Health status and mortality rates of adolescents and young adults in the Brussels-Capital Region: differences according to region of origin and migration history

Abstract

Objective

To examine and quantify differences in both self-rated health (SRH) and mortality according to region of origin, migration history and educational level among adolescents and young adults living in the Brussels-Capital Region (BCR).

Design

The data consist of the census of 2001 for the BCR linked to death and emigration records for the period of 01/10/2001–01/01/2006. Belgian, Maghreb, Turkish and sub-Saharan African 15–34 year olds are included in the analyses. Odds ratios are calculated for SRH (0 = poor health, 1 = good health) using logistic regression. Age-standardised mortality rates are computed and mortality rate ratios are shown using Poisson regression.

Results

There are marked health differences according to region of origin. While Maghrebins and Turks (M/T) feel less healthy, sub-Saharan Africans (SSA) feel healthier than Belgians. Furthermore, there are important differences within nationality groups, with second-generation M/T having a worse health status than the first generation. While first-generation SSA feel a lot healthier than Belgians, there is no difference between second-generation SSA and Belgians. Education plays a marked role in health and mortality differences, especially in young adulthood (25–34 years). Migration history is even more important than region of origin concerning mortality differences. First-generation M/T show lower mortality risks compared to Belgians and second-generation M/T, while the latter show comparable mortality risks as Belgians after controlling for education.

Conclusion

Important differences are observed according to both region of origin and migration history among adolescents and young adults in the BCR. These differences significantly reduce when accounting for education, suggesting that investing in education is a public-health strategy worth considering. Further research in this area may benefit from taking migration history into account.

Keywords:

• adolescence
• self-rated health
• region of origin
• all-cause mortality
• migration history
• social inequalities

Acknowledgements

This study was funded by Innoviris, with the programme of Prospective Research for Brussels, made possible by the government of the BCR. In addition we also wish to thank Helga de Valk for her inspiring remarks.