Living Arrangements and the Speed of Chronic Disease Accumulation among Older Migrants and Natives

BACKGROUND: Immigrants may experience a faster health decline than natives due to the deleterious impact of migration-related experiences on healthy ageing. Support from living arrangements where family members reside together is known to provide a buffering effect for such health deterioration. This study examines the role of living arrangements in the health of immigrants versus natives, focusing on the rate of chronic disease accumulation to portray the healthy ageing processes. METHODS: We use data from the Survey of Health, Ageing and Retirement in Europe (SHARE). First, we employ ordinary least square regression models with clustered standard errors in the pooled sample to determine the average number of chronic diseases by migration background. Then, we run immigrant status- and living arrangement-stratified analyses to illustrate the age-related profiles of chronic disease accumulation in immigrants versus natives. RESULTS: According to our results, living with a spouse or family has a buffering effect on chronic health deterioration for natives, which disappears among immigrants. This beneficial effect is especially prevalent for native men, explaining the immigrant-native gap in the average number of chronic diseases - observed only in a couple or family households among men. Further, chronic diseases accumulate at different rates with age between immigrants and natives based on their living arrangements. Immigrant men living with a family have a slower chronic disease accumulation than native men, while among women, the accumulation speed is faster in immigrants than in natives. CONCLUSIONS: Our results indicate that living with a spouse or a family member provides a different amount of protection by the migration background, leading to different healthy ageing processes between immigrants and natives. Therefore, public policies should monitor the health of the ageing migrant population not only as a whole but also by living arrangements. KEY MESSAGES: • Types of living arrangements are associated with age-related profiles of chronic disease accumulation. • Living with a spouse or a family member provides a different amount of protection by the immigration background, leading to different healthy ageing processes between immigrants and natives.