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Henares-Montiel J, Ruiz-Perez I, Mendoza-Garcia O. Health inequalities between male and female immigrants in Spain after the beginning of the economic crisis. HEALTH & SOCIAL CARE IN THE COMMUNITY 2018; 26:891-897. [PMID: 30014605 DOI: 10.1111/hsc.12613] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 06/01/2018] [Accepted: 06/12/2018] [Indexed: 06/08/2023]
Abstract
The aim of this study was to analyse health inequalities in the immigrant population in Spain in 2014, while differentiating between immigrant and native-born men and women. We have designed a cross-sectional study on the population aged over 15 years resident in Spain and the data were obtained from the 2014 European Health Survey in Spain (n = 22,842). Among immigrant men and women, we observed a lower risk of having a Chronic Physical Problem (CPP) or a Mental Health Problem (MHP) and a lower consumption of psychiatric drugs. We also observed a higher risk of lack of medical care in immigrant men compared to native-born. The country of origin was not significantly related to self-perception of health or use of Primary Care (PC) and Emergency Care services. In conclusion, we observed that now that the peak of the crisis has passed it seems that the "healthy immigrant" effect is being recovered, although the gender inequalities observed in the general population are transferred to the immigrant population. We need to approach the feminisation of migration from a new perspective and understand how inequalities affect immigrant women.
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Affiliation(s)
- Jesus Henares-Montiel
- Escuela Andaluza de Salud Pública, Granada, Spain
- UGC Interniveles Prevención Promoción y Vigilancia de la Salud, Granada, Spain
| | - Isabel Ruiz-Perez
- Escuela Andaluza de Salud Pública, Granada, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Instituto de Investigación Biosanitaria (IBS), Granada, Spain
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Pérez-Urdiales I, San Sebastián M, Goicolea I. Free clinic utilisation by immigrants after the introduction of a restrictive health policy in the Basque Country (Spain). Public Health 2018; 163:9-15. [DOI: 10.1016/j.puhe.2018.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Revised: 06/01/2018] [Accepted: 06/05/2018] [Indexed: 11/25/2022]
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53
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Jordão NM, Freitas CD, García Ramírez M. Efeitos da crise económica e das políticas de austeridade na saúde e no acesso aos cuidados de saúde da população migrante em países do sul da Europa: revisão scoping. REMHU: REVISTA INTERDISCIPLINAR DA MOBILIDADE HUMANA 2018. [DOI: 10.1590/1980-85852503880005411] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo O objectivo deste artigo é reunir e sintetizar o conhecimento existente sobre o impacto da crise económica e das consequentes políticas de austeridade no estado de saúde e no acesso aos cuidados de saúde das populações migrantes em países do sul da Europa, nomeadamente Portugal, Espanha, Itália e Grécia. Os resultados analisados indicam que a crise económica e as políticas de austeridade tiveram um impacto negativo na saúde e no acesso aos cuidados de saúde dos migrantes em três países, já que não se encontraram dados relativos a Portugal. Os seus efeitos negativos espelham-se na saúde mental, saúde ocupacional, doenças transmissíveis e não transmissíveis, saúde infantil e na perceção subjetiva de saúde. A acessibilidade dos cuidados de saúde tornou-se mais limitada em Espanha, especialmente para a população de imigrantes em situação irregular.
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54
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Malmusi D, Muntaner C, Borrell C. Social and Economic Policies Matter for Health Equity: Conclusions of the SOPHIE Project. INTERNATIONAL JOURNAL OF HEALTH SERVICES 2018; 48:417-434. [PMID: 29895205 DOI: 10.1177/0020731418779954] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Since 2011, the SOPHIE project has accumulated evidence regarding the influence of social and economic policies on population health levels, as well as on health inequalities according to socioeconomic position, gender, and immigrant status. Through comparative analyses and evaluation case studies across Europe, SOPHIE has shown how these health inequalities vary according to contexts in macroeconomics, social protection, labor market, built environment, housing, gender equity, and immigrant integration and may be reduced by equity-oriented policies in these fields. These studies can help public health and social justice advocates to build a strong case for fairer social and economic policies that will lead to the reduction of health inequalities that most governments have included among their policy goals. In this article, we summarize the main findings and policy implications of the SOPHIE project and the lessons learned on civil society participation in research and results communication.
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Affiliation(s)
- Davide Malmusi
- 1 Ajuntament de Barcelona, Barcelona, Catalonia, Spain.,2 CIBER Epidemiology and Public Health, Barceloa, Catalonia, Spain.,3 Biomedical Research Institute Sant Pau (IIB-Sant Pau), Barcelona, Catalonia, Spain
| | | | - Carme Borrell
- 2 CIBER Epidemiology and Public Health, Barceloa, Catalonia, Spain.,3 Biomedical Research Institute Sant Pau (IIB-Sant Pau), Barcelona, Catalonia, Spain.,5 Agencia de Salut Publica de Barcelona, Barcelona, Catalonia, Spain
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55
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Kana MA, Correia S, Barros H. Adverse Pregnancy Outcomes: A Comparison of Risk Factors and Prevalence in Native and Migrant Mothers of Portuguese Generation XXI Birth Cohort. J Immigr Minor Health 2018; 21:307-314. [PMID: 29779076 DOI: 10.1007/s10903-018-0761-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Epidemiological studies report conflicting findings regarding association between maternal immigration status and pregnancy outcomes. In this study we compared risk factors and prevalence of adverse pregnancy outcomes in native Portuguese and migrants. Cross-sectional analysis was conducted using information collected at delivery from the participants of Generation XXI birth cohort. Logistic regression models were fitted to assess the association between migrant status and adverse pregnancy outcomes. Prevalence of risk factors for adverse pregnancy outcomes varied between native Portuguese and migrants: teenage mothers (5.6 and 2.0%), primiparae (57.1 and 63.9%), smoking during pregnancy (23.0 and 19.1%), twins (3.2 and 8.0%), and caesarean section (35.2 and 45.7%). Among singleton births, prevalence of low birthweight, preterm birth and small for gestational age were 7.3 and 3.9%, 7.5 and 6.2%, and 15.1 and 7.6%, respectively for native Portuguese and migrants. The native Portuguese had an adjusted significantly higher risk of low birthweight (OR 2.67, 95% CI 1.30, 5.48) and small for gestational age (OR 2.01, 95% CI 1.26, 3.21), but a similar risk for preterm birth (OR 1.38, 95% CI 0.81, 2, 34). Migrant mothers presented a lower risk of low birthweight and small for gestation and data suggest a healthy immigrant effect.
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Affiliation(s)
- Musa Abubakar Kana
- EPIUnit-Instituto de Saúde Pública da Universidade do Porto (ISPUP), Rua das Taipas, 135, 4050-600, Porto, Portugal.
- Department of Community Medicine, College of Medicine, Kaduna State University, Kaduna, Nigeria.
| | - Sofia Correia
- EPIUnit-Instituto de Saúde Pública da Universidade do Porto (ISPUP), Rua das Taipas, 135, 4050-600, Porto, Portugal
| | - Henrique Barros
- EPIUnit-Instituto de Saúde Pública da Universidade do Porto (ISPUP), Rua das Taipas, 135, 4050-600, Porto, Portugal
- Faculdade de Medicina, Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Universidade do Porto, Porto, Portugal
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56
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Sdona E, Papamichail D, Ragkou E, Kakalou E, Briana DD, Panagiotopoulos T, Malamitsi-Puchner A. Migration status and perinatal parameters in a Greek public maternity hospital: an illustration of the "healthy immigrant effect". J Matern Fetal Neonatal Med 2017; 32:62-66. [PMID: 28830312 DOI: 10.1080/14767058.2017.1371131] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Although socioeconomic disparities adversely affect health, studies referring to the "healthy immigrant effect" imply more favorable health outcomes in immigrants than natives. We aimed to investigate the impact of immigration on several perinatal parameters. METHODS Birth records (01/01/2010 - 31/12/2014) from a public maternity hospital in Athens, Greece were reviewed for maternal (ethnicity, age, delivery mode) and neonatal (gender, birthweight, gestational age) variables. Immigrants were classified by country of origin, according to Human Development Index. Comparison of results between Greeks and immigrants were made. Stratification by maternal age (< and ≥35 years) was conducted to test for confounding and interaction. RESULTS Almost one-third of 7506 deliveries applied to immigrants; 36.3% of Greeks and 19.2% of immigrants [risk ratio (RR) = 0.53, 95% confidence interval (CI) = 0.52-0.54] delivered at ≥35 years; 10.5% of Greek and 7.0% of immigrant neonates weighted <2500 g (RR = 0.67, 95% CI = 0.61-0.74); 10.9% of Greeks and 8.1% of immigrants were born <37 wks (RR = 0.74, 95% CI = 0.67-0.82); 55.7% of Greeks and 48.2% of immigrants delivered by caesarean section (RR = 0.87, 95% CI = 0.85-0.88). CONCLUSION We found that immigrant women deliver at a younger age, vaginally, more mature, and heavier neonates. Furthermore, we confirmed that the protective effect of immigrant status could not be explained by maternal age only.
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Affiliation(s)
- E Sdona
- a Department of Neonatology , National and Kapodistrian University of Athens, Aretaieion University Hospital , Athens , Greece
| | - D Papamichail
- b Department of Child Health, National School of Public Health , Athens , Greece
| | - E Ragkou
- a Department of Neonatology , National and Kapodistrian University of Athens, Aretaieion University Hospital , Athens , Greece.,c Programme of Postgraduate Education "International Medicine - Health Crisis Management" , Medical School, National & Kapodistrian University of Athens , Athens , Greece
| | - E Kakalou
- c Programme of Postgraduate Education "International Medicine - Health Crisis Management" , Medical School, National & Kapodistrian University of Athens , Athens , Greece
| | - D D Briana
- a Department of Neonatology , National and Kapodistrian University of Athens, Aretaieion University Hospital , Athens , Greece
| | - T Panagiotopoulos
- b Department of Child Health, National School of Public Health , Athens , Greece
| | - A Malamitsi-Puchner
- a Department of Neonatology , National and Kapodistrian University of Athens, Aretaieion University Hospital , Athens , Greece
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57
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Alonso-Fernández N, Jiménez-García R, Alonso-Fernández L, Hernández-Barrera V, Palacios-Ceña D. Mental Health and Quality of Life Among Spanish-born and Immigrant Children in Years 2006 and 2012. J Pediatr Nurs 2017; 36:103-110. [PMID: 28888489 DOI: 10.1016/j.pedn.2017.05.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 05/09/2017] [Accepted: 05/13/2017] [Indexed: 01/23/2023]
Abstract
BACKGROUND One of every five children and adolescents in the European Union suffers from behavioural, and emotional disturbances. OBJECTIVES To compare factors associated with the quality of life and mental health of immigrant and Spanish children aged 4-14years both during the years 2006 and 2012 and to evaluate changes over this time period. DESIGN AND METHODS An epidemiologic age and sex matched case-control study (1:2) was conducted. The study group were 677 immigrant children and 1354 matched Spanish children (controls). This study was conducted using data obtained from the Spanish National Health Surveys done in 2006 and 2012. We used the Strengths and Difficulties Questionnaire to obtain the score for variables derived from mental health and the Kidscreen-10 questionnaire to score the Health-Related Quality of Life. RESULTS Spanish girls scored higher in conduct problems (2.04±0.1) and better in problems with peers (1.21±0.08) regarding immigrant girls (1.82±0.12-1.92±0.13 respectively). Concerning total scores, immigrant children obtained significantly lower scores in quality of life (81.29±0.76) and in problems with peers (2.04±0.09) than their matched Spanish children (84.4±0.45 and 1.26±0.06) in 2006. Immigrant children had lower total scores in prosocial behaviour (8.62±0.11) compared to the matched Spanish children (8.92±0.06) in 2012. The total average scores of immigrant children in terms of quality of life, emotional symptoms, behavioural problems, hyperactivity and problems with peers were significantly better in 2012 (86.58; 1.84; 1.46; 3.77 and 1.48 respectively) than in 2006 (81.29; 2.15; 1.90; 4.58 and2.04). CONCLUSIONS Immigrant children had a poorer quality of life and mental health than matched Spanish children in 2006.
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Affiliation(s)
- Nazaret Alonso-Fernández
- Department of Medicine and Surgery, Psychology, Preventive Medicine and Public Health and Immunology, and Medical Microbiology, Universidad Rey Juan Carlos, Madrid, Spain.
| | - Rodrigo Jiménez-García
- Department of Medicine and Surgery, Psychology, Preventive Medicine and Public Health and Immunology, and Medical Microbiology, Universidad Rey Juan Carlos, Madrid, Spain.
| | - Leticia Alonso-Fernández
- Department of Medicine and Surgery, Psychology, Preventive Medicine and Public Health and Immunology, and Medical Microbiology, Universidad Rey Juan Carlos, Madrid, Spain.
| | - Valentín Hernández-Barrera
- Department of Physiotherapy, Occupational Therapy, Rehabilitation, and Physical Medicine, Universidad Rey Juan Carlos, Madrid, Spain.
| | - Domingo Palacios-Ceña
- Department of Physiotherapy, Occupational Therapy, Rehabilitation, and Physical Medicine, Universidad Rey Juan Carlos, Madrid, Spain.
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58
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Nicolau P, Del Amo E, Carreras R. Primary gynecological care in multicultural areas. Med Clin (Barc) 2017; 149:37-38. [PMID: 28396136 DOI: 10.1016/j.medcli.2017.02.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Accepted: 02/23/2017] [Indexed: 11/17/2022]
Affiliation(s)
- Pau Nicolau
- Servicio de Ginecología y Obstetricia, CAP Raval Drassanes, Hospital del Mar, Barcelona, España.
| | - Elisabeth Del Amo
- Servicio de Ginecología y Obstetricia, CAP Raval Drassanes, Hospital del Mar, Barcelona, España; Departamento Pediatría, Obstetricia y Ginecología, Medicina Preventiva, Universitat Autònoma de Barcelona, Barcelona, España
| | - Ramón Carreras
- Servicio de Ginecología y Obstetricia, CAP Raval Drassanes, Hospital del Mar, Barcelona, España; Departamento Pediatría, Obstetricia y Ginecología, Medicina Preventiva, Universitat Autònoma de Barcelona, Barcelona, España
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59
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Petrelli A, Di Napoli A, Rossi A, Costanzo G, Mirisola C, Gargiulo L. The variation in the health status of immigrants and Italians during the global crisis and the role of socioeconomic factors. Int J Equity Health 2017; 16:98. [PMID: 28606147 PMCID: PMC5468957 DOI: 10.1186/s12939-017-0596-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 06/06/2017] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The effects of the recent global economic and financial crisis especially affected the most vulnerable social groups. Objective of the study was to investigate variation of self-perceived health status in Italians and immigrants during the economic global crisis, focusing on demographic and socioeconomic factors. METHODS Through a cross-sectional design we analyzed the national sample of multipurpose surveys "Health conditions and use of health services" (2005 and 2013) conducted by the Italian National Institute of Statistics (ISTAT). Physical Component Summary (PCS) and Mental Component Summary (MCS) scores, derived from SF-12 questionnaire, were assumed as study outcome, dichotomizing variables distribution at 1st quartile. Prevalence rate ratios (PRR) were estimated through log-binomial regression models, stratified by citizenship and gender, evaluating the association between PCS and MCS with surveys' year, adjusting for age, educational level, employment status, self-perceived economic resources, smoking habits, body mass index. RESULTS From 2005 to 2013 the proportion of people not employed or reporting scarce/insufficient economic resources increased, especially among men, in particular immigrants. Compared with 2005 we observed in 2013 among Italians a significant lower probability of worse PCS (PRR = 0.96 both for males and females), while no differences were observed among immigrants; a higher probability of worse MCS was observed, particularly among men (Italians: PRR = 1.26;95%CI:1.22-1.29; immigrants: PRR = 1.19;95%CI:1.03-1.38). Self-perceived scarce/insufficient economic resources were strongly and significantly associated with worse PCS and MCS for all subgroups. Lower educational level was strongly associated with worse PCS in Italians and slightly associated with worse MCS for all subgroups. Being not employed was associated with worse health status, especially mental health among men. CONCLUSIONS Our findings support the hypothesis that economic global crisis could have negatively affected health status, particularly mental health, of Italians and immigrants. Furthermore, results suggest socioeconomic inequalities increase, in economic resources availability dimension. In a context of public health resources' limitation due to financial crisis, policy decision makers and health service managers must face the challenge of equity in health.
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Affiliation(s)
- Alessio Petrelli
- National Institute for Health, Migration and Poverty (INMP), Via San Gallicano, 25 a, 00153, Rome, Italy.
| | - Anteo Di Napoli
- National Institute for Health, Migration and Poverty (INMP), Via San Gallicano, 25 a, 00153, Rome, Italy
| | - Alessandra Rossi
- National Institute for Health, Migration and Poverty (INMP), Via San Gallicano, 25 a, 00153, Rome, Italy
| | - Gianfranco Costanzo
- National Institute for Health, Migration and Poverty (INMP), Via San Gallicano, 25 a, 00153, Rome, Italy
| | - Concetta Mirisola
- National Institute for Health, Migration and Poverty (INMP), Via San Gallicano, 25 a, 00153, Rome, Italy
| | - Lidia Gargiulo
- National Institute of Statistics (ISTAT), Viale Liegi, 13, 00198, Rome, Italy
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60
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Sidorchuk A, Engström K, Johnson CM, Kayser Leeoza N, Möller J. Employment status and psychological distress in a population-based cross-sectional study in Sweden: the impact of migration. BMJ Open 2017; 7:e014698. [PMID: 28389494 PMCID: PMC5558822 DOI: 10.1136/bmjopen-2016-014698] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Unemployment and temporary employment are known to impact psychological health. However, the extent to which the effect is altered by migration-related and sociodemographic determinants is less clear. The purpose of this study was to investigate whether the association between employment status and psychological distress differs between immigrants and Swedish-born and to what extent, the association is modified by gender and reason for immigration. DESIGN Cross-sectional survey study. PARTICIPANTS AND SETTING Data from public health surveys undertaken in 2002, 2006 and 2010 from random samples of Stockholm County residents, Sweden, were used to analyse a weighted sample of 51 118 individuals aged 18-64 (43 444 Swedish-born, 4055 non-refugees, 3619 refugees). According to their activity in the labour market, the participants were categorised into permanently/self-employed, temporarily employed and unemployed. OUTCOMES MEASURES Associations between self-reported employment and psychological distress measured by a 12-item version of the General Health Questionnaire were explored across individuals with different migration status and reasons for immigration using logistic regression and pairwise comparisons. The analyses were stratified by gender and adjusted for age, socioeconomic characteristics and survey year. RESULTS Unemployment was associated with elevated likelihood of psychological distress across the study population, regardless of migration status and gender. Fully adjusted models revealed nearly a 3-fold higher odds of distress in unemployed Swedish-born (OR 3.05, 95% CI 2.66 to 3.51), non-refugees (OR 3.51, 95% CI 2.44 to 5.05) and refugees (OR 2.91, 95% CI 2.20 to 3.85) when compared with permanently/self-employed. Temporary employment also increased the likelihood of distress, particularly among refugees and Swedish-born. CONCLUSIONS The effect of unemployment on increased likelihood of poor psychological well-being overcomes gender-specific and migration-specific differences and is equally pronounced for Swedish-born, non-refugees and refugees. Exclusion from the labour market appears to be a major determinant of psychological health inequalities in contemporary Sweden.
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Affiliation(s)
- Anna Sidorchuk
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Karin Engström
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- Centre of Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden
| | - Charisse M Johnson
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Naima Kayser Leeoza
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Jette Möller
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
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Malmusi D, Palència L, Ikram UZ, Kunst AE, Borrell C. Inequalities by immigrant status in depressive symptoms in Europe: the role of integration policy regimes. Soc Psychiatry Psychiatr Epidemiol 2017; 52:391-398. [PMID: 28194503 DOI: 10.1007/s00127-017-1348-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 01/13/2017] [Indexed: 10/17/2022]
Abstract
PURPOSE We aimed to study whether country integration policy models were related to inequalities by immigrant status in depressive symptoms in Europe. METHODS This is a cross-sectional study using data from 17 countries in the sixth wave of the European Social Survey (2012), comparing subjects born either in the country of residence (non-immigrants, N = 28,333) or in a country not classified as "advanced economy" by the IMF (immigrants, N = 2041). Depressive symptoms were assessed with the eight-item version of the Center for Epidemiologic Studies Depression scale. Countries were grouped into three integration policy regimes (inclusive, assimilationist, and exclusionist). Linear regressions were fitted adjusting first by age, sex, and education level, then sequentially by citizenship, perceived discrimination, and socio-economic variables. RESULTS In all integration regimes, immigrants report significantly more depressive symptoms than non-immigrants. The gap is the largest in exclusionist countries (immigrants score 1.16, 95% CI 0.65-1.68, points higher than non-immigrants in the depression scale), followed by assimilationist countries (0.85 and 0.57-1.13) and inclusive countries (0.60 and 0.36-0.84). Financial strain explains all the associations in inclusive countries, most of it in assimilationist countries, but only a small part in exclusionist countries. CONCLUSIONS Across most European countries, immigrants seem to experience more depressive symptoms than the population born in the country, mostly reflecting their poorer socio-economic situation. Inequalities are larger in countries with more restrictive policies. Despite some limitations, this study adds new evidence to suggest that immigrants' health is shaped by integration policies in their host country.
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Affiliation(s)
- Davide Malmusi
- Agència de Salut Pública de Barcelona, IIB-Sant Pau, Plaça Lesseps, 1, 08023, Barcelona, Spain. .,Ciber de Epidemiología y Salud Pública, Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0, 28029, Madrid, Spain.
| | - Laia Palència
- Agència de Salut Pública de Barcelona, IIB-Sant Pau, Plaça Lesseps, 1, 08023, Barcelona, Spain.,Ciber de Epidemiología y Salud Pública, Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0, 28029, Madrid, Spain
| | - Umar Z Ikram
- Academic Medical Center, University of Amsterdam, PO Box 22660, 1100 DD, Amsterdam, The Netherlands
| | - Anton E Kunst
- Academic Medical Center, University of Amsterdam, PO Box 22660, 1100 DD, Amsterdam, The Netherlands
| | - Carme Borrell
- Agència de Salut Pública de Barcelona, IIB-Sant Pau, Plaça Lesseps, 1, 08023, Barcelona, Spain.,Ciber de Epidemiología y Salud Pública, Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0, 28029, Madrid, Spain.,Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Doctor Aiguader, 88, 08003, Barcelona, Spain
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62
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Kana MA, Correia S, Peleteiro B, Severo M, Barros H. Impact of the global financial crisis on low birth weight in Portugal: a time-trend analysis. BMJ Glob Health 2017; 2:e000147. [PMID: 28589009 PMCID: PMC5435250 DOI: 10.1136/bmjgh-2016-000147] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 10/14/2016] [Accepted: 10/24/2016] [Indexed: 11/14/2022] Open
Abstract
Background The 2007–2008 global financial crisis had adverse consequences on population health of affected European countries. Few contemporary studies have studied its effect on perinatal indicators with long-lasting influence on adult health. Therefore, in this study, we investigated the impact of the 2007–2008 global financial crisis on low birth weight (LBW) in Portugal. Methods Data on 2 045 155 singleton births of 1995–2014 were obtained from Statistics Portugal. Joinpoint regression analysis was performed to identify the years in which changes in LBW trends occurred, and to estimate the annual per cent changes (APC). LBW risk by time period expressed as prevalence ratios were computed using the Poisson regression. Contextual changes in sociodemographic and economic factors were provided by their trends. Results The joinpoint analysis identified 3 distinct periods (2 jointpoints) with different APC in LBW, corresponding to 1995–1999 (APC=4.4; 95% CI 3.2 to 5.6), 2000–2006 (APC=0.1; 95% CI −050 to 0.7) and 2007–2014 (APC=1.6; 95% CI 1.2 to 2.0). For non-Portuguese, it was, respectively, 1995–1999 (APC=1.4; 95% CI −3.9 to 7.0%), 2000–2007 (APC=−4.2; 95% CI −6.4 to −2.0) and 2008–2014 (APC=3.1; 95% CI 0.8 to 5.5). Compared with 1995–1999, all specific maternal characteristics had a 10–15% increase in LBW risk in 2000–2006 and a 20–25% increase in 2007–2014, except among migrants, for which LBW risk remained lower than in 1995–1999 but increased after the crisis. The increasing LBW risk coincides with a deceleration in gross domestic product growth rate, reduction in health expenditure, social protection allocation on family/children support and sickness. Conclusions The 2007–2008 global financial crisis was associated with a significant increase in LBW, particularly among infants of non-Portuguese mothers. We recommend strengthening social policies aimed at maternity protection for vulnerable mothers and health system maintenance of social equity in perinatal healthcare.
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Affiliation(s)
- Musa Abubakar Kana
- Unidade de Investigação em Epidemiologia - Instituto de Saúde Pública da Universidade do Porto (EPIUnit, ISPUP), Porto, Portugal.,Department of Community Medicine, Faculty of Medicine, Kaduna State University, Kaduna, Nigeria
| | - Sofia Correia
- Unidade de Investigação em Epidemiologia - Instituto de Saúde Pública da Universidade do Porto (EPIUnit, ISPUP), Porto, Portugal
| | - Barbara Peleteiro
- Unidade de Investigação em Epidemiologia - Instituto de Saúde Pública da Universidade do Porto (EPIUnit, ISPUP), Porto, Portugal
| | - Milton Severo
- Unidade de Investigação em Epidemiologia - Instituto de Saúde Pública da Universidade do Porto (EPIUnit, ISPUP), Porto, Portugal.,Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal
| | - Henrique Barros
- Unidade de Investigação em Epidemiologia - Instituto de Saúde Pública da Universidade do Porto (EPIUnit, ISPUP), Porto, Portugal.,Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal
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La Parra-Casado D, Stornes P, Solheim EF. Self-rated health and wellbeing among the working-age immigrant population in Western Europe: findings from the European social survey (2014) special module on the social determinants of health. Eur J Public Health 2017; 27:40-46. [DOI: 10.1093/eurpub/ckw221] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Conway SH, Cayuela A, Delclos GL, Pompeii LA, Ronda E. Association between long work hours and poor self-reported general health among Latin American immigrant and native workers in the United States and Spain. Am J Ind Med 2016; 59:1105-1111. [PMID: 27424568 DOI: 10.1002/ajim.22633] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2016] [Indexed: 11/06/2022]
Abstract
BACKGROUND The relationship between hours worked per week and self-reported general health (SRGH) has not been assessed in Latin American immigrant and native workers across host countries. METHODS Cross-sectional study of the association between long work hours (LWH) (i.e., >51 hr per week) and poor SRGH using data from 2,626 workers in the United States (immigrants = 10.4%) and 8,306 workers in Spain (immigrants = 4.1%). RESULTS Both countries' natives working >51 hr per week had increased odds of reporting poor SRGH compared to those working fewer hours (U.S.: OR = 1.59; 95%CI = 1.01-2.49; Spain: OR = 2.17; 95%CI = 1.71-2.75); when stratified by sex, increased odds also were observed among immigrant female workers in Spain (OR = 3.47; 95%CI = 1.15-10.5). CONCLUSIONS LWH were associated with differential health outcomes in populations of native and Latin American immigrant workers in the United States and Spain, which may reflect social or occupational inequalities in general or resulting from the 2008 financial crisis. Am. J. Ind. Med. 59:1105-1111, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Sadie H. Conway
- Department of Epidemiology, Human Genetics and Environmental Sciences; School of Public Health; University of Texas Health Science Center at Houston; Houston Texas
| | - Ana Cayuela
- Department of Community Nursing, Preventive Medicine and Public Health, and History of Science; University of Alicante; Alicante Spain
- Public Health Research Group; University of Alicante; Alicante Spain
| | - George L. Delclos
- Department of Epidemiology, Human Genetics and Environmental Sciences; School of Public Health; University of Texas Health Science Center at Houston; Houston Texas
- Center for Research in Occupational Health (CiSAL); Universitat Pompeu Fabra; Barcelona Spain
- Hospital del Mar Medical Research Institute (IMIM); Barcelona Spain
- Center for Biomedical Network Research on Epidemiology and Public Health (CIBERESP); Madrid Spain
| | - Lisa A. Pompeii
- Department of Epidemiology, Human Genetics and Environmental Sciences; School of Public Health; University of Texas Health Science Center at Houston; Houston Texas
| | - Elena Ronda
- Department of Community Nursing, Preventive Medicine and Public Health, and History of Science; University of Alicante; Alicante Spain
- Public Health Research Group; University of Alicante; Alicante Spain
- Center for Research in Occupational Health (CiSAL); Universitat Pompeu Fabra; Barcelona Spain
- Center for Biomedical Network Research on Epidemiology and Public Health (CIBERESP); Madrid Spain
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Parmar D, Stavropoulou C, Ioannidis JPA. Health outcomes during the 2008 financial crisis in Europe: systematic literature review. BMJ 2016; 354:i4588. [PMID: 27601477 PMCID: PMC5013230 DOI: 10.1136/bmj.i4588] [Citation(s) in RCA: 122] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To systematically identify, critically appraise, and synthesise empirical studies about the impact of the 2008 financial crisis in Europe on health outcomes. DESIGN Systematic literature review. DATA SOURCES Structural searches of key databases, healthcare journals, and organisation based websites. REVIEW METHODS Empirical studies reporting on the impact of the financial crisis on health outcomes in Europe, published from January 2008 to December 2015, were included. All selected studies were assessed for risk of bias. Owing to the heterogeneity of studies in terms of study design and analysis and the use of overlapping datasets across studies, studies were analysed thematically per outcome, and the evidence was synthesised on different health outcomes without formal meta-analysis. RESULTS 41 studies met the inclusion criteria, and focused on suicide, mental health, self rated health, mortality, and other health outcomes. Of those studies, 30 (73%) were deemed to be at high risk of bias, nine (22%) at moderate risk of bias, and only two (5%) at low risk of bias, limiting the conclusions that can be drawn. Although there were differences across countries and groups, there was some indication that suicides increased and mental health deteriorated during the crisis. The crisis did not seem to reverse the trend of decreasing overall mortality. Evidence on self rated health and other indicators was mixed. CONCLUSIONS Most published studies on the impact of financial crisis on health in Europe had a substantial risk of bias; therefore, results need to be cautiously interpreted. Overall, the financial crisis in Europe seemed to have had heterogeneous effects on health outcomes, with the evidence being most consistent for suicides and mental health. There is a need for better empirical studies, especially those focused on identifying mechanisms that can mitigate the adverse effects of the crisis.
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Affiliation(s)
- Divya Parmar
- School of Health Sciences, City University London, London EC1V 0HB, UK
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Jakič M, Rotar Pavlič D. Patients' perception of differences in general practitioners' attitudes toward immigrants compared to the general population: Qualicopc Slovenia. Zdr Varst 2016; 55:155-165. [PMID: 27703534 PMCID: PMC5031064 DOI: 10.1515/sjph-2016-0020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Accepted: 01/21/2016] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Globally, the number of immigrants is rising every year, so that the number of immigrants worldwide is estimated at 200 million. In Slovenia, immigrants comprise 6.5% of the overall population. Immigrants bring along to a foreign country their cultural differences and these differences can affect immigrants' overall health status and lead to chronic health conditions. The aim of this study was to identify patients' perception of general practitioners' (GPs') attitudes toward immigrants in Slovenia. METHODS This study was based on the Qualicopc questionnaire. We used the questions that targeted patients' experience with the appointment at their GP on the day that the study was carried out. RESULTS There were no differences in GPs' accessibility based on groups included in our study (p>0.05). Compared to the non-immigrant population, first-generation immigrants answered that their GPs were impolite (p=0.018) and that they did not take enough time for them (p=0.038). In addition, they also experienced more difficulties understanding their GP's instructions (p<0.001). Second-generation immigrants experienced more negative behaviour from GPs, and first-generation immigrants had more difficulties understanding GPs' instructions. CONCLUSION There may be some differences in patients' perception of GPs' attitudes towards immigrants in comparison with the general Slovenian population. However, based on the perception of the immigrants that do benefit from the medical care it is not possible to judge the GPs' attitudes towards immigrants as worse compared to their attitude towards the non-immigrant population. Indeed, there may be other reasons why the patients answered the way they did.
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Affiliation(s)
- Maja Jakič
- University of Ljubljana, Faculty of Medicine, Department of Familiy Medicine, Poljanski nasip 58, 1000 Ljubljana, Slovenia
| | - Danica Rotar Pavlič
- University of Ljubljana, Faculty of Medicine, Department of Familiy Medicine, Poljanski nasip 58, 1000 Ljubljana, Slovenia
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