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The European Journal of Public Health Advance Access originally published online on June 14, 2007
The European Journal of Public Health 2008 18(2):150-155; doi:10.1093/eurpub/ckm052
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© The Author 2007. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Health Inequalities

Selective international migration by social position, health behaviour and personality

Karri Silventoinen1, Niklas Hammar2,3, Ebba Hedlund2,4, Markku Koskenvuo1, Tapani Rönnemaa5 and Jaakko Kaprio1,6

1 Department of Public Health, University of Helsinki, Helsinki, Finland
2 Department of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
3 Epidemiology, AstraZeneca R&D, Mölndal, Sweden
4 Centre for Migration Research, Stockholm University, Stockholm Sweden
5 Department of Medicine, University of Turku, Turku, Finland
6 Department of Mental Health and Alcohol Research, National Public Health Institute, Helsinki, Finland

Correspondence: Karri Silventoinen, PhD, Department of Public Health, University of Helsinki, P.O. Box 41, Mannerheimintie 172, FIN-00014 University of Helsinki, Finland, tel: 358-9-19127572, fax: 358-9-19127570, e-mail: karri.silventoinen{at}helsinki.fi

Received February 7, 2007 , accepted May 13, 2007

Background: Immigrants is an important minority in many countries, but little is known how they are self-selected. We analysed differences in psycho-social and health behavioural factors between international migrants and non-migrants prior to migration in a large cohort of Finnish twins. Methods: A questionnaire was sent to Finnish twins in 1975 (response rate 89%, N = 26555 twin individuals). Follow-up data on migration and mortality were derived from population registries in Finland and Sweden up to 31 March 2002. In 1998, another questionnaire was sent to Finnish twins migrated to Sweden and their co-twins (response rate 71%, N = 1534 twin individuals). The data were analysed using Cox and conditional logistic regression models. Results: Life dissatisfaction, higher alcohol use and smoking at baseline predicted future migration. In men additionally, unemployment, neuroticism and extroversion increased the probability to migrate. Similar associations were found for alcohol use in men and smoking in men and women within twin pairs discordant for migration. Twins also reported retrospectively that prior to migration the migrated twin had been less satisfied with his/her educational institution or job and was generally less satisfied with life, used more alcohol (men) and smoked more (women) than the co-twin stayed in Finland. Conclusion: Migrants are self-selected by health behavioural and personality factors, which may compromise their health. The special requirements of migrants should be recognized in health care.

Keywords: health behaviour, migrants, personality


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