The pattern
Markides and Coreil (1986) described an epidemiologic paradox: Hispanics in the US Southwest had health similar to or better than non-Hispanic whites despite lower income. Similar advantages appear in Canada, Australia and the UK (Kennedy et al., 2015).
Explanations
Healthy people self-select into migration and screening filters further. Abraído-Lanza and colleagues (1999) tested 'salmon bias', where sick migrants return home, and Palloni and Arias (2004) combined data error and selection. Riosmena and colleagues (2013) used binational data.
Erosion
McDonald and Kennedy (2004) and Antecol and Bedard (2006) found immigrant health converges to native levels through diet, obesity, discrimination and stress, 'unhealthy assimilation' linked to segmented assimilation and the social determinants of health.
FAQ
- What is the healthy immigrant effect in simple terms?
- New immigrants are often healthier than locals, but the advantage fades over time.
- Why are immigrants healthier?
- Healthy people tend to migrate, sick ones often return, and home habits persist at first.
Sources reviewed: 2026-10-26
References
- Markides, K. S., & Coreil, J. (1986). The health of Hispanics in the southwestern United States: An epidemiologic paradox. Public Health Reports, 101(3), 253–265. The origin of the Hispanic paradox.
- Abraído-Lanza, A. F., Dohrenwend, B. P., Ng-Mak, D. S., & Turner, J. B. (1999). The Latino mortality paradox: A test of the "salmon bias" and healthy migrant hypotheses. American Journal of Public Health, 89(10), 1543–1548. Tests salmon bias and selection.
- McDonald, J. T., & Kennedy, S. (2004). Insights into the 'healthy immigrant effect': Health status and health service use of immigrants to Canada. Social Science & Medicine, 59(8), 1613–1627. Canadian evidence of convergence.
- Palloni, A., & Arias, E. (2004). Paradox lost: Explaining the Hispanic adult mortality advantage. Demography, 41(3), 385–415. Decomposes the mortality advantage.
- Antecol, H., & Bedard, K. (2006). Unhealthy assimilation: Why do immigrants converge to American health status levels? Demography, 43(2), 337–360. Unhealthy assimilation.
- Riosmena, F., Wong, R., & Palloni, A. (2013). Migration selection, protection, and acculturation in health: A binational perspective on older adults. Demography, 50(3), 1039–1064. Binational evidence on selection.
- Kennedy, S., Kidd, M. P., McDonald, J. T., & Biddle, N. (2015). The healthy immigrant effect: Patterns and evidence from four countries. Journal of International Migration and Integration, 16(2), 317–332. Evidence from four countries.