Immigrants in Nordic countries live longer than native-born populations but suffer from more diseases and medical conditions—a pattern researchers call the morbidity-mortality paradox. This matters because the global foreign-born population, if combined into a single country, would be the fifth largest in the world. As these populations age in place, the paradox suggests millions of people are living long lives in poor health. Yet existing evidence comes from scattered, low-quality data sources, leaving a gap in direct, coherent knowledge about whether the paradox is real, how widespread it is, and what causes it. The researcher will analyse longitudinal population register data from Denmark, Finland, Norway, and Sweden—tracking both disease and death from the same source. One work package will reveal how common the paradox is across the Nordic region. Another will identify the specific diseases, causes of death, and immigrant origins driving it. A third will pinpoint the mechanisms behind it. If successful, this research could transform how immigrant health is conceptualised and analysed, and directly inform national and international health policy. It is primarily fundamental science aimed at establishing empirical knowledge where none currently exists.
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If the global foreign-born population all lived in single country, it would be the fifth largest country in the world. The rapid rise and diversification of contemporary worldwide migration has no precedent in history. There is clear evidence that immigrants have lower mortality risks than native-born populations do. Although this advantage is pervasive for mortality (i.e., death), it is regularly absent, or even reversed, for morbidity (i.e., diseases and medical conditions). This is alarming because it suggests that migrants are living long lives in poor overall health. With immigrants’ ageing in place, this should constitute one of the most highly relevant social and public health concerns today. Yet, beyond evidence from disparate data sources of variable quality and coverage, there is a distinct absence of direct, coherent, empirical knowledge of this morbidity-mortality paradox. To address this gap, I aim to establish the existence, extent, and causes of this immigrant morbidity-mortality paradox. I will use cutting-edge techniques to analyse longitudinal micro-level data on morbidity and mortality from the same source of information: the population registers of Denmark, Finland, Norway and Sweden. Work Package A will reveal how prevalent an immigrant morbidity-mortality paradox is within the Nordic region and evaluate the role that this paradox plays in our understanding of wider population health. Work Package B will identify the intricate disease spectrum, causes-of-death, and granular immigrant origins essential to understanding the paradox. Work Package C will identify the mechanisms that can explain the paradox. This research has the potential to (1) transform the limited way in which the health of immigrants is currently conceptualised and understood, (2) revolutionise how researchers analyse immigrant health, (3) highlight immigrant health and its role in wider population health, and (4) directly inform national and international policy.
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