Global comparative assessments of life expectancy: the impact of migration with reference to Australia.

OBJECTIVE To investigate the effect of immigration on life expectancy in Australia for the period from 1981 to 2003, and to compare life expectancy of the Australian-born population with that of other countries in the Organisation for Economic Cooperation and Development (OECD). METHODS Standard life-table methods using age-specific all-cause mortality and population data from 1981 to 2003 were used to calculate life expectancy at birth (e0) for the total Australian population (including migrants) and for people born in Australia (excluding migrants). Mean differences in life expectancy for each sex were compared using paired t-tests. Rankings of life expectancy among OECD countries were reassessed, and rank changes measured using the Wilcoxon signed rank test. FINDINGS Life expectancy of males and females was significantly lower in the Australian-born group than in the total Australian population. During 1981 to 2003, there was a mean difference in life expectancy of 0.41 years (95% confidence interval, CI: 0.37-0.44; t(17) = 27.0; P < 0.0001) in males and 0.29 years (95% CI: 0.26-0.31; t(17) = 27.6; P < 0.0001) in females between the Australian-born and the total population. After excluding migrant groups, Australia no longer ranked among the top five OECD countries with the highest life expectancy in the two most recent years examined. CONCLUSION While Australia has one of the highest life expectancies in the industrialized world, this is partly attributable to immigration of populations with low rates of mortality. This effect needs to be considered in international comparative assessments of mortality levels.