Migration, Health Status and Utilization of Health Services (original) (raw)
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Assessing Migration Health Care Implications: A Sistematic Review of Literature
diem.unige.it
At present the migrant phenomenon concerns all developed countries and is steadily raising with direct implications on health. The uprooting of people from their places of origin, the impact with an often completely different cultural and religious context, the unemployment and state of poverty which expose these people to peculiar risks deeply affect these migrant populations making them particularly vulnerable. The situation is made even more worrying because of the difficult access of migrants to health information. Therefore it is extremely important to carry out actions and interventions aiming at informing groups of mobile populations both on health risks and the opportunity they have to access health services.
Health of Immigrants in European Countries
The health of older immigrants can have important consequences for needed social support and demands placed on health systems. This paper examines health differences between immigrants and the native-born populations aged 50 years and older in 11 European countries. We examine differences in functional ability, disability, disease presence, and behavioral risk factors for immigrants and nonimmigrants using data from the Survey of Health, Aging and Retirement in Europe (SHARE) database. Among the 11 European countries, migrants generally have worse health than the native population. In these countries, there is a little evidence of the “healthy migrant” at ages 50 years and over. In general, it appears that growing numbers of immigrants may portend more health problems in the population in subsequent years.
Health of Immigrants in European Countries 1
International Migration Review, 2008
The health of older immigrants can have important consequences for needed social support and demands placed on health systems. This paper examines health differences between immigrants and the native-born populations aged 50 years and older in 11 European countries. We examine differences in functional ability, disability, disease presence, and behavioral risk factors for immigrants and nonimmigrants using data from the Survey of Health, Aging and Retirement in Europe (SHARE) database. Among the 11 European countries, migrants generally have worse health than the native population. In these countries, there is a little evidence of the “healthy migrant” at ages 50 years and over. In general, it appears that growing numbers of immigrants may portend more health problems in the population in subsequent years.
A systematic review of the use of health services by immigrants and native populations
Background: Changes in migration patterns that have occurred in recent decades, both quantitative, with an increase in the number of immigrants, and qualitative, due to different causes of migration (work, family reunification, asylum seekers and refugees) require constant u pdating of the analysis of how immigrants access health services. Understanding of the existence of changes in use patterns is necessary to adapt health services to the new socio-demographic reality. The aim of this study is to describe the scientific evidence that assess the differences in the use of health services between immigrant and native populations. Methods: A systematic review of the electronic database MEDLINE (PubMed) was conducted with a search of studies published between June 2013 and February 2016 that addressed the use of health services and compared immigrants with native populations. MeSH terms and key words comprised Health Services Needs and Demands/Accessibility/Disparities/Emigrants and Immigrants/Native/Ethnic Groups. The electronic search was supplemented by a manual search of grey literature. The following information was extracted from each publication: context of the study (place and year), characteristics of the included population (definition of immigrants and their sub-groups), methodological domains (design of the study, source of information, statistical analysis, variables of health care use assessed, measures of need, socio-economic indicators) and main results. Results: Thirty-six publications were included, 28 from Europe and 8 from other countries. Twenty-four papers analysed the use of primary care, 17 the use of specialist services (including hospitalizations or emergency care), 18 considered several levels of care and 11 assessed mental health services. The characteristics of immigrants included country of origin, legal status, reasons for migration, length of stay, different generations and socio-demographic variables and need. In general, use of health services by the immigrants was less than or equal to the native population, although some differences between immigrants were also identified. Conclusions: This review has identified that immigrants show a general tendency towards a lower use of health services than native populations and that there are significant differences within immigrant sub-groups in terms of their patterns of utilization. Further studies should include information categorizing and evaluating the diversity within the immigrant population.
The influence of contextual factors on immigrants health status: a population census approach
2006
Previous research on health disparities between immigrant and native populations has put the emphasis on individual socio-economic factors. However, poor health among immigrants might also be accounted for by risk factors linked to the place where they live. The aim of this study was to investigate the influence of contextual factors on disparities in self-rated health between immigrant groups. We used the Belgian census, covering 6,712,497 individuals aged 25-64 and living in private households. Subjective health and long-term illness were assessed for 15 groups of nationalities. Environmental nuisance, migrant concentration, lack of public service amenities, lack of social capital, and unemployment rate were the contextual factors computed at the neighborhood level. Logistic regression was used to analyze the influence of such factors, while controlling for socio-economic status. Compared with Belgians, immigrant groups from Turkey and Morocco were more likely to have poorer subjective health. Local unemployment rate and perceived lack of public services were associated with a higher risk of poor health status. These associations were weakened, but remained significant, after controlling for the composition of the neighbourhood. When contextual factors or socioeconomic status were allowed for, all immigrant groups had a similar or even better health status than Belgians. The influence of contextual factors on migrant disparities in health were similar between metropolitan areas and non-metropolitan areas. We concluded that policies should aim at improving local opportunities in public services and tackling labour market discrimination.
Immigrant Access to Health Care and Public Health: An International Perspective
Annals of Health Law, 2008
Press 1968) (defining migration as "a relatively permanent moving away of... migrants, from one geographical location to another, preceded by decision-making on the part of the migrants on the basis of a hierarchically ordered set of values or valued ends and resulting in changes in the interactional system of the migrants"); Everett S. Lee, A Theory of Migration, 3 DEMOGRAPHY 47, 49 (1966) (defining migration as "a permanent or semi-permanent change of residence"). 3.
2013
A growing body of research conducted in Northern and Western European countries, such as Great Britain, Sweden, Germany and France have shown that some immigrant groups tend to have poorer health status in later life with respect to native-born people (Vaillant and Wolff, 2010; Leão et al., 2009; Solé-Aurò and Crimmins, 2008; Pudaric et al., 2003; Silveira and Ebrahim, 1998). It has been suggested that socioeconomic disadvantages, cultural and linguistic barriers, the unequal access of health care and social service, discrimination, psychological stress of living in a new environment, lack of social and familiar relationships and housing conditions are all factors which may explain the increased risk of perceiving a worse health among foreign-born groups with respect the majority of population (Ringbäck et al., 1999, Ronellenfitsch & Razum, 2004, Silveira et al. (2002). Moreover, according to the theory of cumulative disadvantage (Dowd & Bengtson, 1978) the successive addition of ad...
Tropical Medicine & International Health, 2015
objective Firstly, to map out and compare all-cause and cause-specific mortality patterns by migrant background in Belgium; and secondly, to probe into explanations for the observed patterns, more specifically into the healthy-migrant, acculturation and the migration-as-rapid-health-transition theories. methods Data comprise individually linked Belgian census-mortality follow-up data for the period 2001-2011. All official inhabitants aged 25-54 at time of the census were included. To delve into the different explanations, differences in all-cause and chronic-and infectious-disease mortality were estimated using Poisson regression models, adjusted for age, socioeconomic position and urbanicity. results First-generation immigrants have lower all-cause and chronic-disease mortality than the host population. This mortality advantage wears off with length of stay and is more marked among non-Western than Western first-generation immigrants. For example, Western and non-Western male immigrants residing 10 years or more in Belgium have a mortality rate ratio for cardiovascular disease of 0.72 (95% CI 0.66-0.78) and 0.59 (95% CI 0.53-0.66), respectively (vs host population). The pattern of infectious-disease mortality in migrants is slightly different, with rather high mortality rates in first-generation sub-Saharan Africans and rather low rates in all other immigrant groups. As for second-generation immigrants, the picture is gloomier, with a mortality disadvantage that disappears after control for socioeconomic position. conclusion Findings are largely consistent with the healthy-migrant, acculturation and the migration-as-rapid-health-transition theories. The convergence of the mortality profile of secondgeneration immigrants towards that of the host population with similar socioeconomic position indicates the need for policies simultaneously addressing different areas of deprivation.
The healthy migrant effect in primary care
Objective: To compare the morbidity burden of immigrants and natives residing in Aragón, Spain, based on patient registries in primary care, which represents individuals' first contact with the health system. Methods: A retrospective observational study was carried out, based on linking electronic primary care medical records to patients' health insurance cards. The study population consisted of the entire population assigned to general practices in Aragón, Spain (1,251,540 individuals, of whom 12% were immigrants). We studied the morbidity profiles of both the immigrant and native populations using the Adjusted Clinical Group System. Logistic regressions were conducted to compare the morbidity burden of immigrants and natives after adjustment for age and gender. Results: Our study confirmed the "healthy immigrant effect", particularly for immigrant men. Relative to the native population, the prevalence rates of the most frequent diseases were lower among immigrants. The percentage of the population showing a moderate to very high morbidity burden was higher among natives (52%) than among Latin Americans (33%), Africans (29%), western Europeans (27%), eastern Europeans and North Americans (26%) and/or Asians (20%). Differences were smaller for immigrants who had lived in the country for 5 years or longer. Conclusion: Length of stay in the host country had a decisive influence on the morbidity burden represented by immigrants, although the health status of both men and women worsened with longer stay in the host country.
Determinants of health care utilization by immigrants in Portugal
BMC Health Services Research, 2008
The increasing diversity of population in European Countries poses new challenges to national health systems. There is a lack of data on accessibility and use of health care services by migrants, appropriateness of the care provided, client satisfaction and problems experienced when confronting the health care system. This limits knowledge about the multiple determinants of the utilization of health services. The aim of this study was to describe the access of migrants to health care and its determinants in Portugal.