Skips are wheezers: the ‘healthy migrant’ effect

3 minute read

Aussies from English-speaking and other European backgrounds have more chronic illness, and other interesting findings.

Unpicking the relationships between chronic disease, culture, time lived in Australia and English language proficiency is a task that only our stalwart Australian Institute of Health and Welfare would have the stomach for.

In its newest report, Chronic health conditions among culturally and linguistically diverse Australians, 2021, the institute has found that people born overseas have lower prevalence of chronic health conditions than people born in Australia.

The picture – which is generated from the 2021 ABS Census, the first to collect data on certain long-term conditions – gets more complicated from there.

The AIHW looked at prevalence of a range of chronic conditions by country of birth, time since arrival, main language used at home and English proficiency, then by combinations of all those variables.

For asthma, arthritis, mental health conditions and lung disease, no country of birth had higher prevalence than Australia.

The same disease pattern was seen when time lived in Australia was measured: those who’d been here longer than 10 years had more asthma, arthritis, mental health conditions and lung disease, and the finding was most striking in those with low English proficiency.

Dementia, heart disease, stroke, diabetes and kidney disease were different, with higher prevalence in many countries of birth, especially Polynesia, south Asia and the Middle East. Bangladesh-born Australians had the highest rates of diabetes and heart disease (12% and 4.6%), while kidney disease was highest in people born in Tonga (1.9%) and Samoa (1.5%).

The same differences were found, unsurprisingly, in main languages spoken, with Tongan and Maori-speaking Australians having the most diabetes and kidney disease.

Among the 20 most frequent non-English-speaking countries of birth, people born in Iraq had the highest prevalence (29%) of at least one chronic condition, followed by those born in Lebanon (26%) and Sri Lanka (25%), while those born in China (15%), Nepal (15%) and South Korea (16%) had the lowest.

The report goes into the problems around the category “culturally and linguistically diverse” (CALD) – which is extremely heterogeneous and has no universally accepted definition.

It also mentions the “healthy migrant” effect, whereby the stringent requirements and health checks for immigrants ensure better-than-average health on arrival, but this deteriorates over time (adjusting, one assumes, for the effects of ageing).

The Back Page wonders if that is the same everywhere, or whether Australia excels at importing healthy people and making them sicker.

With more than seven million Australians born overseas (28%, up from the 2016 Census proportion of 26%) and 23% speaking a language other than English at home, improving health communications, literacy and access for CALD groups will only become more important.

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