Immigrant mortality in Belgium: The person and the place

Migrants generally have lower mortality than the indigenous population. In the present study we consider to what extent this migrant effect depends on the place in which the immigrants live. Working with matched records of the 9,978,654 residents enumerated in the 1991 Belgian census, followed up over almost six years (600,264 deaths), we computed the Cox survival models for each of the 588 Belgian municipalities. The municipalities were characterised by location, urbanisation and various Quality of Life indicators. By analysing the parameters of the Cox models, we were able to show that: 1. Both men and women non-Belgians have a lower mortality risk than Belgian nationals, and this risk is even lower when personal characteristics are allowed for; 2. Immigrant status is a more important determinant of mortality risk in areas with a high proportion of immigrants, weak family structures and low social power; 3. In municipalities with a high proportion of immigrants and/or a socially powerful population and weak family structures, non-Belgians tend to have a lower mortality risk; 4. Municipality-level effects on migrant mortality remain, even after controlling for individual social characteristics; 5. Net of local quality of life indicators, there are few regional differences in migrant mortality risks. We suggest, in conclusion, that lower immigrant mortality may derive from the development, in areas with a high concentration of immigrants, of a supportive milieu which substitutes for a strong family structure, but this is less effective under conditions of poverty.