Immigrant disadvantage or the healthy immigrant effect? Evidence about low birth weight differences in the Czech Republic

Background: Most of the research about immigrants' birth outcomes comes from countries with high numbers of immigrants. This article provides evidence from the Czech Republic, a country with a short immigration history and a small immigrant population. Two hypotheses are tested: the immigrant disadvantage hypothesis and the healthy immigrant hypothesis. Methods: Live singleton births in 2013–14 from the national birth register are analysed. The odds of low birth weight (LBW) among the native population and five immigrant groups are compared using logistic regression. Control variables include maternal age, parity, education and marital status, paternal immigrant status, age and education. Results: All immigrant groups, except for Slovaks, showed smaller odds of LBW than native mothers. Adjusted odds ratios for non-Slovak immigrants range between 0.52 and 0.65. Furthermore, maternal immigrant status interacts with education. There is a wide educational gradient in LBW among Czech and Slovak mothers with low education representing a large disadvantage. Such pattern is not present among other ethnic groups. This makes the outcomes of Czech and Slovak mothers less favourable. Native mothers and immigrants with higher level of education show more similar outcomes. Paternal immigrant status does not have a net effect on LBW when maternal ethnicity is taken into account. Conclusions: Results provide evidence for the healthy immigrant effect. The favourable outcomes of non-Slovak immigrants seem to result from a combination of two factors, health selection of immigrants and relatively high prevalence of LBW in the native population caused by adverse outcomes of mothers with low education.

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