Ethnic health inequalities in Europe. The moderating and amplifying role of healthcare system characteristics

Health inequalities between ethnic majority and ethnic minority members are prevalent in contemporary European societies. In this study we used theories on socioeconomic deprivation and inter-sectionality to derive expectations on how ethnic inequalities in health may be exacerbated or mitigated by national healthcare policies. To test our hypotheses we used data from six waves of the European Social Survey (2002-2012) on 172,491 individuals living in 24 countries. In line with previous research, our results showed that migrants report lower levels of health than natives. In general a country's healthcare expenditure appears to reduce socioeconomic differences in health, but at the same time induces health differences between recent migrants and natives. We also found that specific policies aimed at reducing socioeconomic inequalities in health appeared to work as intended, but as a side-effect amplified differences between natives and recent migrants in self-assessed health and well-being. Finally, our results indicated that policies specifically directed at the improvement of migrants' health, only affected well-being for migrants who have lived in the receiving country for more than 10 years. (C) 2016 Elsevier Ltd. All rights reserved.