The effect of age at immigration and generational status of the mother on infant mortality in ethnic minority populations in The Netherlands.
BACKGROUND
Migrant populations consist of migrants with differences in generational status and length of residence. Several studies suggest that health outcomes differ by generational status and duration of residence. We examined the association of generational status and age at immigration of the mother with infant mortality in migrant populations in The Netherlands.


METHODS
Data from Statistics Netherlands were obtained from 1995 through 2000 for infants of mothers with Dutch, Turkish and Surinamese ethnicity. Mothers were categorized by generational status (Dutch-born and foreign-born) and by age at immigration (0-16 and >16 years). The associations of generational status and age at immigration of the mother with total and cause-specific infant mortality were examined.


RESULTS
The infant mortality rate in Turkish mothers rose with lower age at immigration (from 5.5 to 6.4 per 1000) and was highest for Dutch-born Turkish mothers (6.8 per 1000). Infant death from perinatal and congenital causes increased with lower age at immigration and was highest in the Dutch-born Turkish women. In contrast, in Surinamese mothers infant mortality declined with lower age at immigration (from 8.0 to 6.3 per 1000) and was lowest for Dutch-born Surinamese mothers (5.5 per 1000). Generational status and lower age at immigration of Surinamese women were associated with declining mortality of congenital causes.


CONCLUSIONS
Total and cause-specific infant mortality seem to differ according to generational status and age at immigration of the mother. The direction of these trends however differs between ethnic populations. This may be related to acculturation and selective migration.
Troe
Ernst-Jan W M
EJ
Department of Public Health, Erasmus Medical Centre Rotterdam, The Netherlands. j.troe@erasmusmc.nl
Kunst
Anton E
AE
Bos
Vivian
V
Deerenberg
Ingeborg M
IM
Joung
Inez M A
IM
Mackenbach
Johan P
JP
D000069:Acculturation; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001719:Birth Certificates; D002423:Cause of Death / Q000639:trends*; D002648:Child; D002675:Child, Preschool; D003431:Cross-Cultural Comparison; D003644:Death Certificates; D004641:Emigration and Immigration / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D007226:Infant Mortality / Q000639:trends*; D007231:Infant, Newborn; D008297:Male; D008423:Maternal Age; D008875:Middle Aged; D008913:Minority Groups / Q000706:statistics & numerical data*; D009426:Netherlands / Q000453:epidemiology; D011247:Pregnancy; D016016:Proportional Hazards Models; D012042:Registries; D013532:Suriname / Q000208:ethnology; D013997:Time Factors; D014421:Turkey / Q000208:ethnology