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Frentz-Göllnitz M, Remund A, Harmsen C, Stoeldraijer L, van der Toorn J, Doblhammer G, Janssen F. Contributions of causes of death to differentials in life expectancy by internal migrant status in the Netherlands. A population register based study, 2015-2019. SSM Popul Health 2024; 27:101690. [PMID: 39035781 PMCID: PMC11259871 DOI: 10.1016/j.ssmph.2024.101690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 06/09/2024] [Accepted: 06/10/2024] [Indexed: 07/23/2024] Open
Abstract
Important health differences exist in the context of international migration and residential mobility. Less is known about health differences regarding the medium-distance level of internal migration. This study examines life expectancy gaps between internal movers and stayers in the Netherlands and their underlying processes by assessing the contribution of different causes of death by age and sex. It uses individually-linked death counts and population exposures extracted from population registers, covering the native Dutch population aged 10+ from 2015 to 2019. The pooled data were disaggregated by causes-of-death group (neurodegenerative diseases, cardiovascular diseases, lifestyle-related mortality, external causes, and other causes), internal migrant status (movers and stayers, based on past 10-year residence in the 40 NUTS-3 [Nomenclature of Territorial Units for Statistics, level 3] regions), age, and sex. Comparing movers and stayers, we computed life expectancy at age 10 (e10), age- and cause-specific mortality risks, and applied decomposition methods to assess contributions of causes of death to e10 gaps. In the Netherlands in 2015-2019, e10 was lower for movers between NUTS-3 regions than stayers (males: 2.49 years; females: 3.51 years), due to excess mortality for movers at most ages. Movers only had a lower mortality than stayers at younger working ages (males: ages 20-44; females: ages 20-34). Mortality from neurodegenerative diseases and cardiovascular diseases were the largest contributors to the e10 gap, especially at ages 75+ and for females. Mortality from lifestyle-related and external causes of death contributed less, with the largest contributions for females aged 75-89 and males aged 45-69. The lower e10 of movers in the Netherlands is likely explained by health selection effects-in particular care-related moves as coping behaviour-rather than by causal effects through risk accumulation. Research focusing on regional or spatial heterogeneity of the mover-stayer health gap would be insightful to further understand these processes.
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Affiliation(s)
- Maximilian Frentz-Göllnitz
- Population Research Centre, Faculty of Spatial Sciences, University of Groningen, Groningen, The Netherlands
- Institute of Sociology and Demography, University of Rostock, Rostock, Germany
| | - Adrien Remund
- Population Research Centre, Faculty of Spatial Sciences, University of Groningen, Groningen, The Netherlands
| | | | | | | | - Gabriele Doblhammer
- Institute of Sociology and Demography, University of Rostock, Rostock, Germany
- German Center for Neurodegenerative Diseases, Bonn, Germany
| | - Fanny Janssen
- Population Research Centre, Faculty of Spatial Sciences, University of Groningen, Groningen, The Netherlands
- Netherlands Interdisciplinary Demographic Institute - KNAW/University of Groningen, The Hague, The Netherlands
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2
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Wilson B, Wallace M, Saarela J. Understanding the Intergenerational Impact of Migration: An Adult Mortality Advantage for the Children of Forced Migrants? Epidemiology 2024; 35:589-596. [PMID: 38985517 PMCID: PMC11309332 DOI: 10.1097/ede.0000000000001763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 05/28/2024] [Indexed: 07/12/2024]
Abstract
BACKGROUND Children of immigrants often have excess mortality rates, in contrast to the low mortality typically exhibited by their parents' generation. However, prior research has studied children of immigrants who were selected for migration, thereby rendering it difficult to isolate the intergenerational impact of migration on adult mortality. METHODS We use semiparametric survival analysis to carry out a total population cohort study estimating all-cause and cause-specific mortality among all adult men and women from age of 17 years among all men and women born in 1953-1972 and resident in Finland in 1970-2020. We compare children of forced migrants from ceded Karelia, an area of Finland that was ceded to Russia during the Second World War, with the children of parents born in present-day Finland. RESULTS Children with two parents who were forced migrants have higher mortality than children with two parents born in Northern, Southern, and Western Finland, but similar or lower mortality than the subpopulation of children whose parents were born in the more comparable areas of Eastern Finland. For women and men, a mortality advantage is largest for external causes and persists after controlling for socioeconomic factors. CONCLUSION Our findings suggest that forced migration can have a beneficial impact on the mortality of later generations, at least in the case where forced migrants are able to move to contextually similar locations that offer opportunities for rapid integration and social mobility. The findings also highlight the importance of making appropriate comparisons when evaluating the impact of forced migration.
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Affiliation(s)
- Ben Wilson
- From the Department of Sociology, University of Stockholm, Stockholm, Sweden
- Department of Methodology, London School of Economics, London, United Kingdom
| | - Matthew Wallace
- From the Department of Sociology, University of Stockholm, Stockholm, Sweden
| | - Jan Saarela
- Demography Unit, Åbo Akademi University, Vaasa, Finland
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3
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Guillot M, Khlat M, Gansey R, Solignac M, Elo I. Return Migration Selection and Its Impact on the Migrant Mortality Advantage: New Evidence Using French Pension Data. Demography 2023; 60:1335-1357. [PMID: 37650652 PMCID: PMC10587819 DOI: 10.1215/00703370-10938784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
The migrant mortality advantage (MMA) has been observed in many immigrant-receiving countries, but its underlying factors remain poorly understood. This article examines the role of return migration selection effects in explaining the MMA among males aged 65+ using a rich, unique dataset from France. This dataset contains information on native-born and foreign-born pensioners who are tracked worldwide until they die, providing a rare opportunity to assess return migration selection effects and their impact on the MMA. Results provide evidence of substantial and systematic negative return migration selection among foreign-born males in France. Old-age returns, in particular, appear particularly affected by such selection; however, they are not frequent enough to explain the MMA at ages 65+. By contrast, returns at younger ages are much more frequent, and the MMA at ages 65+ essentially disappears once these earlier returns are considered. This study extends the literature on negative selection at return and its impact on the MMA by providing evidence that such negative selection may operate not only at older ages but throughout the life course, with impacts on the MMA that are larger than previously suggested.
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Affiliation(s)
- Michel Guillot
- Population Studies Center, University of Pennsylvania, Philadelphia, PA, USA
- French Institute for Demographic Studies, Aubervilliers, France
| | - Myriam Khlat
- French Institute for Demographic Studies, Aubervilliers, France
| | | | - Matthieu Solignac
- University of Bordeaux, Bordeaux, France
- French Institute for Demographic Studies, Aubervilliers, France
| | - Irma Elo
- Population Studies Center, University of Pennsylvania, Philadelphia, PA, USA
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4
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Florian S, Ichou M, Panico L, Pinel-Jacquemin S, Vrijkotte TGM, Harskamp-van Ginkel MW, Huang RC, Carson J, Rodriguez LSM, Subiza-Pérez M, Vrijheid M, Fernández-Barrés S, Yang TC, Wright J, Corpeleijn E, Cardol M, Isaevska E, Moccia C, Kooijman MN, Voerman E, Jaddoe V, Welten M, Spada E, Rebagliato M, Beneito A, Ronfani L, Charles MA. Differences in birth weight between immigrants' and natives' children in Europe and Australia: a LifeCycle comparative observational cohort study. BMJ Open 2023; 13:e060932. [PMID: 36958776 PMCID: PMC10040079 DOI: 10.1136/bmjopen-2022-060932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 02/17/2023] [Indexed: 03/25/2023] Open
Abstract
OBJECTIVE Research on adults has identified an immigrant health advantage, known as the 'immigrant health paradox', by which migrants exhibit better health outcomes than natives. Is this health advantage transferred from parents to children in the form of higher birth weight relative to children of natives? SETTING Western Europe and Australia. PARTICIPANTS We use data from nine birth cohorts participating in the LifeCycle Project, including five studies with large samples of immigrants' children: Etude Longitudinale Française depuis l'Enfance-France (N=12 494), the Raine Study-Australia (N=2283), Born in Bradford-UK (N=4132), Amsterdam Born Children and their Development study-Netherlands (N=4030) and the Generation R study-Netherlands (N=4877). We include male and female babies born to immigrant and native parents. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome is birth weight measured in grams. Different specifications were tested: birth weight as a continuous variable including all births (DV1), the same variable but excluding babies born with over 4500 g (DV2), low birth weight as a 0-1 binary variable (1=birth weight below 2500 g) (DV3). Results using these three measures were similar, only results using DV1 are presented. Parental migration status is measured in four categories: both parents natives, both born abroad, only mother born abroad and only father born abroad. RESULTS Two patterns in children's birth weight by parental migration status emerged: higher birth weight among children of immigrants in France (+12 g, p<0.10) and Australia (+40 g, p<0.10) and lower birth weight among children of immigrants in the UK (-82 g, p<0.05) and the Netherlands (-80 g and -73 g, p<0.001) compared with natives' children. Smoking during pregnancy emerged as a mechanism explaining some of the birth weight gaps between children of immigrants and natives. CONCLUSION The immigrant health advantage is not universally transferred to children in the form of higher birth weight in all host countries. Further research should investigate whether this cross-national variation is due to differences in immigrant communities, social and healthcare contexts across host countries.
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Affiliation(s)
- Sandra Florian
- French National Institute for Demographic Studies, INED, Paris, France
| | - Mathieu Ichou
- French National Institute for Demographic Studies, INED, Paris, France
| | - Lidia Panico
- French National Institute for Demographic Studies, INED, Paris, France
- Centre for Research on Social Inequalities (CRIS), Sciences Po, Paris, France
| | | | - Tanja G M Vrijkotte
- Department of Public Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Reproduction and Development Research Institute, Amsterdam, The Netherlands
| | - Margreet W Harskamp-van Ginkel
- Department of Public Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Reproduction and Development Research Institute, Amsterdam, The Netherlands
| | - Rae-Chi Huang
- Nutrition and Health Innovation Research Institute, Edith Cowan University School of Medical and Health Sciences, Perth, Western Australia, Australia
| | - Jennie Carson
- Telethon Kids Institute, School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia
| | - Loreto Santa Marina Rodriguez
- Sub Directorate for Public Health and Addictions of Gipuzkoa, Ministry of Health of the Basque Government, San Sebastián, Spain
- Group of Environmental Epidemiology and Child Development, Biodonostia Health Research Institute, San Sebastián, Spain
| | - Mikel Subiza-Pérez
- Group of Environmental Epidemiology and Child Development, Biodonostia Health Research Institute, San Sebastián, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Martine Vrijheid
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- ISGlobal, Barcelona, Spain
| | | | - Tiffany C Yang
- Bradford Teaching Hospitals NHS Foundation Trust, Bradford Institute for Health Research, Bradford, UK
| | - John Wright
- Bradford Teaching Hospitals NHS Foundation Trust, Bradford Institute for Health Research, Bradford, UK
| | - Eva Corpeleijn
- Department of Epidemiology, GECKO Drenthe Cohort, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Marloes Cardol
- Department of Epidemiology, GECKO Drenthe Cohort, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Elena Isaevska
- Dipartimento di Scienze Mediche, Universita degli Studi di Torino, Torino, Italy
| | - Chiara Moccia
- Department of Medical Sciences, University of Turin, Torino, Italy
| | - Marjolein N Kooijman
- The Generation R Study Group, University Medical Center, Erasmus Medical Center, Rotterdam, The Netherlands
- University Medical Center, Erasmus Medical Center Department of General Pediatrics, Rotterdam, The Netherlands
| | - Ellis Voerman
- The Generation R Study Group, University Medical Center, Erasmus Medical Center, Rotterdam, The Netherlands
- University Medical Center, Erasmus Medical Center Department of General Pediatrics, Rotterdam, The Netherlands
| | - Vincent Jaddoe
- The Generation R Study Group, University Medical Center, Erasmus Medical Center, Rotterdam, The Netherlands
- University Medical Center, Erasmus Medical Center Department of General Pediatrics, Rotterdam, The Netherlands
| | - Marieke Welten
- The Generation R Study Group, University Medical Center, Erasmus Medical Center, Rotterdam, The Netherlands
- University Medical Center, Erasmus Medical Center Department of General Pediatrics, Rotterdam, The Netherlands
| | - Elena Spada
- Unit of Epidemiology, Meyer Children's University Hospital, Florence, Italy
| | - Marisa Rebagliato
- Predepartamental Unit of Medicine, Universitat Jaume I, Castello de la Plana, Comunitat Valenciana, Spain
- CIBERESP, Madrid, Spain
| | - Andrea Beneito
- Joint Research Unit in Epidemiology, Environment and Health, FISABIO, Valencia, Spain
| | - Luca Ronfani
- Clinical Epidemiology and Public Health Research Unit, Istituto di Ricovero e Cura a Carattere Scientifico materno infantile Burlo Garofolo, Trieste, Italy
| | - Marie-Aline Charles
- Inserm and INED Joint Research Group, Paris, France
- Université Paris Cité, Inserm, Inrae, Cress, Paris, France
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Helgesson M, Brendler-Lindqvist M, Johansson B, Nordquist T, Tondel M, Svartengren M. Sustainable Earnings among Immigrants, and the Role of Health Status for Self-Sufficiency: A 10-Year Follow-Up Study of Labour Immigrants and Refugees to Sweden 2000-2006. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:663. [PMID: 36612978 PMCID: PMC9819060 DOI: 10.3390/ijerph20010663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/23/2022] [Accepted: 12/27/2022] [Indexed: 06/17/2023]
Abstract
This study aimed to investigate economic self-sufficiency for immigrants, and how health status affected self-sufficiency. The proportion of self-sufficiency during years 1-10 after receiving a residence permit is presented for all non-European labour immigrants (n = 1259) and refugees (n = 23,859), aged 18-54, who immigrated to Sweden 2000-2006, and compared to a control group of Swedish-born (n = 144,745). The risk of not being self-sufficient in year 10 was analysed with Cox regression models, and the results are presented as hazard ratios (HRs) with 95% confidence intervals (CIs). Moreover, the impact on the self-sufficiency of having a diagnosis from specialised health care during the first five years in Sweden was analysed. The results showed that half of the refugees and three-quarters of the labour immigrants were self-sufficient 10 years after residency. The adjusted risk of not being self-sufficient at year 10 was 80% higher among labour immigrants (HR = 1.8; CI = 1.6-2.0) and more than two-fold among refugees (HR = 2.7; CI = 2.6-2.8) compared to the Swedish-born. Having a diagnosis from specialised health care during the first five years in Sweden had an impact on self-sufficiency in all groups; however, the impact of having a diagnosis did not differ between refugees and Swedish-born. Measures must be taken to increase immigrants' work participation.
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Affiliation(s)
- Magnus Helgesson
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, SE-752 37 Uppsala, Sweden
- Department of Public Health and Caring Sciences, Health Equity and Working Life, Uppsala University, SE-752 37 Uppsala, Sweden
| | - Maria Brendler-Lindqvist
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, SE-752 37 Uppsala, Sweden
- Occupational and Environmental Medicine, Uppsala University Hospital, SE-751 85 Uppsala, Sweden
| | - Bo Johansson
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, SE-752 37 Uppsala, Sweden
| | - Tobias Nordquist
- Occupational and Environmental Medicine, Uppsala University Hospital, SE-751 85 Uppsala, Sweden
| | - Martin Tondel
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, SE-752 37 Uppsala, Sweden
- Occupational and Environmental Medicine, Uppsala University Hospital, SE-751 85 Uppsala, Sweden
| | - Magnus Svartengren
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, SE-752 37 Uppsala, Sweden
- Occupational and Environmental Medicine, Uppsala University Hospital, SE-751 85 Uppsala, Sweden
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6
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Differences in all-cause and cause-specific mortality due to external causes and suicide between young adult refugees, non-refugee immigrants and Swedish-born young adults: The role of education and migration-related factors. PLoS One 2022; 17:e0279096. [PMID: 36538535 PMCID: PMC9767339 DOI: 10.1371/journal.pone.0279096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 11/30/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND International migration has increased during the past years and little is known about the mortality of young adult immigrants and refugees that came to Sweden as children. This study aimed to investigate 1) the risk of all-cause and cause-specific mortality in young accompanied and unaccompanied refugees and non-refugee immigrants compared to Swedish born individuals; and 2) to determine the role of educational level and migrations-related factors in these associations. METHODS This register linkage study is based on 682,358 individuals (633,167 Swedish-born, 2,163 unaccompanied and 25,658 accompanied refugees and 21,370 non-refugee immigrants) 19-25 years old, who resided in Sweden 31.12.2004. Outcomes were all-cause mortality and mortality due to suicide and external causes. Hazard ratios (HR) and 95% confidence intervals (CI) were calculated using Cox regression models with a maximum follow-up to 2016. RESULTS After adjusting for covariates, all-cause mortality was significantly lower in non-refugee immigrants (aHR 0.70, 95% CI 0.59-0.84) and refugees (aHR 0.76, 95% CI 0.65-0.88) compared to Swedish-born individuals. The same direction of association was observed for mortality due to suicide and external causes. No differences between accompanied and unaccompanied refugees were found. Risk estimates for all migrant groups varied with educational level, duration of residency, age at arrival and country of birth. Further, the mortality risk of migrants arriving in Sweden before the age of 6 years did not significantly differ from the risk of their Swedish-born peers. Low education was a considerable risk factor. CONCLUSION In general, young adult refugees and non-refugee immigrants have a lower risk of all-cause and cause-specific mortality than Swedish-born individuals. The identified migrant groups with higher mortality risk need specific attention.
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Nisar M, Uddin R, Kolbe-Alexander T, Khan A. The prevalence of chronic diseases in international immigrants: a systematic review and meta-analysis. Scand J Public Health 2022:14034948221116219. [DOI: 10.1177/14034948221116219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Aims: The purpose of this study is systematically to review and synthesise available prevalence data of major chronic diseases in international immigrants. Methods: Four electronic databases were searched to retrieve peer-reviewed original articles published in English between January 2000 and December 2020. Cross-sectional, cohort, or longitudinal studies that reported the prevalence of cardiovascular disease, any type of cancer, chronic obstructive pulmonary disease, and type 2 diabetes among immigrant adults were included. We calculated pooled prevalence using random-effects meta-analyses. Results: Of 13,363 articles retrieved, 24 met the eligibility criteria. The pooled prevalence of diabetes was 9.0% (95% confidence interval (CI) 7.6–10.4) with a higher prevalence in North American countries 11.1% (95% CI 8.0–14.1) than in the other destination countries: 6.6% (95% CI 5.1–8.1) including Italy, Sweden, The Netherlands, Australia, and Israel. The pooled prevalence of cardiovascular diseases and respiratory diseases was 7.7% (95% CI 5.7–9.6) and 6.5% (95% CI 2.3–10.7), respectively. Only two articles reported the prevalence of cancers (2.7% and 3.8%). We found high heterogeneity among all studies regardless of the disease. Conclusions: The prevalence of diabetes was higher than other chronic diseases in international immigrants. There is a strong need to enhance health information systems to understand the magnitude of chronic diseases among different immigrant subgroups.
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Affiliation(s)
- Mehwish Nisar
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Riaz Uddin
- Institute for Physical Activity and Nutrition, Deakin University, Burwood, Australia
| | - Tracy Kolbe-Alexander
- School of Health and Wellbeing, University of Southern Queensland, Ipswich, Australia
| | - Asaduzzaman Khan
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
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8
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Khlat M, Ghosn W, Guillot M, Vandentorren S. Impact of the COVID-19 crisis on the mortality profiles of the foreign-born in France during the first pandemic wave. Soc Sci Med 2022; 313:115160. [PMID: 36260967 PMCID: PMC9574003 DOI: 10.1016/j.socscimed.2022.115160] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 06/15/2022] [Accepted: 06/16/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND Immigrants in Western countries have been particularly affected by the COVID-19 crisis. OBJECTIVE We analysed excess mortality rates among the foreign-born population and changes in their distinctive mortality profiles ("migrant mortality advantage") during the first pandemic wave in France. DATA AND METHODS Deaths from all causes in metropolitan France from March 18 to May 19, 2020 were used, with information on sex, age, region of residence and country of birth. Similar data from 2016 through 2019 were used for comparisons. RESULTS During the pre-pandemic period (2016-2019), immigrant populations (except those from Central and Eastern Europe) had lower standardized mortality rates than the native-born population, with a particularly large advantage for immigrants from sub-Saharan Africa. In the regions most affected by COVID-19 (Grand-Est and Île-de-France), the differences in excess mortality by country of birth were large, especially in the working-age groups (40-69 years), with rates 8 to 9 times higher for immigrants from sub-Saharan Africa, and about 3 to 4 times higher for immigrants from North Africa, from the Americas and from Asia and Oceania relative to the native-born population. The relative overall mortality risk for men born in sub-Saharan Africa compared to native-born men, which was 0.8 before the pandemic, shifted to 1.8 during the first wave (0.9 to 1.5 for women). It also shifted from 0.8 to 1.1 for men from North Africa (0.9 to 1.1 for women), 0.7 to 1.0 for men from the Americas (0.9 to 1.3 for women), and 0.7 to 1.2 for men from Asia and Oceania (0.9 to 1.3 for women). CONCLUSION Our findings shed light on the disproportionate impact of the first wave of the pandemic on the mortality of populations born outside Europe, with a specific burden of excess mortality within the working-age range, and a complete reversal of their mortality advantage.
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Affiliation(s)
- Myriam Khlat
- Institut National d'Etudes Démographiques, Aubervilliers, France.
| | - Walid Ghosn
- Inserm (Institut National de la Santé et de la Recherche Médicale) - CépiDc (Centre d'épidémiologie sur les causes médicales de Décès), Le Kremlin Bicêtre, France
| | - Michel Guillot
- Institut National d'Etudes Démographiques, Aubervilliers, France; Population Studies Center, University of Pennsylvania, Philadelphia, USA
| | - Stéphanie Vandentorren
- Santé publique France (SpF), Direction scientifique et international, Saint-Maurice, France; Institut Convergences Migrations/CNRS, Aubervilliers, France; Inserm UMR 1219, Phares team, Bordeaux Population Health, University of Bordeaux, France
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9
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Wallace M. Mortality Advantage Reversed: The Causes of Death Driving All-Cause Mortality Differentials Between Immigrants, the Descendants of Immigrants and Ancestral Natives in Sweden, 1997-2016. EUROPEAN JOURNAL OF POPULATION = REVUE EUROPEENNE DE DEMOGRAPHIE 2022; 38:1213-1241. [PMID: 36507238 PMCID: PMC9727037 DOI: 10.1007/s10680-022-09637-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 08/10/2022] [Indexed: 12/12/2022]
Abstract
A small but growing body of studies have documented the alarming mortality situation of adult descendants of migrants in a number of European countries. Nearly all of them have focused on all-cause mortality to reveal these important health inequalities. This paper takes advantage of the Swedish population registers to study all-cause and cause-specific mortality among men and women aged 15-44 in Sweden from 1997 to 2016 to a level of granularity unparalleled elsewhere. It adopts a multi-generation, multi-origin and multi-cause-of-death approach. Using extended, competing-risks survival models, it aims to show (1) how the all-cause mortality of immigrants arriving as adults (the G1), immigrants arriving as children (the G1.5) and children of immigrants born in Sweden to at least one immigrant parent (the G2) differs versus ancestral Swedes and (2) what causes-of-deaths drive these differentials. For all-cause mortality, most G1 (not Finns or Sub-Saharan Africans) have a mortality advantage. This contrasts with a near systematic reversal in the mortality of the G1.5 and G2 (notably among men), which is driven by excess accident and injury, suicide, substance use and other external cause mortality. Given that external causes-of-death are preventable and avoidable, the findings raise questions about integration processes, the levels of inequality immigrant populations are exposed to in Sweden and ultimately, whether the legacy of immigration has been positive. Strengths of the study include the use of quality data and advanced methods, the granularity of the estimates, and the provision of evidence that highlights the precarious mortality situation of the seldom-studied G1.5.
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Affiliation(s)
- Matthew Wallace
- Sociology Department, Stockholm University Demography Unit, Stockholm, Sweden.
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10
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Montez JK, Mehri N, Monnat SM, Beckfield J, Chapman D, Grumbach JM, Hayward MD, Woolf SH, Zajacova A. U.S. state policy contexts and mortality of working-age adults. PLoS One 2022; 17:e0275466. [PMID: 36288322 PMCID: PMC9604945 DOI: 10.1371/journal.pone.0275466] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 09/16/2022] [Indexed: 01/24/2023] Open
Abstract
The rise in working-age mortality rates in the United States in recent decades largely reflects stalled declines in cardiovascular disease (CVD) mortality alongside rising mortality from alcohol-induced causes, suicide, and drug poisoning; and it has been especially severe in some U.S. states. Building on recent work, this study examined whether U.S. state policy contexts may be a central explanation. We modeled the associations between working-age mortality rates and state policies during 1999 to 2019. We used annual data from the 1999-2019 National Vital Statistics System to calculate state-level age-adjusted mortality rates for deaths from all causes and from CVD, alcohol-induced causes, suicide, and drug poisoning among adults ages 25-64 years. We merged that data with annual state-level data on eight policy domains, such as labor and taxes, where each domain was scored on a 0-1 conservative-to-liberal continuum. Results show that the policy domains were associated with working-age mortality. More conservative marijuana policies and more liberal policies on the environment, gun safety, labor, economic taxes, and tobacco taxes in a state were associated with lower mortality in that state. Especially strong associations were observed between certain domains and specific causes of death: between the gun safety domain and suicide mortality among men, between the labor domain and alcohol-induced mortality, and between both the economic tax and tobacco tax domains and CVD mortality. Simulations indicate that changing all policy domains in all states to a fully liberal orientation might have saved 171,030 lives in 2019, while changing them to a fully conservative orientation might have cost 217,635 lives.
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Affiliation(s)
- Jennifer Karas Montez
- Department of Sociology, Syracuse University, Syracuse, NY, United States of America
- * E-mail:
| | - Nader Mehri
- Aging Studies Institute, Syracuse University, Syracuse, NY, United States of America
| | - Shannon M. Monnat
- Department of Sociology, Syracuse University, Syracuse, NY, United States of America
| | - Jason Beckfield
- Department of Sociology, Harvard University, Cambridge, MA, United States of America
| | - Derek Chapman
- Division of Epidemiology, Virginia Commonwealth University, Richmond, VA, United States of America
| | - Jacob M. Grumbach
- Department of Political Science, University of Washington, Seattle, WA, United States of America
| | - Mark D. Hayward
- Department of Sociology, University of Texas at Austin, Austin, TX, United States of America
| | - Steven H. Woolf
- Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA, United States of America
| | - Anna Zajacova
- Department of Sociology, University of Western Ontario, Ontario, CA, United States of America
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11
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Zheng H, Yu WH. Diminished Advantage or Persistent Protection? A New Approach to Assess Immigrants' Mortality Advantages Over Time. Demography 2022; 59:1655-1681. [PMID: 36069266 PMCID: PMC9762986 DOI: 10.1215/00703370-10175388] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Much research has debated whether immigrants' health advantages over natives decline with their duration at destination. Most such research has relied on (pooled) cross-sectional data and used years since immigration as a proxy for the duration of residence, leading to the challenge of distilling the duration effect from the confounding cohort-of-arrival and age-of-arrival effects. Because longitudinal studies tend to use self-rated health as the outcome, the changes they observed may reflect shifts in immigrants' awareness of health problems. We illuminate the debate by examining how immigrants' mortality risk-a relatively unambiguous measure tied to poor health-changes over time compared to natives' mortality risk. Our analysis uses the National Health Interview Survey (1992-2009) with linked mortality data through 2011 (n = 875,306). We find a survival advantage for U.S. immigrants over the native-born that persisted or amplified during the 20-year period. Moreover, this advantage persisted for all immigrants, regardless of their race/ethnicity and gender or when they began their U.S. residence. This study provides unequivocal evidence that immigrant status' health protection as reflected in mortality is stable and long-lasting.
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Affiliation(s)
- Hui Zheng
- Department of Sociology, Institute for Population Research, The Ohio State University
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12
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Vignier N, Moussaoui S, Marsaudon A, Wittwer J, Jusot F, Dourgnon P. Burden of infectious diseases among undocumented migrants in France: Results of the Premiers Pas survey. Front Public Health 2022; 10:934050. [PMID: 35991026 PMCID: PMC9386354 DOI: 10.3389/fpubh.2022.934050] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 07/11/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction An increase in migration rates to the European Union has been observed over the last few years. Part of these migrants is undocumented. This work aimed to describe the reported frequency of infectious diseases and their associated factors among unselected samples of undocumented migrants in France. Methodology The Premier Pas survey is a cross-sectional epidemiological survey of a random sample (two-stage sample design) conducted among undocumented migrants recruited in Paris and the Bordeaux region, in places and facilities likely to be frequented by undocumented migrants. The percentages were weighted. The analysis was performed using Stata 15.1 software. Results A total of 1,223 undocumented migrants were recruited from 63 places and facilities, with a participation rate of 50%. Most of them were between 30 and 40 years of age (36%), 69% were men, aged mainly 30–40 (36%) years old, from sub-Saharan Africa (60%) or North Africa (25%), and 60% had arrived <3 years earlier. Among the participants, 24.8% declared a poor perceived health status and 33.5% a chronic health condition. Dental infections concerned 43.2% of the participants. Apart from dental issues, 12.9% reported suffering from at least one infectious disease: HIV infection (3.5%), chronic hepatitis B virus infection (3.1%), upper respiratory tract infection (1.7%), skin mycosis (1.2%), skin and soft tissue infection (0.8%), chronic hepatitis C infection (0.8%), urinary tract infection (0.7%), lower respiratory tract infection (0.7%), scabies (0.3%), tuberculosis disease (0.2%), vaginal mycosis (0.6%), and herpes (0.1%). Regarding HIV, HBV, and HCV infections, 56, 71, and 89%, respectively, were diagnosed after their arrival. Chronic viral infections were more often reported by undocumented migrants from sub-Saharan Africa and Latin America. In multivariate analysis, a higher risk of reporting chronic viral infection was observed among people food insecure. Conclusion This original study on a large random sample confirms the frequency of infectious diseases among undocumented migrants in France and the importance of integrating their screening during a health Rendezvous and their management into early access to care and inclusive medico-psycho-social management.
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Affiliation(s)
- Nicolas Vignier
- Institut de recherche et documentation en économie de la santé, IRDES, Paris, France
- Centre d'Investigation Clinique Antilles Guyane, CIC INSERM 1424, Centre hospitalier de Cayenne, Cayenne, French Guiana
- Sorbonne Université, INSERM UMR 1136, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, Department of Social Epidemiology, Paris, France
- French Collaborative Institute on Migration, Institut Convergences Migrations, ICM, Aubervilliers, France
- Université Sorbonne Paris Nord, UFR SMBH, IAME, INSERM UMR 1137, Hôpital Avicenne, Hôpitaux Universitaires Paris Seine-Saint-Denis, AP-HP, Department of Infectious and Tropical diseases, Bobigny, France
- *Correspondence: Nicolas Vignier
| | - Sohela Moussaoui
- Institut de recherche et documentation en économie de la santé, IRDES, Paris, France
- Sorbonne Université, INSERM UMR 1136, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, Department of Social Epidemiology, Paris, France
- Bordeaux University, Bordeaux Population Health, INSERM U1219, Economic and Management of Healthcare Organizations Team, Emos Team, Bordeaux, France
| | - Antoine Marsaudon
- Institut de recherche et documentation en économie de la santé, IRDES, Paris, France
| | - Jérome Wittwer
- Bordeaux University, Bordeaux Population Health, INSERM U1219, Economic and Management of Healthcare Organizations Team, Emos Team, Bordeaux, France
| | - Florence Jusot
- Institut de recherche et documentation en économie de la santé, IRDES, Paris, France
- Université Paris-Dauphine, PSL-Research University, Leda-Legos, Paris, France
| | - Paul Dourgnon
- Institut de recherche et documentation en économie de la santé, IRDES, Paris, France
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13
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Wallace M, Thomas MJ, Aburto JM, Jørring Pallesen AV, Mortensen LH, Syse A, Drefahl S. Immigration, mortality, and national life expectancy in the Nordic region, 1990–2019. SSM Popul Health 2022; 19:101177. [PMID: 36046066 PMCID: PMC9421394 DOI: 10.1016/j.ssmph.2022.101177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 07/18/2022] [Accepted: 07/18/2022] [Indexed: 11/18/2022] Open
Abstract
Immigrants have higher life expectancy at age 1 than the native-born in Denmark, Finland and Norway do from 1990 to 2019. Immigrants in Denmark, Finland and Norway increasingly enhance national life expectancy at age 1 over time. Immigrants in Sweden have lower life expectancy at age 1 than native-born in Sweden do in 1990, but similar levels by 2019. The effect of immigrants on national life expectancy at age 1 in Sweden transforms from negative to positive over time. The unique mortality of immigrants affects rankings of life expectancy at age 1 in the Nordic region in recent years.
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Affiliation(s)
- Matthew Wallace
- Stockholm University, Stockholm, Sweden
- Corresponding author. Sociology Department, Stockholm University, SE-106 91, Stockholm, Sweden.
| | | | - José Manuel Aburto
- University of Oxford, Oxford, England, UK
- University of Southern Denmark, Odense, Denmark
| | | | - Laust Hvas Mortensen
- University of Copenhagen, Copehagen, Denmark
- Statistics Denmark, Copehagen, Denmark
| | - Astri Syse
- Norwegian Institute of Public Health, Oslo, Norway
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14
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Di Napoli A, Ventura M, Grande E, Frova L, Mirisola C, Petrelli A. Nationwide longitudinal population-based study on mortality in Italy by immigrant status. Sci Rep 2022; 12:10986. [PMID: 35768625 PMCID: PMC9243023 DOI: 10.1038/s41598-022-15290-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 06/22/2022] [Indexed: 11/09/2022] Open
Abstract
A systematic analysis of the mortality of immigrant residents throughout Italy has never been carried out. The present study aimed to evaluate differences in mortality by immigrant status. A longitudinal study of the Italian resident population (native and immigrants) recorded in the 2011 National Institute of Statistics Census was conducted. This cohort was followed up from 2012 to 2018 until death, emigration, or end of the study period. The exposure variable was the immigrant status, measured through citizenship, dichotomized into Italian and immigrant. The main outcome was overall and cause-specific mortality. Age-standardized mortality ratios (SMRs) were calculated. The SMRs among immigrants were half that of Italians, both for men (SMR 0.52) and women (SMR 0.51), with the lowest SMRs observed for subjects from North Africa and Oceania. For some causes of death, mortality was higher among immigrants: tuberculosis in both men (SMR 4.58) and women (SMR 4.72), and cervical cancer (SMR 1.58), complications of pregnancy, childbirth, and puerperium (SMR 1.36), and homicide (SMR 2.13) for women. A multivariable quasi-Poisson regression analysis, adjusted for age and macro area of residence in Italy, confirmed a lower all-cause mortality for immigrants compared to Italians, both for men (RR 0.46) and women (RR 0.44). Although immigration to Italy is no longer a recent phenomenon, and the presence of immigrants is acquiring structural characteristics, our study confirms their health advantage, with a lower mortality than that of Italians for almost all causes of death and for all areas of origin.
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Affiliation(s)
- Anteo Di Napoli
- National Institute for Health, Migration and Poverty (INMP), Via di San Gallicano, 25a - 00153, Rome, Italy.
| | - Martina Ventura
- National Institute for Health, Migration and Poverty (INMP), Via di San Gallicano, 25a - 00153, Rome, Italy
| | - Enrico Grande
- National Institute of Statistics (Istat), Rome, Italy
| | - Luisa Frova
- National Institute of Statistics (Istat), Rome, Italy
| | - Concetta Mirisola
- National Institute for Health, Migration and Poverty (INMP), Via di San Gallicano, 25a - 00153, Rome, Italy
| | - Alessio Petrelli
- National Institute for Health, Migration and Poverty (INMP), Via di San Gallicano, 25a - 00153, Rome, Italy
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15
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Helgesson M, Björkenstam E, Filatova S, Rahman SG, Cullen A, Dorner T, Gémes K, Amin R, Mittendorfer-Rutz E. Mental and somatic disorders and the subsequent risk of all-cause and cause-specific mortality in refugees, non-refugee migrants and the Swedish-born youth: a population-based cohort study in Sweden. BMJ Open 2022; 12:e054351. [PMID: 35545376 PMCID: PMC9096569 DOI: 10.1136/bmjopen-2021-054351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 04/24/2022] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES The aims were to investigate the associations between specific mental and somatic disorders and subsequent all-cause and cause-specific mortality (suicide, external and other causes) in young refugees and non-refugee migrants compared with Swedish-born individuals of similar age. METHODS In this register-based prospective cohort study, all 1 003 760 individuals (40 305 refugees, 31 687 non-refugee migrants as the exposure groups and the rest as the Swedish-born comparison group), 16-25 years old, residing in Sweden on 31 December 2004 were included. These individuals were followed regarding the outcome of all-cause and cause-specific mortality (suicide and external causes) between 2005 and 2016. The study population was also stratified according to any use of specialised healthcare for mental or somatic diagnoses before baseline (2000-2004). Cox regression models yielding crude and multivariate Hazard Ratios (HR and aHR, respectively) with 95% Confidence Intervals (CI) were used to investigate the afore-mentioned associations. RESULTS A lower proportion of both refugees (12%) and non-refugee migrants (10%) had college/university education compared with the Swedish-born individuals (17%). The proportion of unemployed (>180 days) among refugees (2.3%) and non-refugees (2.9%) was higher than the Swedish born (1.4%). Refugees and non-refugee migrants had about a 20% lower risk of all-cause mortality and external causes of mortality compared with Swedish-born individuals. An even greater reduction in suicide risk (aHR 0.51, 95% CI 0.37 to 0.70, and 0.63, 95% CI 0.49 to 0.82 for non-refugees and refugees, respectively) was found. When restricted to those with a mental or somatic disorder, a lower risk of both general and specific mortality was also found among both refugees and non-refugee migrants compared with Swedish-born individuals. Refugees had, however, equal point estimates of all-cause mortality associated with substance misuse disorder and neoplasms as their Swedish-born peers with these disorders. CONCLUSIONS With few exceptions, young migrants with specific mental and somatic disorders have a mortality advantage compared with their Swedish-born peers with the same disorders. Further research on protective factors is warranted.
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Affiliation(s)
- Magnus Helgesson
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Emma Björkenstam
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Svetlana Filatova
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Syed Ghulam Rahman
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Alexis Cullen
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Psychosis Studies, King's College London, London, UK
| | - Thomas Dorner
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
- Karl-Landsteiner Institute for Health Promotion Research, Sitzenberg-Reidling, Austria
| | - Katalin Gémes
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Ridwanul Amin
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Ellenor Mittendorfer-Rutz
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
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16
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Grigoriev O, Doblhammer G. Does the Mortality of Individuals with Severe Disabilities Contribute to the Persistent East-West Mortality Gap Among German Men? EUROPEAN JOURNAL OF POPULATION = REVUE EUROPEENNE DE DEMOGRAPHIE 2022; 38:247-271. [PMID: 35619745 PMCID: PMC9127014 DOI: 10.1007/s10680-022-09609-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 01/24/2022] [Indexed: 06/15/2023]
Abstract
UNLABELLED After three decades since reunification male life expectancy in East Germany still lags behind that of West Germany. Unlike most of the prior studies focusing on the role of socioeconomic factors, this study aims at assessing the contribution of the population with severe disabilities to the persistent East-West male mortality gap. Our analysis is mainly based on the German Pension Fund data. It is restricted to men aged 30-59 receiving disability pension (DP). We estimate mortality indicators and compare trends among populations with or without DP. We use decomposition method to quantify the effects of changes in mortality and compositional changed in the prevalence of receiving DP on the East-West mortality difference. The analysis covers the period 1995-2013. The German Socioeconomic Panel data and Cox proportional hazard models are used to evaluate the regional differences in the risk of receiving DP. Our results suggest that both the higher prevalence of receiving DP in the East and the higher mortality level among men not receiving DP in the East explain the East-West gap. The mortality difference among those receiving DP is negligible and does not contribute much to it. The observed higher prevalence in receiving DP in the East is very likely to reflect the reality as we found no regional differences in the risk of transitioning to receiving DP. The disadvantageous position of the East can be explained by the post-reunification crisis which particularly hit young men in the 1990s, selective migration from East to West after reunification, and the higher proportion of the healthier foreign population living in the West. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s10680-022-09609-4.
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Affiliation(s)
- Olga Grigoriev
- Max Planck Institute for Demographic Research, Rostock, Germany
| | - Gabriele Doblhammer
- Institute for Sociology and Demography, University of Rostock, Rostock, Germany
- German Center for Neurodegenerative Disease, Bonn, Germany
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17
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Azadi B, Tantet C, Sylla F, Andro A. Women who have undergone female genital mutilation/cutting's perceptions and experiences with healthcare providers in Paris. CULTURE, HEALTH & SEXUALITY 2022; 24:583-596. [PMID: 34751634 DOI: 10.1080/13691058.2021.1982010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 09/14/2021] [Indexed: 06/13/2023]
Abstract
Female genital mutilation/cutting (FGM/C) is a health and human rights issue and a dangerous form of gender-based violence. Given migratory flows from the countries in which it is practised, FGM/C concerns a substantial number of women living in Western countries. In this study, we looked at women who had undergone FGM/C experiences with French medical practitioners. We also discussed with them the desirability of screening for, and prevention of, FGM/C in international travel medicine centres. A qualitative approach was used to collect and analyse the data. Focus groups and semi-structured interviews were held with 26 women (24 participants in focus groups and 2 individual interviews). Transcriptions were coded and analysed thematically. All the participants came from sub-Saharan Africa. Their median age was 32.9 years. Persistent silence about FGM/C in the host society following immigration resulted in dissatisfaction with healthcare providers. Participants expected professionals to address the subject of FGM/C, feeling professionals should bring up the subject first so as to put women at ease. International travel medicine centres were discussed by some as a possible means of prevention.
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Affiliation(s)
- Bahar Azadi
- INSERM, CRIDUP, University of Paris 1- Panthéon-Sorbonne, Paris, France
| | | | - Fatoumata Sylla
- INSERM, CRIDUP, University of Paris 1- Panthéon-Sorbonne, Paris, France
| | - Armelle Andro
- INSERM, CRIDUP, University of Paris 1- Panthéon-Sorbonne, Paris, France
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18
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Hiam L, Zhang CX, Burns R, Darlington-Pollock F, Wallace M, McKee M. What can the UK learn from the impact of migrant populations on national life expectancy? J Public Health (Oxf) 2022; 44:e499-e505. [PMID: 35313344 PMCID: PMC9383602 DOI: 10.1093/pubmed/fdac013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 01/11/2022] [Accepted: 01/17/2022] [Indexed: 01/19/2023] Open
Abstract
Improvements in life expectancy at birth in the UK had stalled prior to 2020 and have fallen during the COVID-19 pandemic. The stagnation took place at a time of relatively high net migration, yet we know that migrants to Australia, the USA and some Nordic countries have positively impacted national life expectancy trends, outperforming native-born populations in terms of life expectancy. It is important to ascertain whether migrants have contributed positively to life expectancy in the UK, concealing worsening trends in the UK-born population, or whether relying on national life expectancy calculations alone may have masked excess mortality in migrant populations. We need a better understanding of the role and contribution of migrant populations to national life expectancy trends in the UK.
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Affiliation(s)
| | - Claire X Zhang
- Institute of Health Informatics, University College London, NW1 2DA, UK
| | - Rachel Burns
- Institute of Health Informatics, University College London, NW1 2DA, UK
| | | | - Matthew Wallace
- Demography Unit, Sociology Department, Stockholm University, 106 91 Stockholm, UK
| | - Martin McKee
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, WC1H 9SH, UK
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19
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Hraiech S, Pauly V, Orleans V, Auquier P, Boyer L, Papazian L, Azoulay E. Undocumented migrants in French intensive care units in 2011-2018: retrospective nationwide study. Intensive Care Med 2022; 48:290-299. [PMID: 35044486 DOI: 10.1007/s00134-021-06606-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 12/22/2021] [Indexed: 12/17/2022]
Abstract
PURPOSE Whether undocumented migrants admitted to intensive care units (ICUs) have specific features is unknown. We aimed to determine the features and outcomes of undocumented migrants admitted to French ICUs. METHODS We retrospectively included all undocumented adult migrants admitted in 2011-2018 and compared them to the general ICU population. We also compared these two groups matched on age, sex, severity, comorbidities, reason for ICU admission and public/private hospital. RESULTS We identified 14,554 ICU stays, with an increase from 2 to 4‰ of all ICU admissions over time. Shock (16.7%), post-operative care (13.8%), and trauma (10.5%) were the main reasons for ICU admission. Compared to general ICU patients, migrants were younger and had greater disease severity. After adjustment on age and sex, the following were more common in migrants: shock (OR 1.2 [1.14-1.25]; P < 0.0001), infections (1.48 [1.38-1.54]; P < 0.001), acute respiratory failure (1.09 [1.03-1.15]; P = 0.006), acute kidney injury (1.12 [1.05-1.19]; P < 0.001), obstetric events (1.53 [1.66-1.81]; P < 0.0001), and neurological deficits (1.19 [1.12-1.27]; P < 0.0001). In the matched study, migrants more often required vasopressors, mechanical ventilation, and renal replacement therapy; had longer ICU stays (median 4 [2-8] vs. 4 [2-7] days; P < 0.0001) and hospital stays (10 [5-20] vs. 8 [4-15]; P < 0.0001) and had higher hospital costs (14.2 ± 23.6 vs. 13.4 ± 11.5 K€; P < 0.0001). Hospital mortality was similar (6.7% vs. 6.6%; P = 0.69). CONCLUSION Admissions of undocumented migrants to French ICUs doubled from 2011 to 2018. The patients were younger and, although sicker, achieved similar outcomes to those in general ICU patients.
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Affiliation(s)
- Sami Hraiech
- Service de Médecine Intensive-Réanimation, AP-HM, Hôpital Nord, Marseille, France. .,Health Service Research and Quality of Life Center (CEReSS), Aix-Marseille Université, 27 Boulevard Jean-Moulin, 13005, Marseille, France. .,Department of Medical Information, AP-HM, Marseille, France.
| | - Vanessa Pauly
- Health Service Research and Quality of Life Center (CEReSS), Aix-Marseille Université, 27 Boulevard Jean-Moulin, 13005, Marseille, France.,Department of Medical Information, AP-HM, Marseille, France
| | - Véronica Orleans
- Health Service Research and Quality of Life Center (CEReSS), Aix-Marseille Université, 27 Boulevard Jean-Moulin, 13005, Marseille, France.,Department of Medical Information, AP-HM, Marseille, France
| | - Pascal Auquier
- Health Service Research and Quality of Life Center (CEReSS), Aix-Marseille Université, 27 Boulevard Jean-Moulin, 13005, Marseille, France.,Department of Medical Information, AP-HM, Marseille, France
| | - Laurent Boyer
- Health Service Research and Quality of Life Center (CEReSS), Aix-Marseille Université, 27 Boulevard Jean-Moulin, 13005, Marseille, France.,Department of Medical Information, AP-HM, Marseille, France
| | - Laurent Papazian
- Service de Médecine Intensive-Réanimation, AP-HM, Hôpital Nord, Marseille, France.,Health Service Research and Quality of Life Center (CEReSS), Aix-Marseille Université, 27 Boulevard Jean-Moulin, 13005, Marseille, France.,Department of Medical Information, AP-HM, Marseille, France
| | - Elie Azoulay
- Service de Médecine Intensive et Réanimation, Hôpital Saint-Louis, AP-HP, Paris, France
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20
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Mkoma GF, Johnsen SP, Iversen HK, Andersen G, Norredam M. Incidence of stroke, transient ischaemic attack and determinants of poststroke mortality among immigrants in Denmark, 2004‒2018: a population-based cohort study. BMJ Open 2021; 11:e049347. [PMID: 34675015 PMCID: PMC8532551 DOI: 10.1136/bmjopen-2021-049347] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE Using recent registry data, we aimed to quantify the incidence of stroke and transient ischaemic attack (TIA) and to examine factors influencing the risk of poststroke mortality among immigrants compared with Danish-born individuals. DESIGN Population-based cohort study between 2004 and 2018. We estimated age-standardised incidence rate ratios (IRR) of stroke, stroke types and TIA for each ethnic group using Danish-born individuals as the reference by direct method of standardisation. We calculated the risk of poststroke mortality using Cox proportional hazard regression. SETTING The study was conducted using Danish nationwide registers. PARTICIPANTS All cases of first-ever stroke and TIA by country of origin (n=132 936) were included. RESULTS Overall, Western immigrants (IRR=2.25; 95% CI 2.20 to 2.31) and non-Western immigrants (IRR=1.37; 95% CI 1.30 to 1.44) had a higher risk of stroke than Danish-born individuals. The risk of TIA was higher in Western immigrants (IRR=2.08; 95% CI 1.93 to 2.23) followed by non-Western immigrants (IRR=1.45; 95% CI 1.27 to 1.63) than in Danish-born individuals. All-cause 1-year mortality hazard was higher but not significantly different in non-Western men (adjusted HR=1.38; 95% CI 0.92 to 2.08) compared with Danish-born men and additional adjustment for comorbidities reduced the HR to 0.85 (0.51 to 1.40) among ischaemic stroke cases. Among intracerebral haemorrhage cases, the adjusted mortality hazard was decreased in Western men (from HR of 1.76; 95% CI 1.09 to 2.85 to HR of 1.30; 95% CI 0.80 to 2.11) compared with Danish-born men after adjustment for stroke severity. Immigrants with ≤15 years of residence had a lower poststroke mortality hazard than Danish-born individuals after additional adjustment for sociodemographic factors (HR=0.36; 95% CI 0.14 to 0.91). CONCLUSIONS The age-standardised risk of stroke and TIA was significantly higher among the majority of immigrants than Danish-born individuals. Interventions that reduce the burden of comorbidities, improve acute stroke care and target sociodemographic factors may address the higher risk of poststroke mortality among immigrants.
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Affiliation(s)
- George Frederick Mkoma
- Danish Research Centre for Migration, Ethnicity and Health, Department of Public Health, University of Copenhagen Faculty of Health and Medical Sciences, Copenhagen, Denmark
| | - Søren Paaske Johnsen
- Danish Centre for Clinical Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Helle Klingenberg Iversen
- Stroke Centre Rigshospitalet, Department of Neurology, University of Copenhagen Faculty of Health and Medical Sciences, Copenhagen, Denmark
| | - Grethe Andersen
- Danish Stroke Centre, Department of Neurology, Aarhus University Hospital, Aarhus University, Aarhus, Denmark
| | - Marie Norredam
- Danish Research Centre for Migration, Ethnicity and Health, Department of Public Health, University of Copenhagen Faculty of Health and Medical Sciences, Copenhagen, Denmark
- Department of Infectious Diseases, Hvidovre Hospital, University of Copenhagen Faculty of Health and Medical Sciences, Copenhagen, Denmark
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Hendi AS, Ho JY. Immigration and improvements in American life expectancy. SSM Popul Health 2021; 15:100914. [PMID: 34522764 PMCID: PMC8426263 DOI: 10.1016/j.ssmph.2021.100914] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 08/31/2021] [Accepted: 09/01/2021] [Indexed: 11/19/2022] Open
Abstract
Despite the immigrant mortality advantage and the increasing share of the population born abroad, relatively little is known about how immigration has impacted trends in US life expectancy. How immigrants contribute to national life expectancy trends is of increasing interest, particularly in the context of an unprecedented stagnation in American mortality. We find that immigration increases US life expectancy by 1.5 years for men and 1.4 years for women. Over half of these contributions occur at the prime working ages of 25-64. The difference between foreign-born and US-born mortality has grown substantially since 1990, with the ratio of US-born to foreign-born mortality rates nearly doubling by 2017. In that year, foreign-born life expectancy reached 81.4 and 85.7 years for men and women, respectively-7.0 and 6.2 years higher than their US-origin counterparts. These life expectancy levels are remarkable by most standards. Foreign-born male life expectancy exceeds that of Swiss men, the world leaders in male life expectancy. Life expectancy for foreign-born women is close to that of Japanese women, the world leaders in female life expectancy. The widening mortality difference between the US-born and foreign-born populations, coupled with an increase in the share of the population born abroad, has been responsible for much of the increase in national life expectancy in recent years. Between 2007 and 2017, foreign-born men and women were responsible for 44% and 60% of national life expectancy improvements. Between 2010 and 2017, immigrants experienced gains while the US-born experienced declines in life expectancy. Thus, nearly all of the post-2010 mortality stagnation is due to adverse trends among the US-born. Without immigrants and their children, national life expectancy in 2017 would be reduced to its 2003 levels. These findings demonstrate that immigration acts to bolster American life expectancy, with particularly valuable contributions at the prime working ages.
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Affiliation(s)
| | - Jessica Y Ho
- University of Southern California, United States
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Helgesson M, Rahman S, Saboonchi F, Mittendorfer Rutz E. Disability pension and mortality in individuals with specific somatic and mental disorders: examining differences between refugees and Swedish-born individuals. J Epidemiol Community Health 2021; 75:721-728. [PMID: 33472869 PMCID: PMC8292560 DOI: 10.1136/jech-2019-213436] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 10/15/2020] [Accepted: 01/04/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND More than half a million refugees have arrived to Sweden during the last decade. The aim was to investigate differences between refugees and Swedish-born individuals regarding different specific somatic and mental disorders, and subsequent disability pension and mortality. METHODS All refugees (n=239 742) and Swedish-born individuals (n=4 133 898), aged 19-60 years, resident in Sweden on 31st of December in 2009 were included in this population-based prospective cohort study. Data from six nationwide Swedish registers were linked by the unique anonymised identification number. HRs with 95% CIs were computed for disability pension and mortality 2010-2013 by Cox regression models. RESULTS Compared with their Swedish-born counterparts with mental or somatic diagnoses, refugees with these diagnoses had a higher risk of subsequent disability pension and a lower risk of mortality. Highest estimates for disability pension were seen for refugees with neoplasm (HR: 1.72; 95% CI: 1.56 to 1.91), musculoskeletal disorders (HR: 1.57; 95% CI: 1.47 to 1.67), diseases of the circulatory system (HR: 1.33; 95% CI: 1.22 to 1.45), depressive disorders (HR: 1.31; 95% CI: 1.21 to 1.41) and diabetes mellitus (HR: 1.30; 95% CI: 1.15 to 1.47). The risk of mortality was lowest for refugees with regard to bipolar disorders (HR: 0.37; 95% CI: 0.16 to 0.82), post-traumatic stress disorder (HR: 0.37; 95% CI: 0.25 to 0.54) and least pronounced in regard to neoplasm (HR: 0.69; 95% CI: 0.61 to 0.77) compared with Swedish-born with similar disorders. CONCLUSION Refugees have a generally higher risk of disability pension compared with Swedish-born with specific somatic and mental disorders. Despite this, refugees with all specific disorders have lower risk estimates of mortality, probably due to a healthy selection. The higher risk of disability pension might therefore be due to other causes besides poor health.
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Affiliation(s)
- Magnus Helgesson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - Syed Rahman
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - Fredrik Saboonchi
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77 Stockholm, Sweden
- Department of Health Sciences, The Swedish Red Cross University, College, SE-102 15 Stockholm, Sweden
| | - Ellenor Mittendorfer Rutz
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77 Stockholm, Sweden
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Ginsburg C, Bocquier P, Menashe-Oren A, Collinson MA. Migrant health penalty: evidence of higher mortality risk among internal migrants in sub-Saharan Africa. Glob Health Action 2021; 14:1930655. [PMID: 34134611 PMCID: PMC8550177 DOI: 10.1080/16549716.2021.1930655] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Despite the greater attention given to international migration, internal migration accounts for the majority of movements globally. However, research on the effects of internal migration on health is limited, with this relationship examined predominantly in urban settings among working-age adults, neglecting rural populations and younger and older ages. Objectives: Using longitudinal data from 29 mostly rural sub-Saharan African Health and Demographic Surveillance Systems (HDSS), this study aims to explore life-course differences in mortality according to migration status and duration of residence. MethodsCox proportional hazards models are employed to analyse the relationship between migration and mortality in the 29 HDSS areas. The analytical sample includes 3 836,173 people and the analysis spans 25 years, from 1990 to 2015. We examine the risk of death by sex across five broad age groups (from ages 1 to 80), and consider recent and past in- and return migrants. Results: In-migrants have a higher risk of mortality compared to permanent rural residents, with return migrants at greater risk than in-migrants across all age-groups. Female migrants have lower survival chances than males, with greater variability by age. Risk of dying is highest among recent return migrant females aged 30–59: 1.86 (95% CI 1.69–2.06) times that of permanent residents. Only among males aged 15–29 who move to urban areas is there evidence of a ‘healthy migrant’ effect (HR = 0.62, 95% CI 0.51–0.77). There is clear evidence of an adaptation effect across all ages, with the risk of mortality reducing with duration following migration. Conclusions: Findings suggest that adult internal migrants, particularly females, suffer greater health disadvantages associated with migration. Policy makers should focus on improving migrant’s interface with health services, and support the development of health education and promotion interventions to create awareness of localised health risks for migrants.
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Affiliation(s)
- Carren Ginsburg
- Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Philippe Bocquier
- Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,Institut d'analyse du changement dans l'histoire et les sociétés contemporaines (IACCHOS), Centre De Recherches En Démographie, Université Catholique De Louvain, Louvain-la-Neuve, Belgium
| | - Ashira Menashe-Oren
- Institut d'analyse du changement dans l'histoire et les sociétés contemporaines (IACCHOS), Centre De Recherches En Démographie, Université Catholique De Louvain, Louvain-la-Neuve, Belgium
| | - Mark A Collinson
- Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,Department of Science and Innovation/South African Medical Research Council, South African Population Research Infrastructure Network, South Africa
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Di Napoli A, Rossi A, Alicandro G, Ventura M, Frova L, Petrelli A. Salmon bias effect as hypothesis of the lower mortality rates among immigrants in Italy. Sci Rep 2021; 11:8033. [PMID: 33850208 PMCID: PMC8044175 DOI: 10.1038/s41598-021-87522-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 03/19/2021] [Indexed: 11/09/2022] Open
Abstract
Compared with natives, immigrants have lower all-cause mortality rates, despite their lower socioeconomic status, an epidemiological paradox generally explained by the healthy migrant effect. Another hypothesis is the so-called salmon bias effect: "statistically immortal" subjects return to their country of origin when they expect to die shortly, but their deaths are not registered in the statistics of the country of residence. This underestimation of deaths determines an artificially low immigrant mortality rate. We aimed to estimate the potential salmon bias effect on differences in mortality rates between Italians and immigrants. We used a national cohort of all Italians registered in the 2011 census and followed up for mortality from 2012 to 2016. Mortality data were retrieved from the Causes of Death Register, which included all deaths occurring in the country and the Resident Population Register, which collects also the deaths occurring abroad. We assumed as a possible salmon bias event the death of an immigrant resident in Italy that died in his/her country of origin. Considering the deaths occurring in the country of origin, we observed an 18.1% increase in the overall mortality rates for immigrants and an increase of 23.7% in the age-standardized mortality rate. Mortality rates of immigrants resident in Italy, calculated without taking into account the deaths occurring in the country of origin, are certainly underestimated. However, the salmon bias only partly explains the difference in mortality rates between immigrants and Italians.
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Affiliation(s)
- Anteo Di Napoli
- National Institute for Health, Migration and Poverty (INMP), Istituto Nazionale per la promozione della salute delle popolazioni Migranti e per il contrasto delle malattie della Povertà (INMP), Via di S. Gallicano 25/a, 00153, Roma, Italy.
| | - Alessandra Rossi
- National Institute for Health, Migration and Poverty (INMP), Istituto Nazionale per la promozione della salute delle popolazioni Migranti e per il contrasto delle malattie della Povertà (INMP), Via di S. Gallicano 25/a, 00153, Roma, Italy
| | - Gianfranco Alicandro
- National Institute of Statistics (Istat), Viale Liegi 13, 00198, Rome, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Martina Ventura
- National Institute for Health, Migration and Poverty (INMP), Istituto Nazionale per la promozione della salute delle popolazioni Migranti e per il contrasto delle malattie della Povertà (INMP), Via di S. Gallicano 25/a, 00153, Roma, Italy
| | - Luisa Frova
- National Institute of Statistics (Istat), Viale Liegi 13, 00198, Rome, Italy
| | - Alessio Petrelli
- National Institute for Health, Migration and Poverty (INMP), Istituto Nazionale per la promozione della salute delle popolazioni Migranti e per il contrasto delle malattie della Povertà (INMP), Via di S. Gallicano 25/a, 00153, Roma, Italy
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Wallace M, Wilson B. Age variations and population over-coverage: Is low mortality among migrants merely a data artefact? Population Studies 2021; 76:81-98. [PMID: 33565944 DOI: 10.1080/00324728.2021.1877331] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The migrant mortality advantage has been observed extensively, but its authenticity is debated. In particular, concerns persist that the advantage is an artefact of the data, generated by the problems of recording mobility among foreign-born populations. Here, we build on the intersection of two recent developments: the first showing substantial age variation in the advantage-a deep U-shaped advantage at peak migration ages-and the second showing high levels of population over-coverage, the principal source of data artefact, at the same ages. We use event history analysis of Sweden's population registers (2010-15) to test whether this over-coverage can explain age variation in the migrant mortality advantage. We document its U-shape in Sweden and, crucially, demonstrate that large mortality differentials persist after adjusting for estimated over-coverage. Our findings contribute to ongoing debate by demonstrating that the migrant mortality advantage is real and by ruling out one of its primary mechanisms.
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Affiliation(s)
| | - Ben Wilson
- Stockholm University.,London School of Economics
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Wrede O, Löve J, Jonasson JM, Panneh M, Priebe G. Promoting mental health in migrants: a GHQ12-evaluation of a community health program in Sweden. BMC Public Health 2021; 21:262. [PMID: 33530971 PMCID: PMC7851926 DOI: 10.1186/s12889-021-10284-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 01/20/2021] [Indexed: 11/23/2022] Open
Abstract
Background Research increasingly highlight post-migration factors for migrants’ mental health status. We investigated the association between participation in a health promotion program and changes in migrants’ mental health, and if socio-demographic factors and length of time in the new home country, Sweden, influenced a potential association. Methods A five-week health promotion program named ‘Hälsostöd’ [Health Support], led by community health workers, was offered to migrants, primarily asylum seekers and newly arrived immigrants (N = 202). The framework for the program was salutogenic psycho-education, which focused on health effects of migration experiences, lifestyle and health, and the health care system. Mental health was measured at the start and end of the program. We analysed this follow up by using the recommended clinical cut off (i.e. > 11 of maximum 36, with higher scores indicating possible mental illness) in the 12- item version of the General Health Questionnaire (GHQ12). Chi Square test was used to analyse statistical significance of changes, and multinomial logistic regression to analyse associations to sociodemographic factors and length of stay in Sweden. Results The number of participants scoring above the clinical cut off after participation in the program (N = 79, 39.1%) was lower compared to the corresponding number before participation (N = 111, 55.0%), Chi Square = 10.17, p < .001. The majority of the participants had no change 72.3 (N = 146), 21.8% (N = 44) had a positive change, yet 5.9% (N = 12) had a negative change, compared to before participation in the program. None of the investigated sociodemographic factors showed to significantly influence the association. Length of stay in Sweden was trending, with participants with longer stay being more likely to have possible mental illness. Conclusion We conclude that psycho-educative programs, similar to ‘Hälsostöd’, have potential for promoting asylum seekers’ and newly arrived immigrants’ mental health as the evaluation showed a considerable number of positive changes in participants. The result suggests the importance of offering immigrants health promotive programs in close connection with arrival to the new home country. Future research should clarify under what circumstances sociodemographic factors influence the effects of such programs.
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Affiliation(s)
- Olof Wrede
- Crisis and Trauma Unit, Region Västra Götaland, Gothenburg, Sweden
| | - Jesper Löve
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Junmei Miao Jonasson
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Mamtuti Panneh
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Gunilla Priebe
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
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Country of birth and mortality risk in hypertension with and without diabetes: the Swedish primary care cardiovascular database. J Hypertens 2020; 39:1155-1162. [PMID: 33298686 DOI: 10.1097/hjh.0000000000002744] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Hypertension and diabetes are common and are both associated with high cardiovascular morbidity and mortality. We aimed to investigate associations between mortality risk and country of birth among hypertensive individuals in primary care with and without concomitant diabetes, which has not been studied previously. In addition, we aimed to study the corresponding risks of myocardial infarction and ischemic stroke. METHODS This observational cohort study of 62 557 individuals with hypertension diagnosed 2001-2008 in the Swedish Primary Care Cardiovascular Database assessed mortality by the Swedish Cause of Death Register, and myocardial infarction and ischemic stroke by the National Patient Register. Cox regression models were used to estimate study outcome hazard ratios by country of birth and time updated diabetes status, with adjustments for multiple confounders. RESULTS During follow-up time without diabetes using Swedish-born as reference, adjusted mortality hazard ratios per country of birth category were Finland: 1.26 (95% confidence interval 1.15-1.38), high-income European countries: 0.84 (0.74-0.95), low-income European countries: 0.84 (0.71-1.00) and non-European countries: 0.65 (0.56-0.76). The corresponding adjusted mortality hazard ratios during follow-up time with diabetes were high-income European countries: 0.78 (0.63-0.98), low-income European countries: 0.74 (0.57-0.96) and non-European countries: 0.56 (0.44-0.71). During follow-up without diabetes, the corresponding adjusted hazard ratio of myocardial infarction was increased for Finland: 1.16 (1.01-1.34), whereas the results for ischemic stroke were inconclusive. CONCLUSION In Sweden, hypertensive immigrants (with the exception for Finnish-born) with and without diabetes have a mortality advantage, as compared to Swedish-born.
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Pinchas-Mizrachi R, Naparstek Y, Nirel R, Kukia E. The "Sick immigrant" and "Healthy immigrant" phenomenon among Jews migrating from the USSR to Israel. SSM Popul Health 2020; 12:100694. [PMID: 33294584 PMCID: PMC7689518 DOI: 10.1016/j.ssmph.2020.100694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 11/02/2020] [Accepted: 11/10/2020] [Indexed: 11/25/2022] Open
Abstract
The “healthy immigrant” phenomenon finds that immigrants are in better health than natives, while the “sick immigrant” phenomenon finds the opposite. We examined this phenomenon using the relationship between immigration and mortality, stratified by income level, among Soviet immigrants to Israel in the 1990s, compared to veteran immigrants with similar ethnic origin. A retrospective cohort study of mortality during 1990–2016 was conducted among 63,847 immigrants born during 1940–1950 in the USSR or Eastern Europe, and who immigrated to Israel during 1990–1995. They were compared to a control group of 75,347 Israeli Jews born during the same period in the same countries or second-generation immigrants with parents from these countries and who immigrated by 1960. After adjusting for sex, age, income, and marital status, we found higher mortality rates among immigrants than non-immigrants for the total study population (adjusted hazard ratio (AHR) = 1.399, 99% confidence intervals (CI) = 1.341, 1.459) and among 19,033 men (AHR = 2.852, 99%CI = 2.619, 3.107) and 24,355 women (AHR = 1.705, 99%CI = 1.566, 1.857) with low incomes. The opposite relationship was found for 25,436 men (AHR = 0.710,99%CI = 0.617, 0.0.816) and for 12,922 women (AHR = 0.693,99%CI = 0.534, 0.900) with high incomes. When examining the total study population, we found evidence to support the “sick immigrant” phenomenon. However, both men and women in the high-income subgroup, and women in the middle-income subgroup, demonstrated the “healthy immigrant” phenomenon. Decision-makers in Israel should pay particular attention to immigrants from a low socioeconomic level. Our results emphasize the need for social stratification when examining the relationships between immigration and health outcomes. This retrospective cohort study of mortality follows immigrants from the USSR, who immigrated to Israel during 1990–1995. Immigration is a risk factor for mortality among both sexes, but more so among men. Whenstratified by sex and income level, we found that among low-income men and women, immigration was associated with increased mortality. Among high-income men and middle- and high-income women, the risk of mortality was lower among immigrants. The study has implications for the health care of immigrants at different stages and from different backgrounds.
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Gender Patterns in Immigrants' Health Profiles in France: Tobacco, Alcohol, Obesity and Self-Reported Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17238759. [PMID: 33255730 PMCID: PMC7728336 DOI: 10.3390/ijerph17238759] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 11/17/2020] [Accepted: 11/20/2020] [Indexed: 11/17/2022]
Abstract
Background: to date, little attention has been given to gender differences in the health of migrants relative to native-born. In this study, we examine the health profile of the largest immigrant groups in metropolitan France, considering several health indicators and with a special interest in the gendered patterns. Methods: The data originate from the 2017 Health Barometer survey representative of metropolitan France. A subsample of 19,857 individuals aged 18-70 years was analysed using modified Poisson regression, and risk ratio estimates (RR) were provided for the different migrant groups regarding alcohol use, current smoking, obesity and less-than-good self-reported health, adjusting for age and educational level. Results: None of the groups of male migrants differs from the native-born in terms of self-reported health, and they have healthier behaviours for alcohol (men from sub-Saharan Africa: 0.42 (0.29-0.61)) and from the Maghreb: 0.30 (0.1-0.54)) and smoking (men from sub-Saharan Africa: 0.64 (0.4-0.84)), with less frequent obesity (men from the Maghreb: 0.61 (0.3-0.95)). The latter, however, more frequently report current smoking (1.21 (1.0-1.46)). For women, less-than-good health is more frequently reported by the groups from sub-Saharan Africa (1.42 (1.1-1.75)) and from the Maghreb (1.55 (1.3-1.84)). Healthier behaviours were found for alcohol (women from overseas départements: 0.38 (0.1-0.85)) and from the Maghreb: (0.18 (0.0-0.57)) and current smoking (women from southern Europe: 0.68 (0.4-0.97), from sub-Saharan Africa: 0.23 (0.1-0.38) and from the Maghreb: 0.42 (0.2-0.61)). Conversely, some were more frequently obese (women from overseas départements: 1.79 (1.2-2.56) and from sub-Saharan Africa: 1.67 (1.2-2.23)). In the latter two groups from Africa, there is a larger relative male excess for tobacco than in the native-born (male-to-female ratios of respectively 2.87 (1.6-5.09) and 3.1 (2.0-4.65) vs 1.13 (1.0-1.20)) and there is a female excess for obesity (0.51 (0.2-0.89) and 0.41 (0.2-0.67)) in contrast with the native-born (1.07 (0.9-1.16)). The female disadvantage in terms of less-than-good self-reported health is more pronounced among migrants from the Maghreb than among the natives (0.56(0.4-0.46) vs. 0.86 (0.8-0.91)). Conclusion: Considering a set of four health indicators, we provide evidence for distinctive gender patterns among immigrants in France. Male immigrants have a healthy behavioural profile in comparison with the natives and no health disadvantage. Female immigrants have a more mixed profile, with a health disadvantage for the non-Western groups from Africa. The contribution to this discordance of socioeconomic factors and gender relations needs to be investigated.
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Stanaway FF, Blyth FM, Naganathan V, Le Couteur DG, Ribeiro R, Hirani V, Waite LM, Handelsman DJ, Seibel MJ, Cumming RG. Mortality Paradox of Older Italian-Born Men in Australia: The Concord Health and Ageing in Men Project. J Immigr Minor Health 2020; 22:102-109. [PMID: 30840179 DOI: 10.1007/s10903-019-00874-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Italian migrants are one of the largest groups of older migrants in Australia. Past research has found lower mortality rates in Italian migrants but it is unclear if this persists into older age. Data came from 334 Italian-born and 849 Australian-born men aged 70 years and over participating in a longitudinal study of men's ageing. Male Italian migrants were more likely to smoke, be overweight, and have lower socio-economic status (SES). They also had higher morbidity from diabetes, chronic pain, dementia and depressive symptoms but lower morbidity from heart disease and cancer. There was no age-adjusted mortality difference. However, adjusting for SES, lifestyle and morbidity differences revealed a 25% lower mortality rate (adjusted HR = 0.75; 95% CI 0.57, 0.98) in Italian-born men. Compared to their Australian-born counterparts, older Italian-born men have a lower mortality than expected considering their lower SES, higher smoking and higher morbidity.
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Affiliation(s)
- Fiona F Stanaway
- Sydney School of Public Health, Sydney University, Edward Ford Building, Camperdown, NSW, 2006, Australia.
| | - Fiona M Blyth
- Concord Clinical School, Concord Hospital, Concord, NSW, 2139, Australia
| | - Vasi Naganathan
- Centre for Education and Research on Ageing, The Ageing and Alzheimers Institute, Concord Hospital and Sydney University, Concord, NSW, 2139, Australia
| | - David G Le Couteur
- Centre for Education and Research on Ageing, The Ageing and Alzheimers Institute, Concord Hospital and Sydney University, Concord, NSW, 2139, Australia
| | - Rosilene Ribeiro
- Centre for Education and Research on Ageing, The Ageing and Alzheimers Institute, Concord Hospital and Sydney University, Concord, NSW, 2139, Australia
- School of Life and Environmental Science, Charles Perkins Centre, Sydney University, Camperdown, 2006, NSW, Australia
| | - Vasant Hirani
- School of Life and Environmental Science, Charles Perkins Centre, Sydney University, Camperdown, 2006, NSW, Australia
| | - Louise M Waite
- Centre for Education and Research on Ageing, The Ageing and Alzheimers Institute, Concord Hospital and Sydney University, Concord, NSW, 2139, Australia
| | - David J Handelsman
- ANZAC Research Institute, Concord Hospital, Sydney University, Concord, 2139, NSW, Australia
| | - Markus J Seibel
- School of Life and Environmental Science, Charles Perkins Centre, Sydney University, Camperdown, 2006, NSW, Australia
| | - Robert G Cumming
- Sydney School of Public Health, Sydney University, Edward Ford Building, Camperdown, NSW, 2006, Australia
- Centre for Education and Research on Ageing, The Ageing and Alzheimers Institute, Concord Hospital and Sydney University, Concord, NSW, 2139, Australia
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Oliva-Arocas A, Pereyra-Zamora P, Copete JM, Nolasco A. Cancer Mortality Trends in Spain (2000-2016): Differences between Immigrant and Native Populations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17145127. [PMID: 32708556 PMCID: PMC7400367 DOI: 10.3390/ijerph17145127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 07/11/2020] [Accepted: 07/12/2020] [Indexed: 12/24/2022]
Abstract
Spain’s population has changed thanks to recent immigration. Therefore, a new epidemiological and demographic profile has been generated in the country. This study aims to analyze immigrant and native cancer mortality trends in Spain for the period 2000 to 2016. An ecological study of trends was carried out. Age-standardized rates of cancer mortality (ASR) and annual percentage change (APC) between groups and study sub-periods were calculated. Significant decreases in ASR were observed for cancer in both the native and the immigrant populations, in both men and women. However, in 2014–2016, there was an increase in ASR in the immigrant population compared to 2011–2013, due to the increase in ASR among immigrants from European regions. Differences in ASR by cancer between immigrant and native populations residing in Spain have been identified, both in the rate of decline and magnitude as well as by the birth region of the immigrant population. The increase observed in the cancer mortality trend at the end of the period in some immigrant groups indicates the need to monitor these indicators given the demographic, social, and economic changes.
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Oliva-Arocas A, Pereyra-Zamora P, Copete JM, Vergara-Hernández C, Martínez-Beneito MA, Nolasco A. Socioeconomic Inequalities in Mortality among Foreign-Born and Spanish-Born in Small Areas in Cities of the Mediterranean Coast in Spain, 2009-2015. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E4672. [PMID: 32610538 PMCID: PMC7370214 DOI: 10.3390/ijerph17134672] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 06/14/2020] [Accepted: 06/19/2020] [Indexed: 12/28/2022]
Abstract
Many studies have analysed socioeconomic inequalities and its association with mortality in urban areas. However, few of them have differentiated between native and immigrant populations. This study is an ecological study of mortality by overall mortality and analyses the inequalities in mortality in these populations according to the level of deprivation in small areas of large cities in the Valencian Community, from 2009 to 2015. The census tract was classified into five deprivation levels using an index based on socioeconomic indicators from the 2011 census. Rates and relative risks of death were calculated by sex, age, level of deprivation and country of birth. Poisson regression models have been used. In general, there was a higher risk of death in natives at the levels of greatest deprivation, which did not happen in immigrants. During the 2009-2015 period, there were socioeconomic inequalities in mortality, particularly in natives, who presented a higher risk of death than immigrants. Future interventions and social policies should be implemented in order to reduce inequalities in mortality amongst socioeconomic levels and to maintain the advantage that the immigrant population enjoys.
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Affiliation(s)
- Adriana Oliva-Arocas
- Research Unit for the Analysis of Mortality and Health Statistics, Department of Community Nursing, Preventive Medicine, Public Health and History of Science, University of Alicante, 03080 Alicante, Spain; (A.O.-A.); (J.M.C.); (A.N.)
| | - Pamela Pereyra-Zamora
- Research Unit for the Analysis of Mortality and Health Statistics, Department of Community Nursing, Preventive Medicine, Public Health and History of Science, University of Alicante, 03080 Alicante, Spain; (A.O.-A.); (J.M.C.); (A.N.)
| | - José M. Copete
- Research Unit for the Analysis of Mortality and Health Statistics, Department of Community Nursing, Preventive Medicine, Public Health and History of Science, University of Alicante, 03080 Alicante, Spain; (A.O.-A.); (J.M.C.); (A.N.)
| | - Carlos Vergara-Hernández
- Área de Desigualdades en Salud, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), 46035 Valencia, Spain;
| | | | - Andreu Nolasco
- Research Unit for the Analysis of Mortality and Health Statistics, Department of Community Nursing, Preventive Medicine, Public Health and History of Science, University of Alicante, 03080 Alicante, Spain; (A.O.-A.); (J.M.C.); (A.N.)
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Cheah SL, Jackson E, Touyz S, Hay P. Prevalence of eating disorder is lower in migrants than in the Australian-born population. Eat Behav 2020; 37:101370. [PMID: 32087555 DOI: 10.1016/j.eatbeh.2020.101370] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Revised: 02/13/2020] [Accepted: 02/13/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVES There are limited data on the epidemiology of eating disorders (ED) in migrants. Recent Scandinavian research suggests that migrants are at lower risk of eating disorders, however, to our knowledge there have not been comparable studies exploring eating disorders in Australian adult populations. We sought to explore the prevalence of EDs in first-generation migrants to Australia in comparison with the Australian-born population. A secondary aim was to explore ED prevalence across first-generation migrants from different regions of birth (Europe, Asia, Africa, and Other). METHODS We conducted sequential cross-sectional population surveys in South Australian individuals aged over 15 years in 2015 and 2016 (n = 6052). Demographic data were collected and migration status was inferred based on a country of birth outside Australia. Questions asked regarding disordered eating were based on the Eating Disorders Examination. FINDINGS The 3-month prevalence of any ED was found to be significantly lower in first-generation migrants born outside Australia (4.5%, 95% CI 3.6-5.6) in comparison to the Australian-born population (6.4%, 95% CI 5.7-7.2). People born in countries in Africa (11.0% 95% CI 6.1-19.1) had a significantly higher prevalence of EDs than those born in Asia (4.0% 95% CI 2.7-5.8). CONCLUSIONS First-generation migrants to Australia may be at lower risk of eating disorders compared to their Australia-born peers, suggesting support for a 'healthy immigrant effect'.
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Affiliation(s)
- Su Lynn Cheah
- Hunter New England Mental Health, Australia; School of Medicine, University of Newcastle, Australia.
| | | | - Stephen Touyz
- InsideOut Institute, Australia; School of Psychology, University of Sydney, Australia
| | - Phillipa Hay
- Translational Health Research Institute, Western Sydney University, Australia; Campbelltown Hospital, Australia; Eating Disorder Unit Wesley Hospital, Australia
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Wang M, Vaez M, Dorner TE, Rahman SG, Helgesson M, Ivert T, Mittendorfer-Rutz E. Sociodemographic, labour market marginalisation and medical characteristics as risk factors for reinfarction and mortality within 1 year after a first acute myocardial infarction: a register-based cohort study of a working age population in Sweden. BMJ Open 2019; 9:e033616. [PMID: 31857317 PMCID: PMC6937026 DOI: 10.1136/bmjopen-2019-033616] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES Research covering a wide range of risk factors related to the prognosis during the first year after an acute myocardial infarction (AMI) is insufficient. This study aimed to investigate whether sociodemographic, labour market marginalisation and medical characteristics before/at AMI were associated with subsequent reinfarction and all-cause mortality. DESIGN Population-based cohort study. PARTICIPANTS The cohort included 15 069 individuals aged 25-64 years who had a first AMI during 2008-2010. PRIMARY AND SECONDARY OUTCOME MEASURES The outcome measures consisted of reinfarction and all-cause mortality within 1 year following an AMI, which were estimated by univariate and multivariable HRs and 95% CIs by Cox regression. RESULTS Sociodemographic characteristics such as lower education showed a 1.1-fold and 1.3-fold higher risk for reinfarction and mortality, respectively. Older age was associated with a higher risk of mortality while being born in non-European countries showed a lower risk of mortality. Labour market marginalisation such as previous long-term work disability was associated with a twofold higher risk of mortality. Regarding medical characteristics, ST-elevation myocardial infarction was predictive for reinfarction (HR: 1.14, 95% CI: 1.07 to 1.21) and all-cause mortality (HR: 3.80, 95% CI: 3.08 to 4.68). Moreover, diabetes mellitus, renal insufficiency, stroke, cancer and mental disorders were associated with a higher risk of mortality (range of HRs: 1.24-2.59). CONCLUSIONS Sociodemographic and medical risk factors were identified as risk factors for mortality and reinfarction after AMI, including older age, immigration status, somatic and mental comorbidities. Previous long-term work disability and infarction type provide useful information for predicting adverse outcomes after AMI during the first year, particularly for mortality.
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Affiliation(s)
- Mo Wang
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Marjan Vaez
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Thomas Ernst Dorner
- Department of Social and Preventive Medicine, Centre for Public Health, Medizinische Universitat Wien, Wien, Austria
| | - Syed Ghulam Rahman
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Magnus Helgesson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Torbjörn Ivert
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
| | - Ellenor Mittendorfer-Rutz
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
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Khlat M, Wallace M, Guillot M. Divergent mortality patterns for second generation men of North-African and South-European origin in France: Role of labour force participation. SSM Popul Health 2019; 9:100447. [PMID: 31497637 PMCID: PMC6718938 DOI: 10.1016/j.ssmph.2019.100447] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 07/03/2019] [Accepted: 07/04/2019] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION In France, second generation men of South-European origin were recently found to experience a mortality advantage, as opposed to second generation men of North-African origin, subjected to a large amount of excess mortality. We analyze the roles of education and labor force participation in the explanation of these contrasting mortality patterns. MATERIALS AND METHODS Our data consisted of a nationally-representative sample of individuals aged 18-64 years derived from the 1999 census, with mortality follow-up until 2010. RESULTS The two groups of second generation men, and particularly those of North-African origin, were less educated than the native-origin population, but only the latter was disadvantaged in terms of labor force participation. Relative to the native-origin population, the mortality hazard ratio for second generation men of North-African origin (HR = 1.71 [1.09-2.70]) remained significant after adjusting for level of educational attainment (HR = 1.59 [1.01-2.50]), but not after adjusting for economic activity (HR = 1.20 [0.76-1.89]) or for both variables (1.16 [0.74-1.83]). Conversely, the mortality hazard ratio for second generation men of South-European origin (HR = 0.64 [0.46-0.90]) remained unchanged after adjustment for level of educational attainment and/or economic activity. CONCLUSION The findings shed light on the salient role of labor market disadvantage in the explanation of the mortality excess of second generation men of North-African origin in France, and on the favorable situation of second-generation men of South-European origin in terms of labour market position and mortality. The theoretical and policy implications of the findings are discussed.
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Affiliation(s)
- Myriam Khlat
- French Institute for Demographic Studies (INED), 133 boulevard Davout, 75980, Paris Cedex 20, France
| | - Matthew Wallace
- French Institute for Demographic Studies (INED), 133 boulevard Davout, 75980, Paris Cedex 20, France
| | - Michel Guillot
- French Institute for Demographic Studies (INED), 133 boulevard Davout, 75980, Paris Cedex 20, France
- Population Studies Center, 239 McNeil Building, University of Pennsylvania, 3718 Locust Walk Philadelphia, PA, 19104-6298, University of Pennsylvania, Philadelphia, USA
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Adult mortality among second-generation immigrants in France: Results from a nationally representative record linkage study. DEMOGRAPHIC RESEARCH 2019; 40:1603-1644. [PMID: 33986627 PMCID: PMC8114944 DOI: 10.4054/demres.2019.40.54] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND France has a large population of second-generation immigrants (i.e., native-born children of immigrants) who are known to experience important socioeconomic disparities by country of origin. The extent to which they also experience disparities in mortality, however, has not been previously examined. METHODS We used a nationally representative sample of individuals 18 to 64 years old in 1999 with mortality follow-up via linked death records until 2010. We compared mortality levels for second-generation immigrants with their first-generation counterparts and with the reference (neither first- nor second-generation) population using mortality hazard ratios as well as probabilities of dying between age 18 and 65. We also adjusted hazard ratios using educational attainment reported at baseline. RESULTS We found a large amount of excess mortality among second-generation males of North African origin compared to the reference population with no migrant background. This excess mortality was not present among second-generation males of southern European origin, for whom we instead found a mortality advantage, nor among North African-origin males of the first-generation. This excess mortality remained large and significant after adjusting for educational attainment. CONTRIBUTION In these first estimates of mortality among second-generation immigrants in France, males of North African origin stood out as a subgroup experiencing a large amount of excess mortality. This finding adds a public health dimension to the various disadvantages already documented for this subgroup. Overall, our results highlight the importance of second-generation status as a significant and previously unknown source of health disparity in France.
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Wallace M, Khlat M, Guillot M. Mortality advantage among migrants according to duration of stay in France, 2004-2014. BMC Public Health 2019; 19:327. [PMID: 30898125 PMCID: PMC6427872 DOI: 10.1186/s12889-019-6652-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 03/13/2019] [Indexed: 11/21/2022] Open
Abstract
Background The migrant mortality advantage is generally interpreted as reflecting the selection of atypically healthy individuals from the country of origin followed by the wearing off of selection effects over time, a process theorised to be accelerated by progressive and negative acculturation in the host country. However, studies examining how migrant mortality evolves over duration of stay, which could provide insight into these two processes, are relatively scarce. Additionally, they have paid little attention to gender-specific patterns and the confounding effect of age. In this study, we analyze all-cause mortality according to duration of stay among male and female migrants in France, with a particular focus on the role of age in explaining duration of stay effects. Methods We use the Échantillon Démographique Permanent (Permanent Demographic Sample; EDP), France’s largest socio-demographic panel and a representative 1% sample of its population. Mortality was followed-up from 2004 to 2014, and parametric survival models were fitted for males and females to study variation in all-cause mortality among migrants over duration of stay. Estimates were adjusted for age, duration of stay, year, education level and marital status. Duration of stay patterns were examined for both open-ended and fixed age groups. Results We observe a migrant mortality advantage, which is most pronounced among recent arrivals and converges towards the mortality level of natives with duration of stay. We show this pattern to be robust to the confounding effect of age and find the pattern to be consistent among males and females. Conclusions Our novel findings show an intrinsic pattern of convergence of migrant mortality towards native-born mortality over time spent in France, independent from the ages at which mortality is measured. The consistent pattern in both genders suggests that males and females experience the same processes associated with generating the migrant mortality advantage. These patterns adhere to the selection-acculturation hypothesis and raise serious concerns about the erosion of migrant health capital with increasing exposure to conditions in France. Electronic supplementary material The online version of this article (10.1186/s12889-019-6652-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Matthew Wallace
- Demography Unit, Department of Sociology, Stockholm University, Stockholm, Sweden.
| | - Myriam Khlat
- Institut national d'études démographiques, French National Demographic Institute, 133 Boulevard Davout, 75020, Paris, France
| | - Michel Guillot
- Institut national d'études démographiques, French National Demographic Institute, 133 Boulevard Davout, 75020, Paris, France.,Population Studies Center, University of Pennsylvania, 242 McNeil Building, Philadelphia, PA19104, USA
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Helgesson M, Johansson B, Nordquist T, Vingård E, Svartengren M. Healthy migrant effect in the Swedish context: a register-based, longitudinal cohort study. BMJ Open 2019; 9:e026972. [PMID: 30878993 PMCID: PMC6429895 DOI: 10.1136/bmjopen-2018-026972] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES Studies have found a 'healthy-migrant effect' (HME) among arriving migrants, that is, a better health status compared with others in the home country, but also in comparison with the population in the host country. The aims were to investigate whether the HME hypothesis is applicable to the Swedish context, that is, if health outcomes differed between a group of mainly labour migrants (Western migrants) and a group of mainly refugee/family reunion migrants (non-Western migrants) compared with the native Swedish population, and if there were any correlations between labour market attachment (LMA) and these health outcomes. DESIGN Register-based, longitudinal cohort study. PARTICIPANTS The cohort was defined on 31 December 1990 and consisted of all migrants aged 18-47 years who arrived in Sweden in 1985-1990 (n=74 954) and a reference population of native Swedes (n=1 405 047) in the same age span. They were followed for three consecutive 6-year periods (1991-1996, 1997-2002 and 2003-2008) and were assessed for five measures of health: hospitalisation for cardiovascular and psychiatric disorders, mortality, disability pension, and sick leave. RESULTS Western migrants had, compared with native Swedes, lower or equal HRs for all health measures during all time periods, while non-Western migrants displayed higher or equal HRs for all health measures, except for mortality, during all time periods. Age, educational level, occupation and LMA explained part of the difference between migrants and native Swedes. High LMA was associated with higher HRs for cardiovascular disorders among Western migrants, higher HRs of psychiatric disorders among non-Western migrants and higher HRs of mortality among both migrant groups compared with native Swedes. CONCLUSIONS There were indications of a HME among Western migrants, while less proof of a HME among non-Western migrants. Stratification for LMA and different migrant categories showed some interesting differences, and measurements of the HME may be inconclusive if not stratified by migrant category or other relevant variables.
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Affiliation(s)
- Magnus Helgesson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Stockholm SE-171 77, Karolinska Institutet
- Occupational- and Environmental Medicine, Department of Medical Sciences, Uppsala University, Uppsala
| | - Bo Johansson
- Occupational- and Environmental Medicine, Department of Medical Sciences, Uppsala University, Uppsala
- Occupational- and Environmental Medicine, Uppsala University Hospital, Uppsala
| | - Tobias Nordquist
- Occupational- and Environmental Medicine, Department of Medical Sciences, Uppsala University, Uppsala
- Occupational- and Environmental Medicine, Uppsala University Hospital, Uppsala
| | - Eva Vingård
- Occupational- and Environmental Medicine, Department of Medical Sciences, Uppsala University, Uppsala
| | - Magnus Svartengren
- Occupational- and Environmental Medicine, Department of Medical Sciences, Uppsala University, Uppsala
- Occupational- and Environmental Medicine, Uppsala University Hospital, Uppsala
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The Immigrant Mortality Advantage in Canada, 2001 and 2011. JOURNAL OF INTERNATIONAL MIGRATION AND INTEGRATION 2019. [DOI: 10.1007/s12134-019-00655-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Burns R, Pathak N, Campos-Matos I, Zenner D, Katikireddi SV, Muzyamba MC, Miranda JJ, Gilbert R, Rutter H, Jones L, Williamson E, Hayward AC, Smeeth L, Abubakar I, Hemingway H, Aldridge RW. Million Migrants study of healthcare and mortality outcomes in non-EU migrants and refugees to England: Analysis protocol for a linked population-based cohort study of 1.5 million migrants. Wellcome Open Res 2019; 4:4. [PMID: 30801036 PMCID: PMC6381442 DOI: 10.12688/wellcomeopenres.15007.1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2019] [Indexed: 12/13/2022] Open
Abstract
Background: In 2017, 15.6% of the people living in England were born abroad, yet we have a limited understanding of their use of health services and subsequent health conditions. This linked population-based cohort study aims to describe the hospital-based healthcare and mortality outcomes of 1.5 million non-European Union (EU) migrants and refugees in England. Methods and analysis: We will link four data sources: first, non-EU migrant tuberculosis pre-entry screening data; second, refugee pre-entry health assessment data; third, national hospital episode statistics; and fourth, Office of National Statistics death records. Using this linked dataset, we will then generate a population-based cohort to examine hospital-based events and mortality outcomes in England between Jan 1, 2006, and Dec 31, 2017. We will compare outcomes across three groups in our analyses: 1) non-EU international migrants, 2) refugees, and 3) general population of England. Ethics and dissemination: We will obtain approval to use unconsented patient identifiable data from the Secretary of State for Health through the Confidentiality Advisory Group and the National Health Service Research Ethics Committee. After data linkage, we will destroy identifying data and undertake all analyses using the pseudonymised dataset. The results will provide policy makers and civil society with detailed information about the health needs of non-EU international migrants and refugees in England.
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Affiliation(s)
- Rachel Burns
- Centre for Public Health Data Science, University College London, London, UK
| | - Neha Pathak
- Centre for Public Health Data Science, University College London, London, UK
- Institute of Epidemiology and Healthcare, University College London, London, UK
| | | | - Dominik Zenner
- Migration Health Division, International Organization for Migration, Brussels, Belgium
- Institute for Global Health, University College London, London, UK
| | - Srinivasa Vittal Katikireddi
- MRC/CSO Social and Public Health Sciences Unit, Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | | | - J. Jaime Miranda
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Ruth Gilbert
- Institute of Epidemiology and Healthcare, University College London, London, UK
- Administrative Data Research Centre for England, University College London, London, UK
| | - Harry Rutter
- Faculty of Humanities and Social Sciences, University of Bath, Bath, UK
| | - Lucy Jones
- UK programme manager, Doctors of the World, London, UK
| | - Elizabeth Williamson
- Faculty of Epidemiology & Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Andrew C. Hayward
- Institute of Epidemiology and Healthcare, University College London, London, UK
| | - Liam Smeeth
- Department of Non-Communicable Diseases Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Ibrahim Abubakar
- Institute for Global Health, University College London, London, UK
| | - Harry Hemingway
- Institute of Health Informatics Research, Faculty of Population Health Sciences, University College London, London, UK
| | - Robert W. Aldridge
- Centre for Public Health Data Science, University College London, London, UK
- Public Health England, London, UK
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