title: Migrant integration policies and health inequalities in Europe.
abstract: Research on socio-economic determinants of migrant health inequalities has produced a large body of evidence. There is lack of evidence on the influence of structural factors on lives of fragile groups, frequently exposed to health inequalities. The role of poor socio-economic status and country level structural factors, such as migrant integration policies, in explaining migrant health inequalities is unclear. The objective of this paper is to examine the role of migrant socio-economic status and the impact of migrant integration policies on health inequalities during the recent economic crisis in Europe.
  
  
  
  Using the 2012 wave of Eurostat EU-SILC data for a set of 23 European countries, we estimate multilevel mixed-effects ordered logit models for self-assessed poor health (SAH) and self-reported limiting long-standing illnesses (LLS), and multilevel mixed-effects logit models for self-reported chronic illness (SC). We estimate two-level models with individuals nested within countries, allowing for both individual socio-economic determinants of health and country-level characteristics (healthy life years expectancy, proportion of health care expenditure over the GDP, and problems in migrant integration policies, derived from the Migrant Integration Policy Index (MIPEX).
  
  
  
  Being a non-European citizen or born outside Europe does not increase the odds of reporting poor health conditions, in accordance with the "healthy migrant effect". However, the country context in terms of problems in migrant integration policies influences negatively all of the three measures of health (self-reported health status, limiting long-standing illnesses, and self-reported chronic illness) in foreign people living in European countries, and partially offsets the "healthy migrant effect".
  
  
  
  Policies for migrant integration can reduce migrant health disparities.
authors.affiliation: Institute of Economics, Università della Svizzera Italiana, via Buffi 13, Lugano, 6900, Switzerland. margherita.giannoni@unipg.it.|Department of Economics, Università degli Studi di Perugia, via Pascoli 20, Perugia, 06123, Italy. margherita.giannoni@unipg.it.
authors.forename: Margherita
authors.initials: M
authors.lastname: Giannoni
authors.affiliation: School of Public Health, University of Maryland, College Park, MD, 20742, USA.
authors.forename: Luisa
authors.initials: L
authors.lastname: Franzini
authors.affiliation: Institute of Economics, Università della Svizzera Italiana, via Buffi 13, Lugano, 6900, Switzerland.|Department of Management, Information and Production Engineering, University of Bergamo, Via Pasubio 7b, Dalmine (BG), 24044, Italy.
authors.forename: Giuliano
authors.initials: G
authors.lastname: Masiero
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005060:Europe; D005260:Female; D006304:Health Status; D054624:Health Status Disparities; D006801:Humans; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D011640:Public Policy / Q000331:legislation & jurisprudence*; D057566:Self Report; D012923:Social Class; D012959:Socioeconomic Factors; D014171:Transients and Migrants / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Health inequalities; Migrant integration policy; Migration and health in Europe; Socio-economic determinants of health