Inmigración y salud

A reference framework for health and safety in the workplace in China and the European Union: A comparative study

BACKGROUND

Occupational Health and Safety (OHS) has a direct repercussion on the work, social and economic environments. The regulatory frameworks developed by each country are a basic aspect of OHS action policies.

OBJECTIVE

This study analyses and compares the differences in OHS regulations in China and the European Union (EU) to identify weaknesses or gaps in the Chinese regulations.

METHODS

Firstly, an overview of the OHS situation in the EU and China is carried out to provide context. Following this, a comparison of OHS regulations is conducted by searching different European and Chinese databases. The comparison focuses on several areas: socio-economic issues, accident rates, and the OHS regulatory framework.

RESULTS

Since 1989, the EU has produced a broad and comprehensive OHS regulatory framework. Almost 30 years later, its positive impact can be seen in EU accident rates, indicating that this framework might be used as a reference for other territories or countries. China has a complicated system with over 280 OHS legislative regulations, in the form of laws, regulations, rules, integrated regulations, etc. that lead to a mixture and repetition of contents.

CONCLUSIONS

The Chinese OHS legislation is still being constructed and complemented, since the two main Chinese OHS laws were approved during the last decade. This contrasts with the mature European framework, as it has been modified and completed over the years.

La salud de los migrantes y los servicios de salud en Medicina Familiar en Iberoamérica

Estudio exploratorio, transversal, descriptivo y cuali-cuantitativo, con el objetivo de determinar las condiciones de acceso y cobertura de los servicios de salud de Medicina Familiar y Atención Primaria para la población migrante en Iberoamérica. Se preparó un cuestionario con 22 preguntas relacionadas con el fenómeno de la migración y la prestación de servicios de salud en medicina familiar y atención primaria, el cual fue validado en apariencia y contenido por profesores de las Universidades de México, Colombia y Ecuador. Posteriormente fue respondida y documentada cada pregunta por los docentes e investigadores de 13 países de la región. Las conclusiones y recomendaciones propuestas por el Grupo de Trabajo sobre Migración y Salud de la VII Cumbre Iberoamericana de Medicina Familiar, fueron: a) reconocer el derecho a la salud de las personas migrantes y sus familias; b) incorporar en los programas de pregrado, posgrado y formación continua, las competencias necesarias para la atención integral de la población migrante y de sus familias y c) la creación de un observatorio de salud de los migrantes.

Factors Associated to Medication Consumption Among the Immigrant Population Residing in Spain

We aimed to determine the prevalence of medication use by the immigrant population residing in Spain, and to identify the factors associated with this consumption. Descriptive cross-sectional study was performed using secondary data retrieved from the 2012 Spanish National Health Survey (SNHS). Using logistic multivariate regression analysis, three models were generated: one for immigrants from high income countries (HIC), another for immigrants from low income countries (LIC), and a third one for the native population. The prevalence of total consumption of medicinal products is greater in the native population (61.75%) than in the immigrant population (HIC: 56.22%; LIC: 48.55%). Analgesics are the most consumed drugs in all the groups. Greater medication consumption is associated with being female, being of an advanced age (immigrants from HIC: AOR 9.75, for older than 75 years), the presence of chronic disease, a perception of bad health (HIC: AOR 3.48) and the use of emergency services (LIC immigrants: AOR 1.68). Medicine consumption in the immigrant population living in Spain is lower than in the native population. The factors associated with this consumption are similar; however, LIC immigrants who needed healthcare services and did not receive them presented a greater probability of consuming medicinal products.

Social factors associated with the knowledge about HIV of the immigrants from China, Latin America, the Maghreb and Senegal in the Basque Country (Spain)

The objective of this study was to identify the social factors that explain the differences in knowledge with regards to HIV/AIDS among immigrants in the Basque Country (Spain). We conducted a cross-sectional study based on information obtained in the Basque Health Survey for 754 immigrants from: 86 China, 368 Latin America, 237 the Maghreb and 74 Senegal. Odds ratios (95% CI) were calculated from logistic regression models to measure the degree of association between inadequate knowledge regarding transmission, prevention and places where HIV testing is offered, and the independent variables. We found that this inadequate knowledge is associated with place of birth, sex, a lower level of education, immigration status, difficulties in understanding Spanish, and not receiving advice about AIDS in primary care. These findings indicate that initiatives must be developed to promote equity in the provision of healthcare through clinical guidelines, including details of the specific needs of different groups of immigrants and considering gender issues.

[Risk factors and cardiovascular events in adult Latin American immigrants in the Macarena District, Seville, Spain: a pilot study]

In order to estimate the prevalence of self-reported risk factors and cardiovascular events in an adult immigrant Latin American population of District 2 (Macarena) in Seville, we conducted a pilot study using cross-sectional descriptive research. We used an anonymous questionnaire with self-reported risk factors and cardiovascular events. 34 people participated (18% of the sample); mean age: 31.8 years, mean residence: 6.5 years, women: 52.9%. Prevalence of risk factors: diabetes 8.8%, high cholesterol 14.7% and high blood pressure 23.5%. Prevalence of coronary events was 8.8%; angina pectoris, myocardial infarction and stroke, 2.9% each. The conclusion is that self-reported prevalence of cardiovascular events was higher than in the literature, this issue deserving the attention of health agencies. This knowledge should be considered by nurses to develop culturally appropriate care plans of the context of immigrants.

[Cardiovascular risk of immigrants living in Spain according to origin and years of stay]

OBJECTIVE

To assess whether there are differences in the immigrant population in terms of the years since their arrival in Spain and their geographical area of origin.

DESIGN

A cross-sectional study was conducted in three immigrant groups.

PARTICIPANTS

The groups selected were: a group of Latin American immigrants (298), a group of North African immigrants (130) and a group from Eastern Europe (114). A control group of 100 from a Spanish population of similar age and sex was also included.

METHODS

Anthropometric variables were measured, including biochemical inflammatory markers, blood pressure and cardiovascular risk estimation according to the tables of the European Societies of Hypertension and Cardiology.

RESULTS

The cardiovascular risk of the three groups of immigrants is similar between them (added cardiovascular risk high or very high at 5.5% in Latin Americans, 4.3% in North Africans, and 1.6% in immigrants from eastern countries), but significantly lower than the Spanish control group (28%). After 8 years in Spain, cardiovascular risk increases in the three groups of immigrants, with those from North Africa and eastern countries being comparable to the Spanish group (added cardiovascular risk high or very high of 18.5% in North Africans, and 20% in group from eastern countries). This cardiovascular risk was higher than the other groups, including the Spanish control group (Latin American immigrants 48.7% vs 28% in Spanish group).

CONCLUSIONS

The cardiovascular risk of immigrants increases over the years in Spain, with this increase being higher if they come from Latin America. This increase becomes clinically significant after the 8 years of stay in Spain.

Primary health care utilization by immigrants as compared to the native population: a multilevel analysis of a large clinical database in Catalonia

BACKGROUND

Immigration is a relevant public health issue and there is a great deal of controversy surrounding its impact on health services utilization.

OBJECTIVE

To determine differences between immigrants and non-immigrants in the utilization of primary health care services in Catalonia, Spain.

METHODS

Population based, cross-sectional, multicentre study. We used the information from 16 primary health care centres in an area near Barcelona, Spain. We conducted a multilevel analysis for the year 2008 to compare primary health care services utilization between all immigrants aged 15 or more and a sample of non-immigrants, paired by age and sex.

RESULTS

Overall, immigrants living in Spain used health services more than non-immigrants (Incidence Risk Ratio (IRR) 1.16 (95% Confidence Interval (CI): 1.15-1.16) and (IRR 1, 26, 95% CI: 1.25-1.28) for consultations with GPs and referrals to specialized care, respectively. People coming from the Maghreb and the rest of Africa requested the most consultations involving a GP and nurses (IRR 1.34, 95% CI: 1.33-1.36 and IRR 1.06, 95% CI: 1.03-1.44, respectively). They were more frequently referred to specialized care (IRR 1.44, 95% CI: 1.41-1.46) when compared to Spaniards. Immigrants from Asia had the lowest numbers of consultations with a GP and referrals (IRR 0.76, 95% CI: 0.66-0.88 and IRR 0.76, 95% CI: 0.61-0.95, respectively.

CONCLUSION

On average, immigrants living in Catalonia used the health services more than non-immigrants. Immigrants from the Maghreb and other African countries showed the highest and those from Asia the lowest, number of consultations and referrals to specialized care.