Alexander Miething is a researcher specializing in socioeconomic heath inequalities, social networks and health, and migration and health. He has been affiliated with CHESS since 2008.
Q: What is your academic background, and and what motivated your interest in health inequalities?
I did my undergraduate studies in sociology. During my studies, I became increasingly fascinated by quantitative research methods and the possibilities they offer, for example to predict social phenomena and to link different social processes to one another.
This interest led me to pursue my doctoral studies at CHESS, which I saw as a good opportunity to test and apply sociological theories and to examine their practical implications for health in the real world. Rather than being primarily interested in health outcomes themselves, I found myself increasingly curious about the social determinants behind these outcomes and how social inequalities in health emerge and persist over time.
For me, the motivation was not only to describe patterns of health and illness, but also to make a difference by pinpointing social problems and health inequalities.
Q: Throughout your career you have investigated how social networks can have implications for health. Why are social networks an important factor to consider when studying health and health inequalities?
Social networks capture the dynamic nature of society and the ways in which individuals are embedded in broader structures of social relations. What I find particularly fascinating about social networks is that they demonstrate how social interactions can give rise to outcomes that are larger than the sum of their parts. Through patterns of connections, social networks can shape behaviours, opportunities, and health outcomes in ways that are often beyond the direct control or awareness of individuals.
Related to this, social network research offers powerful tools for studying the “social contagion” of health-related behaviours. I have studied this in relation to smoking, drinking, and dieting behaviours. By examining how behaviours, norms, and risks spread through networks, it becomes possible to understand how individual health is influenced not only by personal characteristics, but also by the social environments in which people are embedded.
Q: In some of your recent work on migration and health, you have investigated the so-called income mortality paradox. What does this refer to, and why is it important to consider from a public health perspective?
Together with colleagues, I investigated income-related inequalities in immigrants’ mortality in Sweden, and found a markedly weaker association between income and mortality among immigrants compared with native-origin majority population Swedes. In light of the well-known healthy migrant paradox, which describes a mortality advantage among immigrants relative to the native majority population, we referred to this pattern as the income mortality paradox.
Previous research has shown that immigrants’ mortality advantage—typically observed shortly after arrival in the destination country—tends to diminish with longer duration of residence. Consistent with this, our study demonstrated that income-related mortality differences among immigrants increase over time and gradually become more similar to those observed among native-origin Swedes.
Q: You recently published a study that investigates how income-related health inequalities vary by migrant generation in Sweden. What were some of the key findings from this work?
In this study, we extended previous work on the income–mortality paradox by including descendants of immigrants (the so-called second generation). We detected increasing income-related mortality by immigrant generation: our analyses confirmed a weaker income gradient in mortality among first-generation immigrants, but also revealed a markedly steeper income-related mortality gradient among male descendants of non-European immigrants.
To better understand these patterns, we examined cause-specific mortality. When disaggregating mortality by specific causes of death—and excluding external causes such as accidents—the differences across immigrant generations largely disappeared.
Q: What research topics would you like to pursue in the near future?
In my future research, I would like to continue studying intergenerational processes across migrant generations, with a particular focus on how health inequalities emerge, persist, or change over time. I am especially interested in incorporating an intersectional perspective, examining how multiple and intersecting conditions—such as socioeconomic position, gender, migration background, and experiences of disadvantage—interact and jointly contribute to inequalities in health.
By focusing on these intergenerational and intersectional processes, I aim to deepen the understanding of how health disparities are shaped across the life course and across generations, and how structural and social contexts influence health outcomes beyond individual-level factors..