Migration, health and mortality in Italy: An unfinished story

Since the late 1970s Italy has become a country of immigration after being one of the main European countries of emigration for more than a century, with around 27 million expatriates and 11–13 million repatriates. Today, foreign residents number more than 5 million, and if we also take non-residents into account we arrive at almost 6 million – around 10 percent of the population. They are almost all citizens of developing countries and from Central and Eastern Europe, with a significant presence of those that joined the European Union (EU) during the past decade. It should be underlined, however, that the foreign population, which has gradually increased over time, has reached a really important number only in the past decade. For this reason, we do not yet have very full information and knowledge on the health conditions and mortality levels of immigrants. Before analyzing the health and mortality of foreigners, it would be useful to provide a general picture on immigration and the characteristics of the foreign population in Italy. The next section of this chapter describes the development of the phenomenon of migration. The subsequent section discusses the health conditions of the foreign population, using the results that have emerged from literature on hospitalizations and perinatal outcomes, accidents and work-related health problems, by elaborating the micro-data of an important survey carried out in 2009 on self-rated health, activity limitations and chronic morbidity. A comparison of mortality levels of Italians and foreigners is dealt with in the following section on the basis of data elaborated by the National Institute of Statistics (Istat). It considers adult mortality by gender and cause of death, as well as infant mortality, considering both the neonatal and post-neonatal period. Where possible, we have sought to distinguish foreigners by macro-areas of citizenship, following the hypothesis that some observable differences concerning morbidity and mortality are partly the result of different life histories, social and cultural behaviors and working conditions that characterize the individuals of different nationalities. In general, the empirical information available for Italy, which are cited in this work, make it possible to discuss and consider some hypotheses that have emerged in the international literature (for example, healthy immigrant effect, salmon bias, and the possible convergence of health and mortality levels of foreigners and the national population).