Self-rated health and lifestyle behaviours differences in second-generation migrants and Italians: an analysis of the daily life aspects surveys in Italy, 2015–2022

Second-generation migrants represent a growing demographic in Italy, yet evidence on their health status and health-related behaviours remain limited. This study aims to investigate differences in self-rated health and lifestyle behaviours among children, adolescents, and young adults with at least one foreign-citizen parent compared to those with Italian-citizen parents. Data from the Italian Daily Life Aspects cross-sectional surveys (2015–2022) were analysed, including participants aged 0–29 years. Multivariable logistic regression models with household-clustered standard errors were used to estimate adjusted odds ratios (aORs) for non-good self-rated health, overweight/obesity, sedentary lifestyle, low fruit and vegetable consumption, at-risk alcohol use, and smoking, adjusting for demographic, socioeconomic, household, and contextual factors. 84,797 participants were included (77,097 with both Italian parents and 7,700 with one foreign-citizen parent). No significant differences were observed in self-rated health between the two groups (aOR 1.05; 95% CI 0.93–1.18). Individuals with at least one foreign-citizen parent showed higher odds of overweight/obesity (aOR 1.15; 95% CI 1.07–1.24) and sedentary lifestyle (aOR 1.73; 95% CI 1.59–1.87). Conversely, they had lower odds of at-risk alcohol use (aOR 0.66; 95% CI 0.58–0.75) and smoking (aOR 0.85; 95% CI 0.76–0.95). No clear differences were found in fruit and vegetable consumption. While self-perceived health appears similar, young people with foreign-citizen parents in Italy exhibit a distinct behavioural profile, combining higher physical inactivity and excess weight risks with lower substance use. Culturally sensitive public health interventions should address behavioural risks while reinforcing existing protective factors within migrant families. What is already known on this topic - First-generation migrants often exhibit a "healthy immigrant effect," but evidence on the health and lifestyle behaviours of their children - the second generation - remains limited and inconsistent, particularly in Italy. Some studies suggest convergence in self-rated health with native peers, while others document persistent behavioural differences. What this study adds - In a large, nationally representative Italian sample of children, adolescents, and young adults (2015-2022), individuals with at least one foreign-citizen parent did not differ significantly from peers with Italian-citizen parents in self-rated health, but showed higher odds of sedentary lifestyle and overweight or obesity, alongside lower odds of at-risk alcohol use and cigarette smoking, independently of socioeconomic and household factors. How this study might affect research, practice or policy - These findings call for early, culturally sensitive public health interventions targeting physical inactivity and excess weight among second-generation migrants, while recognising and reinforcing the protective cultural factors associated with lower substance use. Future longitudinal research should explore the role of acculturation and parental country of origin to better inform equitable health policies.