Living arrangements and chronic disease accumulation among native-born and immigrant older adults in Europe

Background: Who we live with in later life significantly influences the daily care support we receive, potentially moderating chronic disease trajectories. For immigrants, this relationship is further complicated by cultural preferences for certain living arrangements. This study examines the differential role of living arrangements in chronic disease accumulation among native-born and immigrant older adults in Europe. Methods: Using data from the Survey of Health, Ageing and Retirement in Europe (2006–2022), we analyze how living arrangements moderate the relationship between age, migration background, and the number of chronic diseases. We also conduct stratified analyses based on immigrants’ countries of origin. All models employ inverse probability weights for panel attrition and panel-robust standard errors for longitudinal data. Analyses are conducted separately for men and women. Results: Immigrants generally have a higher chronic disease burden than native-born individuals, although the size of this disparity varies by living arrangements. Among native-born men and women, living with a partner/spouse or family is related to fewer chronic diseases than living alone. Conversely, among immigrants, these benefits of shared living arrangements are absent for men and weaker for women. We also find that the role of living arrangements in chronic disease accumulation among immigrants varies by their country of origin, as supported by, for instance, a considerable chronic disease burden among immigrant women from low HDI countries who live as a family. Conclusion: Older immigrants, particularly men from highly developed countries and women from less developed countries, may experience fewer health benefits from living with a partner or with family. Our findings indicate that these immigrant households may have excessive caregiving burdens, which could contribute to unhealthy aging among immigrants in later life.