Abstract
The purpose of this research is to empirically test the salmon bias hypothesis, which states that the "healthy migrant" effect-referring to a situation in which migrants enjoy lower mortality risks than natives-is caused by selective return-migration of the weak, sick, and elderly. Using a unique longitudinal micro-level database-the Historical Sample of the Netherlands-we tracked the life courses of internal migrants after they had left the city of Rotterdam, which allowed us to compare mortality risks of stayers, returnees, and movers using survival analysis for the study group as a whole, and also for men and women separately. Although migrants who stayed in the receiving society had significantly higher mortality risks than natives, no significant difference was found for migrants who returned to their municipality of birth (returnees). By contrast, migrants who left for another destination (movers) had much lower mortality risks than natives. Natives who left Rotterdam also had significantly lower mortality risks than natives who stayed in Rotterdam. Female migrants, in particular, who stayed in the receiving urban society paid a long-term health price. In the case of Rotterdam, the salmon bias hypothesis can be rejected because the lower mortality effect among migrants was not caused by selective return-migration. The healthy migrant effect is real and due to a positive selection effect: Healthier people are more likely to migrate.