It is commonly observed that immigrants display superior health upon arrival, and for some years following settlement, in their adopted country compared to their native-born counterparts. However, with increased years since migration there is a propensity for this health advantage to dissipate and for health trajectories of some migrant groups to reach, and in some cases fall below, the host national averages. This research aimed to explore the health status of older European-born immigrants as the burden and magnitude of disease outcomes in later life is unclear. This is due partly to a large body of dated literature relying on mortality and hospitalisation data to describe the health status of migrant populations and a historical trend to aggregate country of birth (COB) into large groupings ignoring inherent differences within and between birthplace groups. Using national Australian data, the health status of European and Australian-born groups were explored to provide a descriptive assessment of health outcomes at three points in time. This study illustrated that although both European and Australian-born groups displayed increases in the prevalence of selected chronic conditions, the European-born generally had better health and health-related outcomes. There was also some evidence to suggest that a health advantage may exist for European-born migrants in relation to some chronic conditions. Cross-sectional data collected from the South Australian Monitoring and Surveillance System (SAMSS) explored differences in chronic conditions and health-related risk factors between selected birthplaces (including those born in Australia, Germany, Italy and Greece). This study demonstrated that significant differences exist in the health profiles of birthplace groups, where Italian and Greeks experience higher prevalence of some chronic conditions and risk factors compared to the Australian and German-born. Pooled data collected via SAMSS and the Migrant Health Survey described and compared the demographic, health and health-related characteristics of selected birthplace groups at two points in time and examined the magnitude of change in disease outcomes relative to their Australian-born counterparts. Overall, the results indicated that the Greek and Italian-born had poorer health outcomes over time and displayed the largest change in their health and health-related outcomes. These findings suggested there is a considerable divergence in the long-term health outcomes experienced by selected COB groups and highlighted the value in undertaking birthplace specific analysis. Semi-structured interviews with Greek-born South Australians aged 60 years and over was undertaken to gain a deeper understanding of the health experiences and health-related outcomes of ageing Greek-born South Australians. The findings from this study indicated that 1) health service utilisation may not be an adequate indicator to explain the health differentials experienced by this cohort; 2) children may be Greek-born older migrants most important social resource and act as a vehicle for gaining access to health advice and the support they need in their day-to-day lives; and 3) life-course histories are pivotal in explaining health in later life. This research allowed for the comparisons of demographic, health and health-related outcomes to be analysed over time and across birthplace groups, providing additional information and insight into the diversity of outcomes within and between birthplace groups and adding depth to existing knowledge around migrant health outcomes.Thesis (Ph.D.) -- University of Adelaide, School of Social Sciences, 2016
