Self-perceived workplace discrimination and mental health among immigrant workers in Italy: a cross-sectional study

Discrimination in the Workplace Linked to Psychological Distress: A Longitudinal Study in the United States

OBJECTIVE

This study aimed to explore the relationship between workplace discrimination and psychological distress across 9 years using data from the Midlife in the Unites States study.

METHODS

Workplace discrimination was measured with a validated six-item scale at baseline with three categories (low, intermediate, and high), and psychological distress was measured with the Kessler 6 scale at baseline and follow-up. In total, 1,546 workers were analyzed by linear regression.

RESULTS

High levels of workplace discrimination were significantly associated with increased psychological distress at follow-up (crude β = 0.633; 95% CI, 0.307-0.959). After adjusting for demographic factors, socioeconomic status, and health-related behaviors, associations were slightly attenuated (fully adjusted β = 0.447; 95% CI, 0.115-0.780).

CONCLUSIONS

High workplace discrimination was longitudinally associated with higher levels of psychological distress. Organizations should actively prevent discrimination, which may improve workers' mental health consequently.

Taking Care of Forced Migrants Together: Strengths and Weaknesses of Interorganizational Work from the Perspective of Social Workers

The reception and taking care of forced migrants with mental health issues is undoubtedly a very complex task. The literature shows that reception systems are characterized by a high level of fragmentation due to poor collaboration among services that are required to respond to complex and multidimensional needs brought by forced migrants. Starting from the need to deepen what elements support or hinder the implementation of the services' networks for the care and management of forced migrants, qualitative research was conducted within a constructivist paradigm. As the literature reveals a lack of studies considering the perspective of practitioners, we decided to explore the representations of professionals working with migrants in northern Italy in four different service areas (health and psychological well-being, reception, family, and legal areas). A total of 24 professionals (13 F and 11 M) with an average age of 42.4 years were involved in four focus groups according to the four areas. A paper-pencil content analysis was conducted following IPA guidelines. The results show strengths, weaknesses, and elements of improvement for service network implementation. The needs of forced migrants seem to be effectively met only through a service network that takes shape in the interweaving of social, organizational, group, and individual levels.

Barriers to Accessing Primary Care and Appropriateness of Healthcare Among Immigrants in Italy

INTRODUCTION

The health status and health care needs of immigrant populations must be assessed. The aim of this study was to evaluate barriers to accessing primary care and the appropriateness of health care among resident immigrants in Italy, using indicators regarding maternal health, avoidable hospitalization, and emergency care.

METHODS

Cross-sectional study using some indicators of the National Monitoring System of Health Status and Healthcare of the Immigrant Population (MSHIP), coordinated by the National Institute for Health, Migration and Poverty (INMP), calculated on perinatal care, hospital discharge, and emergency department databases for the years 2016-2017 in nine Italian regions (Piedmont, Trento, Bolzano, Emilia-Romagna, Tuscany, Umbria, Latium, Basilicata, Sicily). The analyses were conducted comparing immigrant and Italian residents.

RESULTS

Compared to Italian women, immigrant women had fewer than five gynecological examinations (8.5 vs. 16.3%), fewer first examinations after the 12th week of gestational age (3.8 vs. 12.5%), and fewer than two ultrasounds (1.0 vs. 3.8%). Compared to Italians, immigrants had higher standardized rates (× 1,000 residents) of avoidable hospitalizations (males: 2.1 vs. 1.4; females: 0.9 vs. 0.7) and of access to emergency departments for non-urgent conditions (males: 62.0 vs. 32.7; females: 52.9 vs. 31.4).

CONCLUSIONS

In Italy, there appear to be major issues regarding accessing services and care for the immigrant population. Policies aimed at improving socioeconomic conditions and promoting integration can promote healthy lifestyles and appropriate access to health care, counteracting the emergence of health inequities in the immigrant population.

Employment among people with epilepsy in Hong Kong

BACKGROUND

People with epilepsy (PWE) face difficulties in employment. Hong Kong depends heavily on tertiary industry and enjoys a low unemployment rate. However, there have been rare reports on employment of PWE in Hong Kong. We aimed at (1) investigating the employment status among PWE; (2) correlating demographic and clinical factors with employment status of PWE; and (3) describing the self-perceived impact of epilepsy on employment and their correlations with employment status.

METHOD

This was a single center cross-sectional study conducted in 2019. Adult with epilepsy but without intellectual disability of year age 16-65 were recruited. Homemakers and retired persons were excluded. A questionnaire with two parts was given to each patient. The first part focused on objective data about employment. The second part focused on self-perception on the impact of epilepsy on employment. Responders expressed their opinions in 5-point Likert scale. Clinical data were retrieved from the computerized medical record system for interpretation.

RESULTS

A total of 138 PWE were recruited. Unemployment rate among the PWE was 33%, which was much higher than the general population. Low education levels, drug-resistant epilepsy, psychiatric comorbidities, and high Charlson Comorbidity Index were correlated to unemployment in PWE. Unemployed respondents significantly more tend to regard that lack of education, stigma of epilepsy, and seizure frequency were main hurdles in employment.

CONCLUSIONS

Unemployment is a severe social problem among PWE in Hong Kong. Various objective clinical and demographic factors correlated with unemployment. Work beliefs of a patient may also correlate with the employment status.

Prevalence of psychosocial risks among immigrants in France and associations with mental health: findings from the national French Working Conditions Survey

PURPOSE

Few studies examined psychosocial risks among immigrants and explored their association with mental health. Our study aims to 1) describe the prevalence of job strain and iso-strain according to migratory status and model the probability of exposure, 2) verify whether the association between job strain, iso strain and anxiety holds for all immigrant groups.

METHODS

We used the nationally-representative cross-sectional French Working Conditions Survey (N = 24 640). Anxiety was measured with the GAD-Mini. We described the prevalence of job strain and iso-strain according to migratory status and sex. We used multivariate Poisson regressions to model the probability to be exposed to job strain and iso-strain. We described the prevalence of anxiety according to migratory status and sex. In each immigrant group, we modelled the probability of anxiety according to sociodemographic characteristics, lifetime suicidal attempt and job strain/iso-train.

RESULTS

Overall, there were important variations in psychosocial risks prevalence, with immigrants groups more exposed than majority population. After adjustment, being first-generation immigrant from Africa remained associated with job strain (aIRR = 1.21 [0.99; 1.47]), and being second-generation immigrant from Africa with iso-strain (aIRR = 1.33 [1.05; 1.69]). The prevalence of anxiety was the highest in second-generation immigrants from Africa (12%). In this population, job strain and iso-strain were associated with anxiety (aIRR job strain = 2.70[1.22;6.01]; aIRR iso-strain 4.26 [2.29;7.92]).

CONCLUSION

Our study provides first estimates of psychosocial risks among first and second-generation immigrants in France and shows that immigrants are particularly exposed to job strain and iso-strain, which could contribute significantly to their mental health.