Mobility, selectivity, and the migrant mortality advantage

 描述（由申请人提供）：本研究的总体目标是提高对解释社会流行病学最普遍结果之一的因素的理解：移民死亡率优势，即，关于移徙者的死亡率往往低于东道国非移徙人口的意见。尽管有大量关于这一主题的文献，但这种死亡率优势仍然存在疑问，而且人们对其了解甚少，部分原因是移民人口的性质：人口高度移动的，难以在数据来源中正确捕捉。记录各国移徙者死亡率优势的研究通常没有充分考虑到这些特点，往往人为地将移徙者死亡率定得很低。在这种情况下，移徙者在抵达东道国时（往往尽管其社会经济地位较低）死亡率较高，但随着时间的推移而降低，并在第二代消失或甚至逆转，这一传统观点仍然难以从流行病学的角度加以解释。这对决策者充分满足移徙人口健康需求的能力提出了挑战。本研究将使用法国的三个丰富而独特的纵向数据集来研究移民死亡率优势的性质和幅度，这是这一研究领域的高度相关背景。这些数据集的具体特征将使我们能够解决迄今为止困扰移民死亡率研究的方法学缺陷。这些功能包括：严格跟踪移徙者在东道国发生的死亡事件;在个人离开东道国时对其进行审查的可能性;严格跟踪世界各地前东道国居民的死亡情况;以及捕获第二代移徙者的可能性。这些独特的特征将使我们能够评估移民死亡率优势的两个主要假设：（1）假设移民死亡率优势是由于移民人口在其东道国的死亡和人年暴露记录不足而造成的数据假象;以及（2）死亡率优势是由选择性返回迁移产生的假设，该假设也被称为“鲑鱼偏好”假设。重点是30岁以上的死亡率，另外重点是65岁以上的死亡率。该项目使用具有独特特征并代表高度相关背景的数据，将以更高的精确度和全面性评估假设，并将为关于一套一般机制如何影响移民死亡率优势模式的辩论做出重要贡献，并对观察到类似优势的各种背景产生影响。

 DESCRIPTION (provided by applicant): The overarching goal of this research is to improve the understanding of factors explaining one of the most pervasive results of social epidemiology: the migrant mortality advantage, i.e., the observation that migrants tend to exhibit lower mortality than the non-migrant population of their host country. In spite of the extensive literatue on the topic, this mortality advantage remains questionable and poorly understood, in part because of the very nature of the migrant population: a population that is highly mobile and difficult to capture correctly in data sources. Studies documenting the migrant mortality advantage in various countries typically fail to adequately account for these features, producing mortality rates among migrants that tend to be artificially low. In such a context, the classic observation that migrants experience a mortality advantage upon arrival in the host country (often in spite of their lower socio-economic status) which diminishes over time and disappears or even reverses for the second generation, remains difficult to interpret in epidemiological terms. This challenges the ability of policy makers to adequately address the health needs of migrant populations. This research will examine the nature and magnitude of the migrant mortality advantage using three rich and unique longitudinal data sets from France, a highly-relevant context for this area of research. Specific features of these data sets will allow us to address methodological pitfalls that have plagued research on migrant mortality so far. These features include: a rigorous follow-up of deaths occurring among migrants in the host country; the possibility of censoring individuals when they leave the host country; a rigorous follow-up of deaths worldwide for former residents of the host country; and the possibility of capturing second-generation migrants. These unique features will allow us to evaluate two major hypotheses for the migrant mortality advantage: (1) the hypothesis that the migrant mortality advantage is a data artifact due to inadequate recording of deaths and person-years of exposure for migrant populations in their host country; and (2) the hypothesis that the mortality advantage is produced by selective return migration, a hypothesis also known as the "salmon bias" hypothesis. The focus is on mortality above age 30, with additional focus on mortality above age 65. Using data with unique features and representing a highly-relevant context, this project will evaluate hypotheses with a greater level of precision and comprehensiveness and will make important contributions to debates about how a set of general mechanisms can affect patterns of the migrant mortality advantage, with implications for a variety of contexts where a similar advantage has been observed.