1. Selective Migration?
Pierre Buekens, MD, PhD

2. Selective Migration
“Healthy migrant effect”: Migrants could be healthier than compatriots who do not migrate (Marmot et al. 1984).

3. Infant Mortality OR
Landale et al., 2000

4. Infant Mortality
“…the results from the pooled analysis are more consistent with an emphasis on selective migration than an emphasis on protective cultural content.”
Landale et al., 2000

5. Infant Mortality
“There may be problems of access to or quality of neonatal intensive care in Puerto Rico. Consequently, high-risk newborns in the United States may be more likely than high-risk newborns in Puerto Rico to receive the medical interventions necessary to ensure their survival (Becerra at al., 1989).”
Landale et al., 2000

6. Low Birth Weight %
Landale et al., 2000

7. Low Birth Weight %
Weeks et al., 1999

8. Low Birth Weight OR
Weeks et al., 1999

9. Notzon F, Bobadilla JL, Coria I. Am J Public Health 1992;82:1014-1017.
Birthweight Distributions in Mexico City and Among US Southwest Mexican Americans: The Effect of Altitude
Notzon F, Bobadilla JL, Coria I.
Am J Public Health 1992;82:

10. Low Birth Weight %
Notzon et al., 1992

11. Low Birth Weight %
Notzon et al., 1992

12. Low Birth Weight 1981-88 Belgian birth certificates%
Buekens et al., 1998

13. Birthweight Distributions 1981-88 Belgian birth certificates
Buekens et al., 1998

14. Ceuta, North Africa Spanish territory on the Moroccan Coast
Birthweight of singletons born at term:
Moroccan origin: 3428g (non smokers: 3430g)
Spanish origin: g (non smokers: 3318g)
Martinez Cortes et al., 1992

15. Selective Migration?
The effect of selective migration on birth outcomes might be relatively small.
Selection might be complex:
High risk linked to poverty and deprivation
Low risk linked to resilience and healthy migrant effect.