Migration History and Self-Reported Health Among Migrants in Italy: Evidence From the MIGHTY Project

Abstract

Introduction

The scientific literature has extensively documented the so-called "immigrant health paradox," whereby newly arrived immigrants often exhibit better health status than native-born populations with comparable demographic and socioeconomic characteristics. However, this advantage tends to diminish over time leading to a process of "unhealthy assimilation" in which health status deteriorates with longer residence in the host country.

Objective

Building on this framework, this study investigates whether a similar dynamic exists within the migrant population in Italy. Specifically, after adjusting for socio-demographic characteristics, we examine whether newly arrived immigrants maintain a health advantage compared with more established migrants and second-generation individuals (those born in Italy of foreign origin). Additionally, this study aims to identify the main determinants associated with self-reported health.

Methods

This study analysed cross-sectional data from the MIGHTY project survey, conducted in the Lombardy and Marche regions, between 2024 and 2025. The sample was stratified into four groups based on migration status and length of residence: recent immigrants (less or equal than 5 years), established immigrants (6–10 years), long-term immigrants (more than 10 years), and second-generation individuals born in Italy to foreign parents. A binary logistic regression model was used to assess the association between self-reported health and various socio-demographic, socio-economic, and health-related covariates. For this analysis, self-reported health was dichotomized from its original categories into good and not good, defining good health as the primary outcome. Health related covariates included the number of chronic diseases and the presence of depressive symptoms assessed through the PHQ8 questionnaire. All analyses were performed using R-studio and results were reported as Odds Ratio (OR) and 95% Confidence intervals (95%CI).

Results

3625 (out 3660 recruited) participants with complete data on self-reported health status were included in this analysis, 75% reported good health status, 80% younger than 50 years. The regression model showed a non-linear relationship between migration status and self-reported health. Using long-term migrants as the reference category, second-generation individuals (OR = 1.93, 95%CI:1.20-3.20) and established immigrants (OR = 1.51, 95%CI: 1.05-2.02) showed a significantly higher probability of reporting good health. Comparison between recent immigrants and long-term residents was not statistically significant (OR = 1.34, 95%CI: 0.88-2.03). Regarding other main determinants, the probability of reporting good health was significantly reduced by increasing age(years) (OR = 0.96, 95%CI: 0.95–0.97), depressive symptoms (OR = 0.86, 95%CI: 0.83–0.89), financial struggles compared to the ability to cover expenses (OR = 0.54, 95%CI: 0.41–0.71), and the presence of chronic diseases (OR = 0.19, 95%CI: 0.14–0.24).

Conclusion

The findings provide partial support to the unhealthy assimilation hypothesis among immigrants in Italy. Rather than indicating a progressive deterioration in health with increasing length of residence, they suggest that the relationship between migration history and self-reported health is non-linear. Migration status, increasing age, depressive symptoms, financial difficulties, and chronic conditions were independently associated with a lower likelihood of reporting good health. These findings highlight that both migration-related and socioeconomic and health-related factors should be considered when addressing health inequalities among migrant populations.