Do all migrants decline equally? Gender and occupational status differences in post-migration health in Italy

Migration research has consistently documented migrants' initial health advantage and its erosion with increasing exposure to destination contexts. However, evidence of within-individual health change across the migration process remains limited, particularly in Southern Europe, where research has largely relied on post-arrival data and indirect proxies. This article analyses whether post-migration health deterioration is socially stratified by gender and occupational status. Using retrospective pre-migration health information from the 2025 MIGHTY Survey, we compare self-rated health before departure and at interview among migrants residing in Lombardy, Italy. We estimate correlated random-effects ordinal logistic models and use adjusted predictions to assess heterogeneity by gender, occupational status, and their interaction. Results document a deterioration in self-rated health following migration that is not uniformly distributed. Once ageing over the migration interval is accounted for, deterioration is significant among women but not distinguishable from age-related change among men - a pattern consistent with cumulative exposure to structurally disadvantaged conditions in the destination society. Occupational status differentiates the decline significantly among men, concentrated in self-employment and marginal labour market positions, but not among women, where deterioration is relatively uniform across occupational categories. By directly comparing pre- and post-migration health, this study provides the first within-individual assessment of post-migration health change in Italy based on retrospectively reported self-rated health, and one of the first in Southern Europe. The findings show that migrant health deterioration is not a uniform process but a socially patterned one, concentrated among women and structured by occupational status among men.