data generating process Thus the danger exists that the formulated models suffer. from incorrect specification and therefore that reliable inference is precluded 3 Our. approach overcomes that danger by using data driven techniques in order to select the. most appropriate model in the given samples Hence any hie evidence obtained after. relaxing the specification assumptions would represent a strong support for the existing. parametric models, The use of Swiss data is also unprecedented in the analysis of the hie While the. absence of any study for this country could stand as a reason per se we argue that. Switzerland is actually a particularly good candidate to evaluate the robustness of. the hie findings This is because the inflows of population from all origins though. mainly from the European Union are among the highest in Switzerland relative to its. population On the other hand the Swiss health system undeniably provides premium. universal health services Hence any hie evidence found in this least favorable case. would necessarily carry a greater weight in discussions concerned with less advanced. health systems, Notice that we must distinguish between the relative insights of these two lines of in.
vestigation We do so by running parametric estimations under standard specifications. of the model for health determinants In other words we replicate the usual procedure. with our data The impact of our alternative econometric approach is thus evaluated. with respect to that benchmark, Our results shed a new light on the hie hypothesis Using a common paramet. ric estimation in line with the usual findings we find prima facie evidence of the. hie in our data from Switzerland However once we abandon any prior for the func. tional form estimated results become dramatically different both quantitatively and. qualitatively Our nonparametric estimations show that as early as they arrive in. Switzerland foreign born are worse off in terms of health than native born with sim. ilar characteristics We interpret the discrepancies between methods as a reminder of. That is an immigrant s initial but eroding health advantage. As Monfort 1996 puts it The possibility of misspecification is often forgotten perhaps because. it is always frustrating to realize that a brilliant result holds only if the model under consideration is. well specified, the key importance of model specification when evaluating the determinants of health. The plan of the paper is as follows Section 2 reviews the literature to provide both. current evidence and explanations of the hie hypothesis Section 3 introduces the main. data set of our analysis while Section 4 explains the methodology adopted Results. are presented in Section 5 Section 6 summarizes our findings and offers concluding. 2 Current evidence and explanations of the hie, Most studies of the hie hypothesis concentrate on a limited set of countries mainly. USA Jasso et al 2004 Antecol and Bedard 2006 Abraido Lanza et al 1999 Thomson. et al 2013 Canada McDonald and Kennedy 2004 Newbold 2005 Ng et al 2005. Kwak 2016 and Australia Biddle et al 2007 Chiswick et al 2008 Powles 1990 4. Results generally confirm the existence of such an effect despite the fact that immigrants. come from countries with lower levels of income and health indicators This apparent. puzzle has triggered various alternative explanations The following lists first those. offered to account for the immigrant s initial health advantage. Selection of immigrants by the local authorities has been suggested to play a role. in explaining the health gap Selectivity can arise via many criteria including health. skills or education Laroche 2000 shows that health screening is unlikely to serve. as an explanation as the number of applicants to Canada rejected on that ground is. very small Also Uitenbroek and Verhoeff 2002 argue that the lower mortality of. immigrants in Amsterdam do not derive from selection by authorities based on health. On the other hand Chiswick et al 2008 find that the type of visa granted by the. Australian authorities reflects in the immigrant s level of health as skilled individuals. are less likely to be in poorer health This last result must be read in light of the current. policies of many destination countries that attempt to attract skilled immigrants e g. UK s point based immigration system USA and Germany s selective policies. The second type of explanation refers to immigrants behaviors prior to migration. To the extent that these latter are healthier than those of the average person in the host. country an advantage in health could appear in the data For instance Abraido Lanza. et al 1999 mention lower cigarette and alcohol consumption by Latino immigrants as. a cause of their lower mortality in the USA, Self selection among potential immigrants has also been proposed as an explanation. for the hie Thereby individuals in the upper tail of the distribution in health and. wealth highly correlated with the former are also the most likely to migrate from. the poorer countries Evidence for self selection effects in other contexts such as labor. market outcomes has already been identified Borjas 1987 Chiswick 1999 Chiquiar. and Hanson 2005 McKenzie and Rapoport 2010 to cite a few examples Jasso. et al 2004 Martinez et al 2015 Kennedy et al 2015 or Farre 2016 among. Kennedy et al 2015 compare patterns among these three countries and the UK. others highlight the role of self selection in the context of health differences between. immigrants and locals 5, With respect to the second component of the hie hypothesis namely the erosion of.
the immigrant s health advantage over the years since migration the following reasons. have been put forward As hypothesized by Jasso et al 2004 the convergence in health. might derive from a phenomenon of acculturation whereby immigrants adopt the local. way of living Alternatively the mere fact of being exposed to common environmental. conditions might also explain why the levels of health become similar for both groups. Stephen et al 1994 Another aspect builds on possible barriers that immigrants. face in the use of health services at least upon their arrival As these barriers lower. with language acquisition or overtaking of cultural differences more adverse conditions. among immigrants may be detected possibly in worse forms than they would have. been should they be diagnosed earlier see Leclere et al 1994 for an argument along. these lines Finally a so called salmon effect would also have an impact on the. apparent declining of immigrants average level of health if less healthy immigrants. with consequent lower job outcome opportunities were to return to their home country. Razum 2006, Notice that all of these potential explanations are interrelated and might simulta. neously be at work It is therefore beyond the scope of this paper to distinguish their. relative contributions in the conundrum 6 Instead we restrict our study to establishing. new reliable evidence, Finally it is worth mentioning that general agreement on the existence of a hie does. stand for unanimity For instance Moullan and Jusot 2014 find that immigrants re. port either poorer or better health depending on which European country is examined 7. This suggests that the relevance of the hie may depend on the status of immigrants and. immigration policy in the host country Focusing on a cohort of refugees and family. reunited immigrants in Denmark relative to local born Danes Norredam et al 2014. generally do not support the hie In the case of Israel where immigration is based. on ideological rather than economic reasons Constant et al 2015 show evidence of a. sick immigrant effect according to which immigrants arrive with a lower health status. than natives and this status persists for several decades ceteris paribus On the other. Rubalcava et al 2008 explores the self selection issue and finds weak evidence of the hie though. Further explanations for the hie have also been mentioned in the literature In a rather unique. natural experiment Gibson et al 2013 compare the health of Tongan immigrants that were accepted. in New Zealand through a random lottery with the health of the unsuccessful candidates Divergence. in various measures between the two groups are interpreted by the authors as evidence of a direct. impact of migration per se on the immigrant s health Yet another view attributes to differences in. perceptions of health between groups e g immigrants vs locals one origin vs another part of the. observed hie McDonald and Kennedy 2004, A possible explanation for this finding may lie in the choice of not controlling for the immigrant s. duration of residence in the host country As mentioned above there are reasons and evidence to. expect the assimilation pattern to affect the immigrant s health Hence pooling individuals over that. criterion may result in compounding contradictory effects. hand Sole Auro and Crimmins 2008 find little evidence of the hie only at high ages. in their sample of European countries McDonald and Kennedy 2004 for immigrants. in Canada find that the hie holds for some measures of health but not others. 3 1 The sample, The data in this analysis consists of observations from the Swiss Labour Force. Survey spanning from 2010 to the latest available data in 2014 The data have a. longitudinal structure but attrition appears to be high and the period length between. each wave is too short For that reason along with computational considerations we. treat each year separately, Data is further screened in the following two ways First only male individuals are.
included as there is evidence that different dynamics are at play with female immigrants. see for instance McDonald and Kennedy 2004 Martinez et al 2015 Second indi. viduals age is restricted to the range 18 65 years This is close to the usual choices8. University of Neuchatel Institute of Economic Research IRENE Working paper 16 15 A Nonparametric Analysis of the Healthy Immigrant Effect Antonio Fidalgo Alberto Holly

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