Disparities in Health Outcomes of Returned Migrants in Mexico

Objective:  A well-established literature shows that immigrants in the U.S. experience better health outcomes than non-immigrants with similar socioeconomic status—the “epidemiological paradox”. However, little is known about the development of health problems over the lifespan of immigrants who return to their country of origin.

Methods:  The 2007-2011 Mexican Migration Project (MMP) employs an Ethnosurvey approach to gather data on randomly sampled households throughout the country of Mexico. Details on border crossings and their U.S. legal, health and socioeconomic status were provided. The analytical sample size was 3,221 for respondents with non-missing health and socioeconomic measures, which included 464 unauthorized migrants, 71 legal migrants and 2,686 non-migrants. We use multivariate Cox regression analysis to estimate the hazard of having self-reported diagnosis of hypertension, diabetes/pre-diabetes and heart problems. 

Results:  Legal immigrants to the U.S. did not have significantly higher risk for any of the studied health problems compared to non-migrants.  The hazard ratio for unauthorized deported immigrants ranged from 2.35 (CI:1.39-3.98) for diabetes to 3.67 (CI:1.54-8.78) for heart problems. Unauthorized immigrants who were never deported had significantly higher hazard of heart (HR=3.29; CI:1.89-5.75) and hypertension (HR=1.60; CI:1.09-2.35) problems than non-migrants. Half of unauthorized immigrants who were deported are predicted to develop diabetes 14 years earlier than their non-migrant peers. About two out of five unauthorized immigrants are predicted to develop heart problems by age 80 compared to only 12.8% of non-migrants.

Conclusions: We find that health problems occur significantly earlier among unauthorized immigrants compared to individuals who never migrated to the U.S. This may result from poor access to health care after crossing into the U.S. resulting in undiagnosed chronic disease or delayed medical treatment later in life.