The living conditions and health status of international immigrants in Chile: Comparisons among international immigrants, and between them and the Chilean-born

The Republic of Chile is a middle-income South American country. In recent decades, Chile has faced a “new immigration” pattern, described as young immigrants, coming mostly from Latin American countries to work. This thesis is the first quantitative population-based study exploring the living conditions and health status of international immigrants in Chile. Secondary data analysis of a cross-sectional population-based survey carried out in 2006 is used (the CASEN survey 2006; 268,873 participants from 73,720 households). This study encompasses a large set of Social Determinants of Health (SDH) and analyses their relationship to several health outcomes among immigrants and the Chilean-born population. Those sets of SDH are the following: demographic, socioeconomic, material living standards, access to health care and migration related determinants. A wide range of statistical methods are used throughout this thesis in order to account for the great variability found in this dataset, as well as the complexity and co-linearity involved in most of its variables. Results show 1% of the sample report as international immigrants, coming mainly from Peru (28%), Argentina (26%), Bolivia (6%) and Ecuador (5%). An additional 0.7% chose not to report their migration-status (migration status missing values) and this group is more likely to live in socioeconomic derivation than immigrants. International immigrants are a heterogeneous group, with wide variation in socioeconomic status (SES). The "healthy migrant" effect appears within the total international immigrant population: this group has a lower prevalence of all health problems compared to the Chilean-born. However, when analyzing prevalence by SES, significant differences are found. Immigrants show clear gradients of health by SES, with different patterns according to the nature of the problem considered. Immigrants with low-SES show no "healthy migrant" effect and they have similar disease prevalence to the average Chilean-born, despite being younger. The “healthy migrant” effect also disappears among those living longer than 20 years in Chile. These key findings have direct policy implications for Chile and suggest relevant future research in this topic in the Latin American region.