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Diaz J, Taboada I, Abreu A, Vargas L, Polanco Y, Zorrilla A, Beatty N. Evaluating Rural Health Disparities in Colombia: Identifying Barriers and Strategies to Advancing Refugee Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6948. [PMID: 37887686 PMCID: PMC10606581 DOI: 10.3390/ijerph20206948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 10/17/2023] [Accepted: 10/18/2023] [Indexed: 10/28/2023]
Abstract
Health disparities within rural communities, notably those affecting migrant and refugee populations, are well-documented. Refugees often grapple with high disease burdens and mortality rates due to limited access to primary healthcare and their vulnerable socio-economic and political situations. This issue is particularly acute in the rural areas around Medellin, Colombia, where the refugee influx exacerbates the existing public health challenges. Studies highlight a substantial gap between community needs and public health policies, resulting in inadequate healthcare access. Our study, utilizing the Delphi technique, aimed to identify common barriers and strategies to enhance rural healthcare for refugees. Through consensus-building with community leaders, we identified six primary barriers to healthcare access and five barriers to healthcare quality. Community leaders endorsed five strategies to address the access barriers and eight strategies to improve healthcare quality. This research provides valuable insights for optimizing resource allocation and designing effective support programs for these vulnerable populations.
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Affiliation(s)
- John Diaz
- Gulf Coast Research and Education Center, University of Florida, Plant City, FL 33563, USA
| | - Isabel Taboada
- College of Medicine, University of Florida, Gainesville, FL 32610, USA; (I.T.); (A.A.); (L.V.); (A.Z.); (N.B.)
| | - Adriana Abreu
- College of Medicine, University of Florida, Gainesville, FL 32610, USA; (I.T.); (A.A.); (L.V.); (A.Z.); (N.B.)
| | - Lara Vargas
- College of Medicine, University of Florida, Gainesville, FL 32610, USA; (I.T.); (A.A.); (L.V.); (A.Z.); (N.B.)
| | - Ysabel Polanco
- Faculty of Medicine, University of Antioquia, Medellin 050010, Antioquia, Colombia;
| | - Alex Zorrilla
- College of Medicine, University of Florida, Gainesville, FL 32610, USA; (I.T.); (A.A.); (L.V.); (A.Z.); (N.B.)
| | - Norman Beatty
- College of Medicine, University of Florida, Gainesville, FL 32610, USA; (I.T.); (A.A.); (L.V.); (A.Z.); (N.B.)
- Emerging Pathogens Institute, University of Florida, Gainesville, FL 32610, USA
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Anillo Arrieta LA, Flórez Lozano KC, Tuesca Molina R, Acosta Vergara T, Rodríguez Acosta S, Aschner P, Diaz Montes Y, Nieto Castillo JP, Florez-Garcia VA, Barengo NC. Glycemic status and health-related quality of life (HRQOL) in populations at risk of diabetes in two Latin American cities. Qual Life Res 2023:10.1007/s11136-023-03398-x. [PMID: 37010804 PMCID: PMC10328894 DOI: 10.1007/s11136-023-03398-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2023] [Indexed: 04/04/2023]
Abstract
PURPOSE To estimate the health-related quality of life (HRQOL) according to glycemic status, and its relationship with sociodemographic and clinical factors in a population at risk of developing type 2 diabetes (T2D). METHODS Cross-sectional study, using cluster sampling. Data were collected from 1135 participants over 30 years of age, at risk of developing T2D from the PREDICOL project. Participants' glycemic status was defined using an oral glucose tolerance test (OGTT). Participants were divided into normoglycemic subjects (NGT), prediabetes and diabetics do not know they have diabetes (UT2D). HRQOL was assessed using the EQ-5D-3L questionnaire of the EuroQol group. Logistic regression and Tobit models were used to examine factors associated with EQ-5D scores for each glycemic group. RESULTS The mean age of participants was 55.6 ± 12.1 years, 76.4% were female, and one in four participants had prediabetes or unknown diabetes. Participants reported problems most frequently on the dimensions of Pain/Discomfort and Anxiety/Depression in the different glycemic groups. The mean EQ-5D score in NGT was 0.80 (95% CI 0.79-0.81), in prediabetes, 0.81 (95% CI 0.79-0.83), and in participants with UT2D of 0.79 (95% CI 0.76-0.82), respectively. Female sex, older age, city of residence, lower education, receiving treatment for hypertension, and marital status were significantly associated with lower levels of HRQOL in the Tobit regression analysis. CONCLUSIONS HRQOL of NGT, prediabetes, and UT2D participants was statistically similar. However, factors such as gender, age. and place of residence were found to be significant predictors of HRQOL for each glycemic group.
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Affiliation(s)
- Luis A Anillo Arrieta
- Division of Basic Sciences, Department of Mathematics and Statistics, Universidad del Norte, Barranquilla, Colombia.
- Division of Health Sciences, Department of Public Health, Universidad del Norte, Barranquilla, Colombia.
| | - Karen C Flórez Lozano
- Division of Basic Sciences, Department of Mathematics and Statistics, Universidad del Norte, Barranquilla, Colombia
| | - Rafael Tuesca Molina
- Division of Health Sciences, Department of Public Health, Universidad del Norte, Barranquilla, Colombia
- ScienceFlows Research Group, University of Valencia, Valencia, Spain
| | - Tania Acosta Vergara
- Division of Health Sciences, Department of Public Health, Universidad del Norte, Barranquilla, Colombia
| | - Sandra Rodríguez Acosta
- Division of Humanities and Sciences, Division Social, Department of Economics, Universidad del Norte, Barranquilla, Colombia
| | - Pablo Aschner
- Asociación Colombiana de Diabetes, Bogotá, Colombia
- Javeriana University, Bogotá, Colombia
- San Ignacio University Hospital, Bogotá, Colombia
| | - Yenifer Diaz Montes
- Division of Health Sciences, Department of Public Health, Universidad del Norte, Barranquilla, Colombia
| | - Julieth P Nieto Castillo
- Division of Health Sciences, Department of Public Health, Universidad del Norte, Barranquilla, Colombia
| | - Víctor Alfonso Florez-Garcia
- Division of Health Sciences, Department of Public Health, Universidad del Norte, Barranquilla, Colombia
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| | - Noël C Barengo
- Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Global Health, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
- Joseph J. Zilber School of Public Health, University of Wisconsin, Milwaukee, USA
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The Role of Physical Education in Preventing Unhealthy Lifestyles in Immigrant Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116889. [PMID: 35682480 PMCID: PMC9180895 DOI: 10.3390/ijerph19116889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 05/30/2022] [Accepted: 06/02/2022] [Indexed: 02/04/2023]
Abstract
In recent years, migratory phenomena have changed the composition of Spanish society. There are many studies that explore the healthy habits of young adolescents, but few focus on young immigrants. The purpose of this study is to examine the causal relationships between certain factors that influence the health of immigrant youth and sports. The sample consisted of 173 students enrolled in secondary education in the city of Cuenca. The structural model confirms the relationship between the latent variables and sports. Specifically, we obtained a positive influence of an active lifestyle (regular physical activity and exercise) and a negative influence for the remaining variables (alcohol consumption, unhealthy foods, self-medication and tobacco consumption in the family). Physical education should promote healthy lifestyles; greater coordination between physical education and other subjects involved in education and the promotion of health are necessary because we consider that this task is not exclusive to physical education.
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Martos-Méndez MJ, Gómez-Jacinto L, Hombrados-Mendieta I, Melguizo-Garín A, Ruiz-Rodríguez I. Psychosocial and Sociodemographic Determinants Related to Chronic Diseases in Immigrants Residing in Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:3900. [PMID: 35409583 PMCID: PMC8997881 DOI: 10.3390/ijerph19073900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 03/17/2022] [Accepted: 03/22/2022] [Indexed: 02/05/2023]
Abstract
The aim of the study is to analyze the effect of the psychosocial determinants of satisfaction with social support, resilience and satisfaction with life, and the sociodemographic determinants of age, gender and length of residence on chronic diseases in immigrants living in Spain. The sample was composed of 1131 immigrants from Africa, Eastern Europe, Latin America and Asia. 47.1% were men and 52.9% were women. Most relevant results point to age as the sociodemographic variable with the highest predictive effect in the six chronic diseases analyzed. Gender, in this case female, predicts arthrosis, chronic back pain and migraine, whereas length of residence was only significant in the case of chronic allergies. Regarding psychosocial variables, resilience is a good predictor of hypertension, chronic allergies and arthrosis. However, satisfaction with social support appears to be the best predictor for chronic back pain in the regression equation, satisfaction with life being a significant variable in migraine, arthrosis, allergies and high cholesterol. Results are notably relevant for the design of preventive health programs in immigrants, as well as in ensuring their appropriate access to the health system so that their chronic diseases can be diagnosed. Given the relevance and incidence of the chronic diseases analyzed in immigrants, preventive strategies should be improved to tackle chronic diseases that can have a serious impact on immigrants' health.
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Affiliation(s)
- María José Martos-Méndez
- Faculty of Psychology, University of Málaga, 29071 Málaga, Spain; (I.H.-M.); (A.M.-G.); (I.R.-R.)
| | - Luis Gómez-Jacinto
- Faculty of Social and Labor Studies, University of Málaga, 29071 Málaga, Spain;
| | | | - Anabel Melguizo-Garín
- Faculty of Psychology, University of Málaga, 29071 Málaga, Spain; (I.H.-M.); (A.M.-G.); (I.R.-R.)
| | - Iván Ruiz-Rodríguez
- Faculty of Psychology, University of Málaga, 29071 Málaga, Spain; (I.H.-M.); (A.M.-G.); (I.R.-R.)
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Cardiometabolic Health Status, Ethnicity and Health-Related Quality of Life (HRQoL) Disparities in an Adult Population: NutrIMDEA Observational Web-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052948. [PMID: 35270641 PMCID: PMC8910247 DOI: 10.3390/ijerph19052948] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 02/25/2022] [Accepted: 02/25/2022] [Indexed: 12/24/2022]
Abstract
Precision public health supported on online tools is increasingly emerging as a potential strategy to achieve health promotion and disease prevention. Our aim was to assess the relationships of sociodemographic variables, anthropometric data, dietary habits and lifestyle factors with health-related quality of life (HRQoL), cardiometabolic health status and ethnicity in an online recruited adult population (NutrIMDEA Study). NutrIMDEA Study is a web-based cross-sectional survey that included 17,333 adults. Self-reported sociodemographic characteristics, anthropometric data, clinical and family history of cardiometabolic illnesses, dietary habits, lifestyle factors and HRQoL features were collected. Diseased individuals showed significative poorer MedDiet and worse HRQoL than those in the healthy cardiometabolic status group (p < 0.05). In comparison, European/Caucasian individuals reported a significantly better HRQoL, higher MedDiet and HRQoL values compared with those of other ethnicities (p < 0.05). We obtained a total of 16.8% who reported poor/fair, 56.5% good and 26.6% very good/excellent HRQoL. Respondents with very good/excellent HRQoL showed lower BMI, greater adherence to a Mediterranean diet (MedDiet) and higher physical activity. The results suggest the presence of interactions between the mental and physical components of HRQoL with obesity, sedentarism and dietary intake, which were dependent on disease status and ethnicity. Online HRQoL assessment could contribute to wider implementation of precision public health strategies to promote health targeted interventions with policy implications to community health promotion.
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Urzúa A, Henríquez D, Caqueo-Urízar A, Landabur R. Ethnic Identity and Collective Self-Esteem Mediate the Effect of Anxiety and Depression on Quality of Life in a Migrant Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:174. [PMID: 35010433 PMCID: PMC8751200 DOI: 10.3390/ijerph19010174] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 12/15/2021] [Accepted: 12/16/2021] [Indexed: 06/14/2023]
Abstract
Migration processes can often trigger negative interactions with the context, generating problems in both the physical and mental health of migrants, which have an impact on both their well-being and their quality of life. In this framework, the research aimed to assess the mediating effect of ethnic identity and collective self-esteem on the inverse relationship between mental health problems and quality of life. Data were collected from 908 first-generation Colombian migrants living in Chile, of whom 50.2% were women and with an average age of 35 years. They were assessed with The World Health Organization Quality of Life (WHOQoL)-Bref, Smith's ethnic identity questionnaire, Basabe's collective self-esteem, and Beck's Anxiety and Depression questionnaires. The results provide evidence that both collective self-esteem and ethnic identity exert a partial mediation effect on the relationship between anxiety and depression on quality of life. The study provides evidence of the protective role that the maintenance and reinforcement of ethnic identity and collective self-esteem can have, with a view to strengthening the planning of interventions both in the field of prevention of mental health problems and in the improvement of quality of life based on evidence.
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Affiliation(s)
- Alfonso Urzúa
- Escuela de Psicología, Universidad Católica del Norte, Antofagasta 1240000, Chile;
| | - Diego Henríquez
- Escuela de Psicología, Universidad Católica del Norte, Antofagasta 1240000, Chile;
| | | | - Rodrigo Landabur
- Departamento de Psicología, Universidad de Atacama, Copiapó 1530000, Chile;
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Belau MH, Becher H, Kraemer A. Loneliness as a mediator of social relationships and health-related quality of life among refugees living in North Rhine-Westphalia, Germany. BMC Public Health 2021; 21:2233. [PMID: 34879832 PMCID: PMC8656054 DOI: 10.1186/s12889-021-12303-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 11/19/2021] [Indexed: 12/15/2022] Open
Abstract
Background Since 2015, more than one million people fled to Germany – mainly from war-affected countries. Nevertheless, little is known about social determinants in refugees located in Germany. This study aims to test the mediation effect of loneliness between social relationships, comprising social integration and social support, and health-related quality of life among refugees living in North Rhine-Westphalia, Germany. Methods The investigation utilizes data from the FlueGe Health Study (N=326), a cross-sectional study conducted by Bielefeld University. The data was collected between February and November 2018 and included interviews and examinations. Participants were recruited from shared and private accommodation in several cities in North Rhine-Westphalia, Germany. We first analyzed correlations between social integration, social support, loneliness, and physical and mental component of health-related quality of life. We then conducted mediation analyses using structural equation modeling. Results The majority of respondents were socially isolated, perceiving a moderate degree of loneliness and social support. In addition, the physical and mental components of health-related quality of life indicate that participants predominantly experienced mental rather than physical impairments. Results from mediation analyses showed indirect effects of loneliness on the association between social integration and mental health (ß = 0.495, 95% bias-corrected and accelerated confidence interval (BCa CI) = [0.018, 0.972]), and between social support and both physical (ß = 0.022, 95% BCa CI = [0.004, 0.040]) and mental health (ß = 0.067, 95% BCa CI = [0.037, 0.097]). Conclusions Loneliness played a mediating role in the association between social relationships and health-related quality of life among refugees living in North Rhine-Westphalia, Germany. The results provide implications for both, health policy and the host society. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-12303-5.
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Affiliation(s)
- Matthias Hans Belau
- School of Public Health, Bielefeld University, Bielefeld, Germany. .,Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. .,University Medical Center Hamburg-Eppendorf, Institute of Medical Biometry and Epidemiology, Martinistraße 52, D-20246, Hamburg, Germany.
| | - Heiko Becher
- Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Health-Related Quality of Life among Rural-Urban Migrants Living in Dhaka Slums: A Cross-Sectional Survey in Bangladesh. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910507. [PMID: 34639807 PMCID: PMC8508420 DOI: 10.3390/ijerph181910507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 09/23/2021] [Accepted: 09/24/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND The study aimed to assess the health-related quality of life (HRQoL) and its associated factors among urban slum dwellers who migrated from different rural parts of Bangladesh. METHODS The present study analyzed data from a Migration and Mobility Determinants on Health survey and was conducted in 2017 among 935 migrant slum dwellers of Dhaka city (North & South) and Gazipur City Corporations, as a part of the icddr,b's Urban Health and Demographic Surveillance System (UHDSS). The face-to-face interviews were conducted with the adult population by using a semi-structured questionnaire that included variables related to socio-demographics, migration, occupation, and HRQoL (SF-12). Bivariate and multiple linear regression analyses were performed to determine the factors associated with HRQoL. RESULTS The mean (±SD) scores of physical component summary (PCS), and mental component summary (MCS) were 57.40 ± 22.73 and 60.77 ± 22.51, respectively. As per multiple regression analysis, lower PCS scores were associated with having older age, being female, and not having any job. Mean MCS scores were significantly lower among participants who reported having older age, not having any job, not working/ less working hours (≤8 h/day), as well as increased work-related stress in the current urban slum. CONCLUSIONS The findings suggest that available urban social protection programs should include a comprehensive social safety net for the improvement of the slum infrastructure as well as proper health care and risk mitigation plans at workplaces.
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Ferrer L, Gaillardin F, Cayuela A, Hernando C, Muñoz R, Sánchez N, Forero CG, Ronda E, Casabona J. [Health status among immigrant in Catalonia from a gender perspective: PELFI project]. GACETA SANITARIA 2021; 36:368-375. [PMID: 33896656 DOI: 10.1016/j.gaceta.2021.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 02/08/2021] [Accepted: 02/13/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The objective of the study is to assess the health status of immigrant men and women from non-EU countries living in the Metropolitan Area of Barcelona (Catalonia, Spain) and to identify the social determinants of health from a gender perspective. METHOD Cross-sectional analysis from a cohort of immigrant families recruited in Badalona and Santa Coloma de Gramenet, in Spain (PELFI cohort). In 2015-2016, 167 immigrants answered the baseline epidemiological questionnaire and the 5-level EuroQol instrument (EQ-5D) which measures health status. To identify health determinants, Tobit models were constructed to the EQ-5D index. RESULTS Women rated poorer self-perceived health (p=0.005). To be diagnosed with and illness was only associated with poor self-perceived health among men (p<0.05). Length of residence, domestic work, and especially double workload deteriorated women's health. After adjusting models by demographics and social determinants, permanent administrative status (-0.136; p=0.015) and social support (0.182; p=0.02) were associated with health status in both sexes. To have a job was associated with better health only in men. CONCLUSIONS Non-EU immigrants living in the Metropolitan Area of Barcelona are a socially vulnerable group of population and present inequalities in health by sex. Social support and occupation are key factors of their health status. Interventions to reduce immigrant vulnerabilities and inequalities in health should promote their social inclusion and cohesion from a gender perspective.
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Affiliation(s)
- Laia Ferrer
- Centre d'Estudis Epidemiològics de les ITS/VIH/SIDA de Catalunya (CEEISCAT), Departament de Salut, Generalitat de Catalunya, Badalona, Barcelona, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España; Institut d'Investigació Fundació Germans Trias i Pujol, Badalona, Barcelona, España.
| | - Florianne Gaillardin
- Centre d'Estudis Epidemiològics de les ITS/VIH/SIDA de Catalunya (CEEISCAT), Departament de Salut, Generalitat de Catalunya, Badalona, Barcelona, España; Institut d'Investigació Fundació Germans Trias i Pujol, Badalona, Barcelona, España
| | - Ana Cayuela
- Área de Medicina Preventiva y Salud Pública, Universidad de Alicante, Alicante, España
| | - Cristina Hernando
- Centre d'Estudis Epidemiològics de les ITS/VIH/SIDA de Catalunya (CEEISCAT), Departament de Salut, Generalitat de Catalunya, Badalona, Barcelona, España; Institut d'Investigació Fundació Germans Trias i Pujol, Badalona, Barcelona, España
| | - Rafael Muñoz
- Centre d'Estudis Epidemiològics de les ITS/VIH/SIDA de Catalunya (CEEISCAT), Departament de Salut, Generalitat de Catalunya, Badalona, Barcelona, España; Grupo de Investigación en Detección Precoz del Cáncer, Programa IDIBELL, Institut de Recerca Biomèdica de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España
| | - Néstor Sánchez
- Facultad de Medicina, Universitat Internacional de Catalunya, Barcelona, España
| | - Carlos G Forero
- Facultad de Medicina, Universitat Internacional de Catalunya, Barcelona, España
| | - Elena Ronda
- CIBER de Epidemiología y Salud Pública (CIBERESP), España; Área de Medicina Preventiva y Salud Pública, Universidad de Alicante, Alicante, España
| | - Jordi Casabona
- Centre d'Estudis Epidemiològics de les ITS/VIH/SIDA de Catalunya (CEEISCAT), Departament de Salut, Generalitat de Catalunya, Badalona, Barcelona, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España; Institut d'Investigació Fundació Germans Trias i Pujol, Badalona, Barcelona, España; Departamento de Pediatría, Obstetricia, Ginecología y Medicina Preventiva, Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola, Barcelona, España
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Zambrano-Barragán P, Ramírez Hernández S, Freier LF, Luzes M, Sobczyk R, Rodríguez A, Beach C. The impact of COVID-19 on Venezuelan migrants' access to health: A qualitative study in Colombian and Peruvian cities. J Migr Health 2020; 3:100029. [PMID: 34405183 PMCID: PMC8352083 DOI: 10.1016/j.jmh.2020.100029] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 12/03/2020] [Accepted: 12/04/2020] [Indexed: 12/02/2022] Open
Abstract
This research seeks to understand how COVID-19 has affected access to healthcare among migrants in Latin American cities. Using ethnographic research methods, we engaged with Venezuelans living in conditions of informality in four Colombian cities-Barranquilla, Cucuta, Riohacha, and Soacha-and three Peruvian cities-Lima, Trujillo, and Tumbes. We conducted 130 interviews of both Venezuelan migrants and state and non-governmental actors within the healthcare ecosystems of these cities. We found that forced migrants from Venezuela in both Colombia and Peru face common obstacles along their access trajectories to healthcare, which we summarize as legal, financial, and relating to discrimination and information asymmetry. By limiting effective access to care during the pandemic, these obstacles have also affected migrants' ability to cover the costs of basic needs, particularly food and housing. Our study also found a prevalent reliance on alternative forms of care, such as telemedicine, easy-to-access pharmacies, and extralegal care networks. We conclude that COVID-19 has exacerbated preexisting conditions of informality and health inequities affecting Venezuelan migrants in Colombia and Peru.
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Affiliation(s)
| | | | - Luisa Feline Freier
- Political and Social Sciences Department, Universidad del Pacífico, Jr. Gral. Luis Sanchez Cerro, 2141, Jesus Maria, Lima, Peru
| | - Marta Luzes
- Centro de Investigación, Universidad del Pacífico, Jr. Gral. Luis Sanchez Cerro, 2141, Jesus Maria, Lima, Peru
| | - Rita Sobczyk
- Faculty of Political Science and Sociology, Department of Sociology, University of Granada, C/ Rector López Argüeta s/n, 18071 Granada, Spain
| | - Alexander Rodríguez
- Oraloteca - Universidad del Magdalena, Carrera 32 No 22 – 08 Santa Marta D.T.C.H, Colombia
| | - Charles Beach
- University College London, 14 Taviton Street, London WC1H 0BW, United Kingdom
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Perceived Discrimination, Psychological Distress and Cardiovascular Risk in Migrants in Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17124601. [PMID: 32604844 PMCID: PMC7345483 DOI: 10.3390/ijerph17124601] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 06/16/2020] [Accepted: 06/24/2020] [Indexed: 01/29/2023]
Abstract
The aim of the present study is to determine the effect of discrimination and psychological distress on the cardiovascular health of immigrants, as well as to analyse potential differences based on age, gender, length of residence in host country and geographic origin. The sample was formed by 1714 immigrants from Africa, Eastern Europe and Latin America. Of the sample, 48.7% were men and 51.3% were women. Most relevant results show that discrimination (t = 4.27; p = 0.000) and psychological distress (t = 4.35; p = 0.000) experienced by immigrants predict their cardiovascular risk. Furthermore, psychological distress mediates the relation between discrimination and risk (t = 4.03; p = 0.000). Significant differences between men and women were found, as well as differences based on ethnicity, although to a lesser extent. Age affects the relation between discrimination, psychological distress and arterial hypertension and hypercholesterolemia. Results are notably relevant for the design of preventive health programmes for immigrants and intervention strategies in order to prevent diseases that may imply cardiovascular risks and seriously affect immigrants' health.
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Differences in Eye Health, Access to Eye Care Specialists and Use of Lenses among Immigrant and Native-Born Workers in Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16071288. [PMID: 30974863 PMCID: PMC6479319 DOI: 10.3390/ijerph16071288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 04/04/2019] [Accepted: 04/06/2019] [Indexed: 11/20/2022]
Abstract
Latin American immigrants make up 49% of the total immigrant population in Spain, yet little is known about their eye health. The aim of this study is to determine if there are differences in self-perceived eye health, access to eye care specialists, and use of lenses between a sample of Latin American immigrant workers from Colombia and Ecuador, and native-born workers in Spain. We used data from the PELFI cohort (Project for Longitudinal Studies of Immigrant Families). The sample consisted of 179 immigrant workers born in Colombia or Ecuador, and 83 Spanish-born workers. The outcome variables were self-perceived eye health, access to eye specialists, and use of lenses. A descriptive analysis of the sample was carried out, and the prevalence of the three outcome variables in immigrants and natives was calculated and adjusted for explanatory variables. Random effects logistic regression models examined eye health outcomes by workers’ country of birth. Immigrants are less likely to report poor self-perceived eye health than native-born (ORc 0.46; CI 95%, 0.22–0.96). Furthermore, they have less access to specialists (ORc 2.61; CI 95%, 1.32–5.15) and a higher probability of needing lenses but not having them (ORc 14.14; CI 95%, 1.77–112.69). This latter variable remained statistically significant after adjusting for covariates (ORa 34.05; CI 95%, 1.59–729.04). Latin American immigrants may not value the use of lenses, despite eye care specialists indicating that they need them. Eye health education is required to recognize the importance of using lenses according to their visual needs.
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Molina KM, Estrella ML, Durazo-Arvizu R, Malcarne VL, Llabre MM, Isasi CR, Ornelas IJ, Perreira KM, Penedo FJ, Brondolo E, Gallo L, Daviglus ML. Perceived discrimination and physical health-related quality of life: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL) Sociocultural Ancillary Study. Soc Sci Med 2019; 222:91-100. [PMID: 30623798 PMCID: PMC6377306 DOI: 10.1016/j.socscimed.2018.12.038] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 12/14/2018] [Accepted: 12/26/2018] [Indexed: 12/19/2022]
Abstract
RATIONALE The aim of this study was to examine the direct associations of perceived personal and group discrimination with physical health-related quality of life (HRQoL) among Latinx adults. We also tested whether ethnic identity and depression symptoms sequentially mediate these associations. METHOD This population-based study included 5313 Latinx adults, ages 18-74 years, from the Hispanic Community Health Study/Study of Latinos (2008-11) and its Sociocultural Ancillary Study (2010-11). Participants were recruited from the Bronx; NY; Chicago, IL; Miami, FL; and San Diego, CA. Self-reported perceived personal and group discrimination, ethnic identity, depression symptoms, and physical HRQoL were ascertained through interviewer-administered surveys. Survey-weighted path analysis was used to examine direct and indirect effects simultaneously in one analytic model controlling for demographic covariates. RESULTS Path analysis indicated that higher perceived personal discrimination was directly associated with poorer physical HRQoL and this association was only mediated by depression symptoms. In contrast, perceived group discrimination was not directly associated with physical HRQoL. However, each of the direct paths linking perceived group discrimination to physical HRQoL were statistically significant: perceived group discrimination was positively associated with ethnic identity, and ethnic identity was negatively associated with depression symptoms, and, in turn, depression symptoms were negatively associated with physical HRQoL. Our model accounted for 18% of the variance of physical HRQoL. CONCLUSIONS Perceived personal and group discrimination are differently associated with physical HRQoL. Results highlight the importance of considering self-perceptions of different discrimination forms when evaluating its impact on the physical HRQoL of Latinx adults.
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Affiliation(s)
- Kristine M Molina
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA.
| | - Mayra L Estrella
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL, USA
| | | | - Vanessa L Malcarne
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Maria M Llabre
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Carmen R Isasi
- Department of Epidemiology and Population Health, Einstein College of Medicine, Bronx, NY, USA
| | - India J Ornelas
- Department of Health Service, University of Washington, Seattle, WA, USA
| | - Krista M Perreira
- Department of Social Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Frank J Penedo
- Department of Medical Social Sciences, Psychology & Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL, USA
| | | | - Linda Gallo
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Martha L Daviglus
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL, USA
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