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Internal migration, health selection, and the salmon bias

A register-based study of Finland

Bibliographic Data

ID4599657
AuthorsEugenio Paglino (0000-0001-8733-6460, University of Helsinki), I T Elo (0000-0003-1858-8239, University of Pennsylvania), Pekka Martikainen (0000-0001-9374-1438, Max Planck Institute for Demographic Research)
Year2025
Volume380
Pages118200
Publication date2025-09-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueSocial Science & Medicine (JOURNAL)
Journal identifiersISSN: 0277-9536 • E-ISSN: 1873-5347
PublisherElsevier BV (PUBLISHER)
DOI10.1016/j.socscimed.2025.118200
PMID40403590
OpenAlexW4410422119
LanguageEN
Citations received1
References cited70

Studies on international migrants have repeatedly found a mortality advantage of migrant over native-born populations. Data artifacts, differential prevalence of health-related behaviors, and health-related selection of immigrants and return migrants have been proposed as explanations. Neither the existence of a migrant mortality advantage for internal migrants nor the validity of existing explanations for this group have been extensively studied. Taking advantage of Finnish register data, we extend the literature on health and internal migration in four ways: 1) by using finer geographic units than previous studies, 2) by adopting models that provide more flexibility compared to alternatives based on the proportional hazard assumption, 3) by distinguishing migrants based on whether they return to their birth region (returnees) or do not (leavers), and by age at migration, and 4) by examining cause-specific mortality. We find that both leavers and returnees enjoy a mortality advantage over non-migrants. For both groups, the mortality advantage relative to non-migrants declines with age but is more pronounced for those who move above age 60 and small or negative for those who move at prime working ages. Circulatory-disease mortality accounts for more than half of the longevity advantage of both leavers and returnees. External and alcohol-related causes also contribute, particularly at younger ages. Our results challenge the idea that findings from studies of international migrants can be fully generalized to internal migrants. We demonstrate a consistent healthy migrant effect for all internal migrants, both those who leave and those who return to their region of birth

Demographic economics · Economics · Internal migration · Population · Public health · Register (sociolinguistics · Selection (genetic algorithm · Selection bias · Sociology · Computer Science · Demography · Health disparities and outcomes · Medicine · Migration and Labor Dynamics · Migration, Health and Trauma · Nursing

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Unique citing works1
Citations per year1
Citation span2026 - 2026 (1)
Citation velocitycurrent
Highly citedNo
Citation typesNeutral: 1
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