Mobility, selectivity, and the migrant mortality advantage

 说明(申请人提供)：这项研究的首要目标是增进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，即观察到移民往往比东道国的非移民人口表现出更低的死亡率。尽管关于这一主题的文献很多，但这一死亡率优势仍然令人怀疑和了解不多，部分原因是移徙人口的本质：他们的流动性很强，很难在数据来源中正确地获取数据。记录各国移民死亡率优势的研究通常不能充分解释这些特征，导致移民死亡率往往被人为压低。在这种情况下，移民在抵达东道国时(往往尽管他们的社会经济地位较低)具有死亡率优势的经典观察仍然很难从流行病学的角度加以解释，这种优势会随着时间的推移而减弱，并在第二代中消失甚至逆转。这对政策制定者充分满足移徙人口健康需求的能力提出了挑战。这项研究将使用来自法国的三个丰富和独特的纵向数据集来检验移民死亡率优势的性质和程度，这是这一研究领域高度相关的背景。这些数据集的具体特点将使我们能够解决迄今为止困扰移民死亡率研究的方法陷阱。这些特点包括：对东道国发生的移民死亡事件进行严格跟踪；对离开东道国的个人进行审查的可能性；对东道国前居民在世界各地的死亡情况进行严格跟踪；以及抓获第二代移民的可能性。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说：(1)移民死亡率优势是由于东道国移民人口的死亡和人-年暴露时间记录不足而产生的数据假说；(2)死亡率优势是由选择性返回移民产生的假说，这一假说也被称为“鲑鱼偏向”假说。重点关注30岁以上的死亡率，另外还关注65岁以上的死亡率。该项目将利用具有独特特点并代表高度相关背景的数据，以更高的精确度和全面性评估假设，并将对关于一套一般机制如何影响移民死亡率优势模式的辩论作出重要贡献，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.