Didier Willaert

Mortality in adult immigrants in the 2000s in Belgium: a test of the ‘healthy‐migrant’ and the ‘migration‐as‐rapid‐health‐transition’ hypotheses

Firstly, to map out and compare all‐cause and cause‐specific mortality patterns by migrant background in Belgium; and secondly, to probe into explanations for the observed patterns, more specifically into the healthy‐migrant, acculturation and the migration‐as‐rapid‐health‐transition theories.

Regional Inequalities in Lung Cancer Mortality in Belgium at the Beginning of the 21st Century: The Contribution of Individual and Area-Level Socioeconomic Status and Industrial Exposure.

Being a highly industrialized country with one of the highest male lung cancer mortality rates in Europe, Belgium is an interesting study area for lung cancer research. This study investigates geographical patterns in lung cancer mortality in Belgium. More specifically it probes into the contribution of individual as well as area-level characteristics to (sub-district patterns in) lung cancer mortality. Data from the 2001 census linked to register data from 2001–2011 are used, selecting all Belgian inhabitants aged 65+ at time of the census. Individual characteristics include education, housing status and home ownership. Urbanicity, unemployment rate, the percentage employed in mining and the percentage employed in other high-risk industries are included as sub-district characteristics. Regional variation in lung cancer mortality at sub-district level is estimated using directly age-standardized mortality rates. The association between lung cancer mortality and individual and area characteristics, and their impact on the variation of sub-district level is estimated using multilevel Poisson models. Significant sub-district variations in lung cancer mortality are observed. Individual characteristics explain a small share of this variation, while a large share is explained by sub-district characteristics. Individuals with a low socioeconomic status experience a higher lung cancer mortality risk. Among women, an association with lung cancer mortality is found for the sub-district characteristics urbanicity and unemployment rate, while for men lung cancer mortality was associated with the percentage employed in mining. Not just individual characteristics, but also area characteristics are thus important determinants of (regional differences in) lung cancer mortality.

A cohort study into head and neck cancer mortality in Belgium (2001–11): Are individual socioeconomic differences conditional on area deprivation?

OBJECTIVE The aim of this study is to assess to what extent individual and area-level socioeconomic position (SEP) are associated to head and neck cancer (HNC) mortality and to what extent they contribute to regional variation in HNC mortality in Belgium. MATERIALS AND METHODS Data on men aged 40-64 are collected from a population based dataset based on the 2001 Belgian census linked to register data on emigration and mortality for 2001-2011. Individual SEP is measured using education, employment status and housing conditions. Deprivation at municipal level is measured by a deprivation index. Absolute mortality differences are estimated by age standardised mortality rates. Multilevel Poisson models are used to estimate the association and interaction between HNC mortality and individual and area-level SEP, and to estimate the regional variation in HNC mortality. RESULTS HNC mortality rates are significantly higher for men with a low SEP and men living in deprived areas. Cross-level interactions indicate that the association between individual SEP and HNC mortality is conditional on area deprivation. HNC mortality in deprived areas is especially high among high-SEP men. As a result, social disparities appear to be smaller in more deprived areas. Regional variation in HNC mortality was significant. Population composition partially explains this regional variation, while area deprivation and cross-level interactions explains little. CONCLUSION Both individual and area-level deprivation are important determinants of HNC mortality. Underlying trends in incidence and survival, and risk factors, such as alcohol and tobacco use, should be explored further.

Suicide mortality in Belgium at the beginning of the 21st century: differences according to migrant background

Background: Suicidal behaviour has long been recognized to vary widely between countries. Yet, rates of suicidal behaviour do not only vary between, but also within countries. Gender and socioeconomic differences in suicidal behaviour are well established, but the literature on suicidal behaviour and migrants is sparse, particularly in Belgium. The present study maps out the occurrence of suicide mortality across three of the largest migrant groups (Italians, Turks and Moroccans) versus the native population in Belgium, and verifies whether this association persists after accounting for socioeconomic variables. Methods: Census-linked mortality follow-up data covering the period 2001–2011 were used to probe into suicide mortality. To compare absolute differences by migrant background, indirect standardisation analyses were carried out. To assess relative differences, Cox proportional hazards models were performed. Analyses were restricted to 18- to 64-year-olds. Results: Belgian men and women have the highest suicide mortality risk, persons of Moroccan/Turkish origin the lowest, and Italians are somewhere in between. When migration generation is considered, the risk is higher for second-generation groups compared to that of the first-generation. Accounting for socioeconomic determinants, the difference between the native population and the various nationality groups intensifies. Conclusion: Although the risk is generally lower for minorities compared to the majority population, the results across migration generations underscore minorities’ increased vulnerability to suicide over time. Future research should focus on understanding the risks and protective factors of suicidal behaviour across different nationality groups. This way, tailored policy recommendations can be developed in order to tackle the burden of suicide.

Cities’ attraction and retention of graduates: a more-than-economic approach

ABSTRACT In skilled migration research, the role of the study location in graduates’ residential behaviour remains unclear. This paper addresses this lacuna by examining the attractiveness and retention of higher education cities for local attendants in the period after study, using Belgium as an empirical case study. Drawing on a unique linkage of census and register data for 1991–2010, logistic and Cox regressions illustrate the relative success of smaller cities once individual, familial and contextual factors are considered. Location-specific characteristics beyond the economic are found to shape skilled migration towards the higher education localities, particularly in the short term.

His and Her Education and Marital Dissolution: Adding a Contextual Dimension

Educationally hypogamous marriages, where the wife is more educated than the husband, have been expected to be less stable than other educational pairings, in part because they do not conform to social norms. With the reversal of the gender gap in education, such marriages have become more common than in the past. Recent research suggests that this new context might be beneficial for the stability of hypogamous unions compared to other educational pairings. Here, we investigate how educational matches in married couples are associated with divorce risks taking into account the local prevalence of hypogamy. Using Belgian census and register data for 458,499 marriages contracted between 1986 and 2001, we show that hypogamy was not associated with higher divorce rates than homogamy in communities where hypogamy was common. Against expectations, marriages in which the husband was more educated than the wife tend to exhibit the highest divorce rates. More detailed analysis of the different types of educational matches revealed that marriages with at least one highly educated partner, male or female, were less divorce prone compared to otherwise similar couple types.

A comparative approach towards ethnic segregation patterns in Belgian cities using multiscalar individualized neighborhoods

ABSTRACT Levels of spatial segregation in Western European cities are persistent over space and time. To demonstrate the degree or appearance of spatial segregation, most studies on urban residential patterns still rely on fixed spatial units, aspatial measures and single scales. However, a spatial or temporal comparison of patterns and levels of segregation based on such units or metrics is not without problems. To that end, this paper takes an explicit geographic approach and considers individualized neighborhoods using EquiPop-software, allowing various scales. Using the k-nearest neighbors for all individuals increases international comparability and facilitates interpretation, so far often hampered in segregation research. This multiscalar, multigroup comparative approach on ethnic urban geographies – using Belgium as a case study – provides an empirical illustration of a valuable method and tool applicable in segregation research, thereby furthering the comprehension of the increasingly diverse urban geographies and building on emerging work in the US, Europe and beyond.

Partner Choice and the Transition to Parenthood for Second-Generation Women of Turkish and Moroccan Origin in Belgium

Studies on fertility among second-generation migrant women across Europe have mainly treated the second generation as a rather homogenous group, not linking and distinguishing fertility patterns by type of partner. This study investigates how and to what extent the origin and generation of the partner (endogamous or exogamous as well as diversity in endogamy) of Turkish and Moroccan second-generation women in Belgium is related to first-birth rates. We distinguish three types of partnerships: those in an endogamous union with a first-generation partner, those in an endogamous union with a second-generation partner, and those in an exogenous union where the partner is of native Belgian origin. We use linked Census-Register data for the period 2001–2006. Applying event history models, our findings reveal clear differences between the endogamous and exogamous unions with respect to the timing of first births. Second-generation women of both origin groups have the lowest parenthood rates when the partner is of native Belgian origin. However, no variation is found within endogamous unions. For endogamous unions with a first-generation partner, the parenthood rates are approximately the same (and not higher, as was expected) compared to when the partner is also of second generation.