Immigrants live longer in spite of being less well educated

Norwegians with a university or university college education live an average of six years longer than someone who has only graduated from primary or lower secondary school.  Having less money, smoking more and having a stressful job are only a few of the reasons why those with less education have poorer prospects for their old age.

But these social differences are not as great among immigrants to Norway, according to a survey of Norwegian residents aged 20 to 69. Less well-educated immigrants are less likely to die at a younger age than their Norwegian-born peers with the same educational level.

“Many people believe that immigrants die younger. They often come from poor countries and have poor living conditions when they come to Norway,” says Jon Ivar Elstad, one of the researchers behind the study. “But that’s not the case.”

Elstad is a sociologist at Norwegian Social Research (NOVA), at Oslo and Akershus University College.

Differences in life expectancies between well-educated Norwegians and their less well-educated peers increased slowly from the middle of the 1990s to around 2010, but the influx of immigrants to Norway did not affect this trend in the way you might think, Elstad said. 

“The differences in life expectancies between those with more and less education would have been greater without immigration,” he said.

Emigrants in good health

Less well-educated in the context of Elstad’s study means having completed elementary school or less, while those who are highly educated have taken a university or university college education. In between are individuals who have completed high school.

There may be many reasons why immigrants with less education seem to live longer, Elstad says.

While the Norwegian researchers have not actually studied this issue, Elstad thinks a likely reason is one that has been identified elsewhere, in studies from many countries: Individuals who leave their homes on a long and often arduous journey to another country are often in better health than those who stay behind.

If you come to Norway as a work immigrant, as many have done in recent years, you have to be in good health to work in physically demanding occupations. As a consequence, this usually means that poorly educated workers with the poorest health do not come.

“There is the thought that people in poor health seek to live in countries with good healthcare and a well-developed welfare state. But most immigrants are not in bad health when they leave their country,” says Elstad.

Major differences between immigrants

Although they may be healthier than those who are left behind, that is no guarantee that immigrants are in better health than the people in the country they move to. That means that there may be something about the way they live or their situation that allows immigrants with less education to live longer than Norwegians with less education.

Smoking may be one possible reason for the trend: Perhaps immigrants smoke less than their Norwegian counterparts? It is well known that Norwegians with less education are more likely to die of lung cancer and chronic lung disease (COPD), mainly because more are likely to smoke.

At the same time, a survey from the early 2000s by the Norwegian Institute of Public Health showed that poorly educated men from some countries smoke more than native Norwegians, while immigrant women smoke less than Norwegian-born women.

Another factor to consider is that Norway’s immigrants come from all over the world. While African and Asian men die later than Norwegian-born men, Pakistanis and Western Europeans have about the same life expectancies as Norwegian-born. However, Pakistani-born women die younger than Norwegian-born women.

Immigrants from Turkey, Iran, Pakistan, Sri Lanka and Vietnam also drink less alcohol than their Norwegian-born counterparts, according to the Institute of Public Health’s survey.

“Different lifestyles are just some of the things that come into play,” says Elstad.

He and his colleagues have not looked at causes of death and can not say anything certain about the reasons for the differences. Some die enough of poor health, but the researchers do not know if immigrants are more likely to die of other causes, such as accidents or suicides than Norwegians.

May be more “Norwegian” over time

Another unanswered question concerns whether these trends will persist as today’s immigrants grow older. Immigration is fairly new to Norway, and almost half of the immigrants surveyed came to Norway after 2000.

Moreover, the researchers only looked at those who died relatively early - before they reached the age of 70. This is because there are simply so few elderly immigrants in Norway that the researchers didn’t have enough data to make sound statistical analyses. For example, in 2008 there were only 88 Somalis who were 70 years old or older.

“As the years go by, this trend may be reversed as immigrants suffer from poor working conditions and lower living standards,” Elstad said.

Yet another confounding factor may be that immigrants choose to move back to their home countries when they become elderly, and may die there without necessarily informing Norwegian officials. That would make it appear that certain immigrants were living for a long time when in fact they were not.

Immigrants may also adapt to life in Norway by adopting unhealthy lifestyles.

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Read the Norwegian version of this article at forskning.no

Scientific links

• Jon Ivar Elstad et. al. Prospective register-based study of the impact of immigration on educational inequalities in mortality in Norway. BMC Public Health 2015, 15 (1). DOI: 10.1186/s12889-015-1717-2
• Bjørn Heine Strand et. al Trends in educational inequalities in cause specific mortality in Norway from 1960 to 2010: a turning point for educational inequalities in cause specific mortality of Norwegian men after the millennium? BMC Public Health 2014, 1

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