1. Morbidity-mortality paradox in Italian-born migrants
Fiona Stanaway
Sydney School of Public Health
University of Sydney, Australia

2. Background and aims
Italian migrants are 2nd largest group of older migrants in Australia
Limited research on the health and ageing of this population and how their morbidity and mortality compares to that of the Australian-born population
Aim: to compare mortality between older Italian-born men and Australian-born men and examine how this relates to differences in distribution of risk factors and morbidity in the two groups

3. CHAMP – Concord Health and Ageing in Men Project
Cohort study of community dwelling men aged 70 years and over
Study area = several suburbs in inner western Sydney
Suburbs with large migrant populations – particularly Italian migrants

4. Comparison of SES measures in CHAMP men by country of birth

5. Cardiovascular risk factors in CHAMP men by country of birth

6. Baseline health characteristics in CHAMP men by country of birth

7. Morbidity comparison between Italian-born and Australian-born men in 70-79 year age group

8. Hazard ratio for country of birth
Comparison of mortality between Italian-born and Australian-born men in CHAMP
Model
Hazard ratio for country of birth
95% Confidence Interval
P value
Country of birth alone (COB)
0.68
0.003
COB + age
0.82
0.11
COB + age + income
0.71
0.01
COB + all differences
0.75
0.03

9. Conclusions, implications and challenges
Mortality in older Italian-born men is lower than expected given their low SES and high morbidity
Doesn’t appear to be explained by many traditional risk factors
Could be driven by low cardiovascular disease and cancer which are important drivers of mortality
?driven by Mediterranean diet
Implications
High morbidity without high mortality can have important implications for healthy ageing

10. Any questions?