Health status by citizenship: insight from survey and register data on immigrant health in Italy

This paper analyses the health status of immigrants in Italy, focusing on their citizenship status and the impact of both individual and macro-level factors on their health. We specifically investigate whether immigrants report different levels of health conditions compared to native-born individuals, using measures such as self-rated health, the number of chronic diseases, and functional limitations. Additionally, we evaluate the relationship between citizenship acquisition and health, while also considering the role of family and social support networks. The study uses a combined dataset of survey and register data from the ISTAT ‘Families, Social Subjects, and Life Cycle’ (FSS) survey conducted in 2016. By linking FSS 2016 survey participants with citizenship acquisition registers, we ascertain the citizenship status of immigrants in Italy. Key findings indicate significant health disparities among different migrant sub-groups. Foreigners have higher odds of reporting good or very good self-rated health compared to Italians but significantly lower odds of experiencing functional limitations and chronic diseases, highlighting a potential 'healthy immigrant effect,' where immigrants often arrive in better health compared to the native-born population. Naturalised citizens tend to have health outcomes more similar to those of native-born Italians, suggesting that the integration process, as proxied by naturalisation, may align immigrant health outcomes with those of the host population. Our study underscores the importance of considering both individual-level factors and broader socio-economic determinants when addressing health disparities among migrant populations. It highlights the need for tailored public health interventions that consider the unique social support structures and integration processes of migrant sub-groups.