Morbidity-mortality paradox in Italian-born migrants Fiona Stanaway fiona.stanaway@sydney.edu.au Sydney School of Public Health University of Sydney, Australia

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

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

Comparison of SES measures in CHAMP men by country of birth

Cardiovascular risk factors in CHAMP men by country of birth

Baseline health characteristics in CHAMP men by country of birth

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

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 0.53-0.88 0.003 COB + age 0.82 0.64-1.05 0.11 COB + age + income 0.71 0.55-0.92 0.01 COB + all differences 0.75 0.57-0.98 0.03

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

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