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Lamy C, Doghri A, Costa E, Boulvain M, Hocquette A, Alexander S, Racapé J. Hypertension as an effect modifier for preterm and small for gestational age births in migrant women in Belgium: A population-based study. PLoS One 2025; 20:e0323652. [PMID: 40367069 PMCID: PMC12077694 DOI: 10.1371/journal.pone.0323652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2024] [Accepted: 04/11/2025] [Indexed: 05/16/2025] Open
Abstract
BACKGROUND The association between migration and pregnancy outcomes gives contradictory results. Women's socio-economic status explains some differences, but its influence may vary according to women's underlying health conditions. Our aim was to understand how comorbidities modify the relationship between migration and preterm birth or small for gestational age in Belgium. METHODS Data are related to all singleton births to women living in Belgium between 2010 and 2019 (n = 1 200 417). Maternal nationalities were grouped as Belgium, European Union, Eastern Europe, North Africa, Sub-Saharan Africa and the Middle East. A logistic regression was used to estimate the association between maternal nationalities and perinatal outcomes, taking into account the socio-economic status and maternal comorbidities: hypertension, obesity, and diabetes. The interaction effect between maternal nationalities and comorbidities was tested. RESULTS Migrant women were more socio-economically disadvantaged than Belgian women. All migrant women without hypertension had a significantly lower Odd Ratio of preterm birth and small for gestational age than Belgian (p < 0.001). In contrast, women with hypertension had a higher OR than Belgian women, even after adjustment for socio-economic status and other comorbidities. This difference was more striking among Sub-Saharan African and Middle Eastern women: respectively, aORs 1.45 (95%CI 1.30-1.62) and 1.24 (95%CI 1.01-1.54) for preterm birth, and aORs 1.17 (95%CI 1.03-1.17) and 1.28 (95%CI 1.02-1.60) for small for gestational age. CONCLUSIONS Hypertension modifies the association between migration and unfavourable pregnancy outcomes. Although migrant women had a lower risk of preterm birth and small for gestational age than Belgian women, in the presence of hypertension, their risk was significantly higher than Belgian women with the same conditions. Further research is needed to analyse the complex relationships between migration, social status, women's living conditions, and perinatal outcome.
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Affiliation(s)
- Clotilde Lamy
- Hôpital Universitaire de Bruxelles (HUB) - Hôpital Érasme, Université Libre de Bruxelles (ULB), Clinique de gynécologie obstétrique, Brussels, Belgium
| | - Amira Doghri
- Research Center in Epidemiology, Biostatistics and Clinical Research. School of Public Health, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Elena Costa
- Belgian Health Care Knowledge Centre, Brussels, Belgium
| | - Michel Boulvain
- Hôpital Universitaire de Bruxelles (HUB) - Hôpital Érasme, Université Libre de Bruxelles (ULB), Clinique de gynécologie obstétrique, Brussels, Belgium
- Department of Obstetrics and Prenatal Medicine, University Hospital UZ Brussel, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | | | - Sophie Alexander
- Research Center in Epidemiology, Biostatistics and Clinical Research. School of Public Health, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Judith Racapé
- Hôpital Universitaire de Bruxelles (HUB) - Hôpital Érasme, Université Libre de Bruxelles (ULB), Clinique de gynécologie obstétrique, Brussels, Belgium
- Faculty of Medecine, Université Libre de Bruxelles (ULB), Brussels, Belgium
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Ferrara A, Cozzani M. Explaining immigrant-native differences in health at birth: The role of immigrant selectivity in Spain. POPULATION STUDIES 2025:1-18. [PMID: 40166837 DOI: 10.1080/00324728.2025.2481953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 12/17/2024] [Indexed: 04/02/2025]
Abstract
Evidence shows that immigrants are often in better health than the native born-the so-called 'immigrant health paradox'-and this advantage may extend to their children's health. A commonly cited but rarely tested explanation is the 'selectivity hypothesis', positing that immigrants are healthier due to selection at origin based on health or socio-economic status (SES). Using 2007-19 Spanish birth registries, we investigate immigrant-native gaps in health at birth and whether they are explained by immigrants' educational selectivity. We find that babies born to immigrants are less likely to be low birthweight (LBW) but are disadvantaged in terms of macrosomia and gestational age. Selectivity is associated with reduced LBW even after accounting for parental SES, explaining the lower risk among children of Northern African and Latin American immigrants but not across other parental country-of-birth groups. Selectivity is not associated with other birth outcomes. We confirm the selectivity hypothesis but question its universality across groups and health outcomes.
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Affiliation(s)
- Alessandro Ferrara
- Freie University
- WZB Berlin Social Science Center
- Einstein Center for Population Diversity
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Sibbald CA, Godecker A, Bailey EJ, Rhoades JS, Adams JH. Association between interpreter use and small for gestational age infants. Am J Obstet Gynecol MFM 2024; 6:101486. [PMID: 39284415 DOI: 10.1016/j.ajogmf.2024.101486] [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: 05/15/2024] [Revised: 08/24/2024] [Accepted: 09/02/2024] [Indexed: 10/21/2024]
Abstract
BACKGROUND Limited English proficiency is associated with worse health outcomes regardless of health literacy. Prior research suggests that using interpreter services for low English proficiency helps mitigate the language barrier, is associated with improved health outcomes, and patient satisfaction; however, obstetric and neonatal outcomes and pregnancy risks in this population are not well studied. OBJECTIVES The primary purpose of this study was to determine if low English proficiency is an independent risk factor for small for gestational age infants by utilizing interpreter use as a proxy for low English proficiency. Due to the known challenges in communication with a language barrier and discrimination against people whose first language is not English, we hypothesized that this could result in an increase in high risk conditions in pregnancy such as SGA. Our hypothesis was that the need for an interpreter would be associated with having small for gestational age infants. STUDY DESIGN We performed a retrospective cohort study at a single center using data between 1/1/2016 and 12/31/2021; we included singleton, live births ≥ 21 weeks gestation. We excluded multiple gestations, intrauterine fetal demise, and delivery < 21 weeks. The primary outcome was rate of small for gestational age. Small for gestational age was defined as birthweight < 10th percentile for gestational age using the 2018 Fenton newborn growth curve. Multivariable logistic regression was performed to control for confounding variables. RESULTS Of the 26,260 patients included in the study, 71.3% were non-Hispanic White, 9.5% were Hispanic/Latino, and 7.9% were non-Hispanic Black. Overall, 1,662 (6.3%) patients utilized an interpreter. Over half (58.0%) of patients requesting interpreter services were Hispanic. In unadjusted analyses, the rate of small for gestational age was not different between patients who used interpreter services (n=106, 6.4%) and those who did not (n=1612, 6.6 %), P=.779. After adjusting for race/ethnicity, gravidity, gestational age, private insurance, diabetes, hypertension, and prepregnancy body mass index, the use of interpreter services was associated with decreased odds of small for gestational age (aOR 0.67, 95% CI 0.53-0.84). CONCLUSIONS Our findings suggest that use of an interpreter is associated with a lower incidence of small for gestational age when controlling for patient characteristics and social determinants of health. Additional research is required to explore this association, but our results indicate that recognizing demographic risk factors and providing patients with social resources such as access to interpreter services may positively impact obstetric and neonatal outcomes.
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Affiliation(s)
- Carrie A Sibbald
- Department of Obstetrics and Gynecology, University of Wisconsin, Madison, WI
| | - Amy Godecker
- Department of Obstetrics and Gynecology, University of Wisconsin, Madison, WI
| | - Erin J Bailey
- Department of Obstetrics and Gynecology, University of Wisconsin, Madison, WI
| | - Janine S Rhoades
- Department of Obstetrics and Gynecology, University of Wisconsin, Madison, WI
| | - Jacquelyn H Adams
- Department of Obstetrics and Gynecology, University of Wisconsin, Madison, WI.
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Hoff TA, Heller S, Reichel JL, Werner AM, Schäfer M, Tibubos AN, Simon P, Beutel ME, Letzel S, Rigotti T, Dietz P. Cigarette Smoking, Risky Alcohol Consumption, and Marijuana Smoking among University Students in Germany: Identification of Potential Sociodemographic and Study-Related Risk Groups and Predictors of Consumption. Healthcare (Basel) 2023; 11:3182. [PMID: 38132073 PMCID: PMC10742791 DOI: 10.3390/healthcare11243182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 11/30/2023] [Accepted: 12/08/2023] [Indexed: 12/23/2023] Open
Abstract
(1) Background: Cigarette smoking, risky alcohol consumption, and marijuana smoking are the most common behaviors related to legal and illicit drug use worldwide, including among university students. To plan effective evidence-based programs to prevent the risky consumption of these substances among university students, the present study aimed to identify potential sociodemographic and study-related risk groups and predictors of consumption. (2) Methods: A cross-sectional online health survey with approximately 270 health-related items was conducted among students at the University of Mainz, Germany. Cigarette smoking, risky alcohol consumption (AUDIT-C score: female ≥ 4, male ≥ 5), and marijuana smoking were chosen as dependent variables. Of the 270 health-related items, 56 were chosen as independent variables and collated into five groups (sociodemographic, psychological, study-related psychosocial, general psychosocial and health behavior). The prevalence of cigarette smoking, risky alcohol consumption, and marijuana smoking was assessed using established and validated instruments. Pearson's chi-square test was used to analyze the differences in prevalence between the sociodemographic and study-related groups, and binary logistic regression was used for analyses with stepwise inclusion of the five variable groups. (3) Results: Of the 3991 university students who entered the analyses, 14.9% reported smoking cigarettes, 38.6% reported risky alcohol consumption, and 10.9% reported smoking marijuana. The prevalence of these differed between genders, fields of study, and aspired degree level, among other factors. Binary logistic regression analyses revealed nine significant predictors (p ≤ 0.05) of cigarette smoking (Nagelkerke R2 = 0.314), 18 significant predictors of risky alcohol consumption (Nagelkerke R2 = 0.270), and 16 significant predictors of marijuana smoking (Nagelkerke R2 = 0.239). (4) Conclusions: This study showed cigarette smoking, risky alcohol consumption, and marijuana smoking among university students in Germany to be associated with multiple factors, especially health behaviors. Furthermore, each of the substances was highly associated with each of the two other substances we examined. Other variable groups, such as psychological or psychosocial variables, seemed to play a rather minor role. Therefore, our recommendation for future prevention programs is that substance use among university students should be addressed as a whole, not just in terms of specific substances.
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Affiliation(s)
- Thilo A. Hoff
- Institute of Occupational, Social and Environmental Medicine, University Medical Centre of the Johannes Gutenberg University, 55131 Mainz, Germany; (T.A.H.); (S.H.); (J.L.R.); (S.L.)
| | - Sebastian Heller
- Institute of Occupational, Social and Environmental Medicine, University Medical Centre of the Johannes Gutenberg University, 55131 Mainz, Germany; (T.A.H.); (S.H.); (J.L.R.); (S.L.)
| | - Jennifer L. Reichel
- Institute of Occupational, Social and Environmental Medicine, University Medical Centre of the Johannes Gutenberg University, 55131 Mainz, Germany; (T.A.H.); (S.H.); (J.L.R.); (S.L.)
| | - Antonia M. Werner
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University, 55131 Mainz, Germany; (A.M.W.); (A.N.T.); (M.E.B.)
| | - Markus Schäfer
- Department of Communication, Johannes Gutenberg University, 55122 Mainz, Germany;
| | - Ana Nanette Tibubos
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University, 55131 Mainz, Germany; (A.M.W.); (A.N.T.); (M.E.B.)
- Nursing Science, Diagnostics in Healthcare and E-Health, Trier University, 54296 Trier, Germany
| | - Perikles Simon
- Department of Sports Medicine, Rehabilitation and Disease Prevention, Institute of Sport Science, Johannes Gutenberg University, 55122 Mainz, Germany;
| | - Manfred E. Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University, 55131 Mainz, Germany; (A.M.W.); (A.N.T.); (M.E.B.)
| | - Stephan Letzel
- Institute of Occupational, Social and Environmental Medicine, University Medical Centre of the Johannes Gutenberg University, 55131 Mainz, Germany; (T.A.H.); (S.H.); (J.L.R.); (S.L.)
| | - Thomas Rigotti
- Department of Work, Organizational and Business Psychology, Institute of Psychology, Johannes Gutenberg University, 55122 Mainz, Germany;
- Leibniz Institute of Resilience Research, 55122 Mainz, Germany
| | - Pavel Dietz
- Institute of Occupational, Social and Environmental Medicine, University Medical Centre of the Johannes Gutenberg University, 55131 Mainz, Germany; (T.A.H.); (S.H.); (J.L.R.); (S.L.)
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Goble G, Formica M, Lane SD, Sous M, Stroup C, Rubinstein RA, Shaw A. Refugee Births and the Migrant Health Effect in Syracuse NY. Matern Child Health J 2023:10.1007/s10995-023-03694-5. [PMID: 37284922 DOI: 10.1007/s10995-023-03694-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/19/2023] [Indexed: 06/08/2023]
Abstract
OBJECTIVES In Syracuse, NY among 5998 births in a 3-year period (2017-2019), 24% were to foreign-born women, among whom nearly 5% were refugees from the Democratic Republic of the Congo and Somalia. The impetus for the study was to identify potential risk factors and birth outcomes of refugee women, other foreign-born women, and US born women to inform care. METHODS This study reviewed 3 years of births (2017-2019) in a secondary database of births in Syracuse, New York. Data reviewed included maternal demographics, natality, behavioral risk factors (e.g., drug use, tobacco use), employment, health insurance, and education. RESULTS In a logistic regression model controlling for race, education, insurance status, employment status, tobacco use and illicit drug use, compared to US born mothers, refugees (OR 0.45, 95% CI 0.24-0.83) and other foreign born (OR 0.63, 95% CI 0.47-0.85) had significantly fewer low birth weight births. CONCLUSION The results of this study supported the "healthy migrant effect," a concept that refugees have fewer low birth weight (LBW) births, premature births, and cesarean section deliveries than US born women. This study adds to the literature on refugee births and the healthy migrant effect.
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Affiliation(s)
- Gretchen Goble
- Indiana University School of Medicine, Indianapolis, IN, USA
| | | | | | - Michaela Sous
- Upstate Medical University, Syracuse, NY, USA
- HEAL Initiative, University of California, San Francisco, San Francisco, USA
| | - Caroline Stroup
- Obstetrics and Gynecology, Dartmouth Health, Lebanon, NH, USA
| | | | - Andrea Shaw
- Upstate Medical University, Syracuse, NY, USA
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Does emigration by itself improve birth weight? Study in European newborns of Indo-Pakistan origin. J Migr Health 2023; 7:100165. [PMID: 36760495 PMCID: PMC9905657 DOI: 10.1016/j.jmh.2023.100165] [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: 09/07/2020] [Revised: 01/24/2023] [Accepted: 01/24/2023] [Indexed: 02/04/2023] Open
Abstract
Objective Our aim was to evaluate the effect of emigration on fetal birth weight (BW) in a group of pregnant women coming from the Indian subcontinent. Methods This was a retrospective study in a mixed population of pregnant women from the Indian subcontinent that either moved to Europe or stayed in their original countries. The influence of emigration along with several pregnancy characteristics: GA at delivery, fetal gender, maternal age, height, weight, body mass index (BMI) and parity on BW was evaluated by means of multivariable linear regression analysis. Results According to European standards, babies born to Indo-Pakistan emigrants and babies born to women staying in the Indian subcontinent were similarly small (BW centile 30± 29 and 30.1 ± 28, p<0.68). Multivariable regression demonstrated that emigration by itself did not exert a direct influence on BW (p = 0.27), being BMI and gestational age at delivery the true determinants of BW (p<0.0001). Conclusions Maternal BMI is the most relevant parameter affecting fetal growth regardless of the place of residence.
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Chang R, Li C, Qi H, Zhang Y, Zhang J. Birth and Health Outcomes of Children Migrating With Parents: A Systematic Review and Meta-Analysis. Front Pediatr 2022; 10:810150. [PMID: 35911841 PMCID: PMC9326113 DOI: 10.3389/fped.2022.810150] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 05/23/2022] [Indexed: 11/13/2022] Open
Abstract
Objective To examine the birth and health outcomes of children migrating with parents internationally and domestically, and to identify whether the healthy migration effect exist in migrant children. Methods Five electronic databases were searched for cross-sectional, case-control, or cohort studies published from January 1, 2000 to January 30, 2021and written by English language, reporting the risk of health outcomes of migrant children (e.g., birth outcome, nutrition, physical health, mental health, death, and substance use) We excluded studies in which participants' age more than 18 years, or participants were forced migration due to armed conflict or disasters, or when the comparators were not native-born residents. Pooled odd ratio (OR) was calculated using random-effects models. Results Our research identified 10,404 records, of which 98 studies were retrained for analysis. The majority of the included studies (89, 91%) focused on international migration and 9 (9%) on migration within country. Compared with native children, migrant children had increased risks of malnutrition [OR 1.26 (95% CI 1.11-1.44)], poor physical health [OR 1.34 (95% CI 1.11-1.61)], mental disorder [OR 1.24 (95% CI 1.00-1.52)], and death [OR 1.11 (95% CI 1.01-1.21)], while had a lower risk of adverse birth outcome [OR 0.92 (95% CI 0.87-0.97)]. The difference of substance use risk was not found between the two groups. Conclusion Migrant children had increased risk of adverse health outcomes. No obvious evidence was observed regarding healthy migration effect among migrant children. Actions are required to address the health inequity among these populations. Systematic Review Registration https://www.crd.york.ac.uk/prospero/#myprospero, identifier: CRD42021214115.
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Affiliation(s)
| | | | | | | | - Jianduan Zhang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Impact of Socio-economic Status on Low Birthweight: Decomposing the Differences Between Natives and Immigrants in Spain. J Immigr Minor Health 2021; 23:71-78. [PMID: 32410013 PMCID: PMC7847452 DOI: 10.1007/s10903-020-01027-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
In this population-based study, we explored the relationships between immigration, socio-economic status (SES), and perinatal outcomes. We quantified the effects of SES on birthweight disparities between native and immigrant mothers in Spain. We obtained birth and SES data from the 2011 census and administrative registers for years 2011–2015. The associations between origin, statuses, and the likelihood of low birthweight were estimated using logistic regressions. Fairlie’s nonlinear extension of the Oaxaca–Blinder decomposition method was applied to identify the extent to which the differences in birthweight between groups corresponded to socio-economic composition or to rates. Our results showed that African and Latin American mothers exhibited advantage in the perinatal outcomes over native mothers [odds ratio (OR) 0.75; 95% confidence interval (CI) 0.63–0.90 and OR 0.73; 95% CI 0.65–0.82, respectively]. Decomposition analyses revealed that such advantage was not affected by the lower positions within the socio-economic structure that African and Latin American populations occupied.
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Stupin JH, Henrich W, David M, Schlembach D, Razum O, Borde T, Breckenkamp J. Perinatales Outcome bei Frauen mit Gestationsdiabetes unter besonderer Berücksichtigung eines Migrationshintergrundes – Ergebnisse einer prospektiven Studie in Berlin. DIABETOL STOFFWECHS 2021. [DOI: 10.1055/a-1474-9761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Zusammenfassung
Hintergrund Etwa 25 % der Bevölkerung Deutschlands haben einen Migrationshintergrund (MH), der mit einem schlechteren perinatalen Outcome einhergehen kann. Der Gestationsdiabetes (GDM) gehört zu den häufigsten Schwangerschaftserkrankungen; von ihm sind Frauen mit MH in höherem Maße betroffen. Bisher liegen keine systematisch erhobenen Daten zur Betreuung von Migrantinnen mit GDM vor.
Fragestellung Ziel der Studie war es, Auswirkungen eines MH auf Schwangerschaften von Frauen mit GDM zu evaluieren: Haben Immigrantinnen und ihre Nachkommen ein schlechteres perinatales Outcome als Frauen ohne MH in den Parametern Geburtseinleitung, Sectio, Makrosomie, Apgar, Nabelschnur-pH-Wert, Verlegung auf eine neonatologische Intensivstation, Frühgeburt und prä-/postpartale Hb-Differenz? Beeinflusst ein MH außerdem den Zeitpunkt der ersten Schwangerenvorsorge sowie die Zahl der Vorsorgeuntersuchungen?
Methoden Datenerhebung an drei Berliner Geburtskliniken 2011/2012 unmittelbar in der Kreißsaalaufnahme über 12 Monate anhand standardisierter Interviews (Fragebogenset) in deutscher, türkischer und anderen Sprachen. Fragen zu soziodemografischen Aspekten, Schwangerenvorsorge sowie ggf. Migration und Akkulturation. Verknüpfung der Befragungsdaten mit Mutterpass- und klinischen Perinataldaten. Adjustierung für Alter, BMI, Parität und sozioökonomischen Status erfolgte in Regressionsmodellen.
Ergebnisse Die Daten von n = 2878 Frauen mit MH (GDM: 4,7 %) und n = 2785 Frauen ohne MH (GDM: 4,8 %) konnten verglichen werden. Eine multiple Regressionsanalyse zeigte keine Unterschiede in den Chancen der beiden Gruppen mit GDM hinsichtlich Sectio, Makrosomie, Apgar, Nabelschnur-pH-Werten, Verlegungen auf eine neonatologische Intensivstation sowie Zeitpunkt der ersten Schwangerenvorsorge ≥ 12 SSW und Zahl der Vorsorgeuntersuchungen < 10. Sowohl für Frauen mit GDM und MH (OR 1,57; 95 %-KI 1,08–2,27) als auch für solche mit GDM ohne MH (OR 1,47; 95 %-KI 1,01–2,14) bestand eine signifikant höhere Chance der Geburtseinleitung.
Schlussfolgerung Frauen mit GDM und MH zeigen ein ähnlich gutes Schwangerschaftsergebnis wie solche mit GDM und ohne MH, was auf eine hohe Qualität der peripartalen Betreuung und Versorgung hinweist. Im Vergleich zu Frauen ohne GDM wird bedingt durch diesen und den höheren BMI unabhängig vom MH vermehrt eingeleitet. Die Ergebnisse für Frauen mit GDM lassen unabhängig vom MH auf einen ähnlichen Standard der Inanspruchnahme von Vorsorgeuntersuchungen in der Schwangerschaft schließen.
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Affiliation(s)
| | | | | | | | - Oliver Razum
- AG3 Epidemiology and International Public Health, Universität Bielefeld, Fakultät für Gesundheitswissenschaften, Bielefeld, Germany
| | - Theda Borde
- Public Health, Alice Salomon Hochschule Berlin, Germany
| | - Jürgen Breckenkamp
- AG3 Epidemiology and International Public Health, Universität Bielefeld, Fakultät für Gesundheitswissenschaften, Bielefeld, Germany
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Ke P, Ke L, Liu B, Liu X. The Relationship Between Mental Health and Psychosocial Stress of Reservoir Migrants in the Middle Route of China's South-to-North Water Diversion Project (SNWDP): The Mediating Role of Social Support. Psychol Res Behav Manag 2021; 14:299-306. [PMID: 33727870 PMCID: PMC7955681 DOI: 10.2147/prbm.s297416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 02/22/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND South-North Water Diversion Project (SNWDP) migrants were vulnerable to developing mental health problems due to post-migration stresses and lack of social support. However, the evidence on the mental health, psychosocial stress and social support of SNWDP migrants and their interrelationships are limited and inconclusive. We aimed to explore the mechanism of influence of social support on the relationship between mental health and social psychosocial stress of SNWDP migrants. METHODS We performed a cross-sectional analysis of the data of 983 SNWDP migrants. The mental health status, psychosocial stress and social support of the participants were evaluated by Symptom Checklist-90-Revised (SCL-90-R), Psychosocial Stress Survey for Groups (PSSG) and Social Support Rating Scale (SSRS). Multiple stepwise regression model was used to analyze the data. RESULTS Among the 983 individuals, the average SCL-90-R score was 1.47, the PSSG score was 30.50, and the SSRS score was 40.30. The SCL-90-R was positively correlated with PSSG (r=0.483, P<0.001) and negatively correlated with SSRS (r=-0.257, P<0.001), PSSG was negatively correlated with SSRS (r=-0.516, P<0.001). Multiple regression analysis showed that PSSG and SSRS had significant effects on SCL-90-R prediction and that SSRS played a partial intermediary role in SCL-90-R and PSSG (46.87%). CONCLUSION The SNWDP migrants performed a strong correlation between social support, mental health and psychosocial stress. Social support plays a part role in mediating mental health and psychosocial stress.
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Affiliation(s)
- Pan Ke
- School of Public Health (SPH), Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, 430040, People’s Republic of China
| | - Li Ke
- School of Nursing, Hubei University of Medicine, Shiyan, 442000, People’s Republic of China
| | - Bing Liu
- School of Public Health, Hubei University of Medicine, Shiyan, 442000, People’s Republic of China
| | - Xiang Liu
- Health Management Center, Shiyan People’s Hospital, Affiliated Hubei University of Medicine, Shiyan, 442000, People’s Republic of China
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Caputo M, Bullara V, Mele C, Samà MT, Zavattaro M, Ferrero A, Daffara T, Leone I, Giachetti G, Antoniotti V, Longo D, De Pedrini A, Marzullo P, Remorgida V, Prodam F, Aimaretti G. Gestational Diabetes Mellitus: Clinical Characteristics and Perinatal Outcomes in a Multiethnic Population of North Italy. Int J Endocrinol 2021; 2021:9474805. [PMID: 34987576 PMCID: PMC8720593 DOI: 10.1155/2021/9474805] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 12/14/2021] [Indexed: 11/17/2022] Open
Abstract
AIM To evaluate clinical characteristics and perinatal outcomes in a heterogeneous population of Caucasians born in Italy and High Migration Pressure Countries (HMPC) women with GDM living in Piedmont, North Italy. METHODS We retrospectively analyzed data from 586 women referring to our unit (2015-2020). Epidemiological (age and country of origin) and clinical-metabolic features (height, weight, family history of DM, parity, previous history of GDM, OGTT results, and GDM treatment) were collected. The database of certificates of care at delivery was consulted in relation to neonatal/maternal complications (rates of caesarean sections, APGAR score, fetal malformations, and neonatal anthropometry). RESULTS 43.2% of women came from HMPC; they were younger (p < 0.0001) and required insulin treatment more frequently than Caucasian women born in Italy (χ 2 = 17.8, p=0.007). Higher fasting and 120-minute OGTT levels and gestational BMI increased the risk of insulin treatment (OGTT T0: OR = 1.04, CI 95% 1.016-1.060, p=0.005; OGTT T120: OR = 1.01, CI 95% 1.002-1.020, p=0.02; BMI: OR = 1.089, CI 95% 1.051-1.129, p < 0.0001). Moreover, two or more diagnostic OGTT glucose levels doubled the risk of insulin therapy (OR = 2.03, IC 95% 1.145-3.612, p=0.016). We did not find any association between ethnicities and neonatal/maternal complications. CONCLUSIONS In our multiethnic GDM population, the need for intensive care and insulin treatment is high in HPMC women although the frequency of adverse peripartum and newborn outcomes does not vary among ethnic groups. The need for insulin therapy should be related to different genetic backgrounds, dietary habits, and Nutrition Transition phenomena. Thus, nutritional intervention and insulin treatment need to be tailored.
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Affiliation(s)
- M. Caputo
- Endocrinology, Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy
- Department of Health Sciences, Università del Piemonte Orientale, Novara, Italy
| | - V. Bullara
- SCDU Endocrinologia, AOU “Maggiore della Carità” Novara, Novara, Italy
| | - C. Mele
- Endocrinology, Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy
| | - M. T. Samà
- SCDU Endocrinologia, AOU “Maggiore della Carità” Novara, Novara, Italy
| | - M. Zavattaro
- SCDU Endocrinologia, AOU “Maggiore della Carità” Novara, Novara, Italy
| | - A. Ferrero
- Endocrinology, Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy
| | - T. Daffara
- Endocrinology, Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy
| | - I. Leone
- Endocrinology, Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy
| | - G. Giachetti
- Endocrinology, Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy
| | - V. Antoniotti
- Department of Health Sciences, Università del Piemonte Orientale, Novara, Italy
| | - D. Longo
- Gynecology and Obstetrics, Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy
| | - A. De Pedrini
- Gynecology and Obstetrics, Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy
| | - P. Marzullo
- Endocrinology, Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy
- IRCCS Istituto Auxologico Italiano, Laboratory of Metabolic Research, Novara, Italy
| | - V. Remorgida
- Gynecology and Obstetrics, Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy
| | - F. Prodam
- Endocrinology, Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy
- Department of Health Sciences, Università del Piemonte Orientale, Novara, Italy
| | - G. Aimaretti
- Endocrinology, Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy
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Stanek M, Requena M, Del Rey A, García-Gómez J. Beyond the healthy immigrant paradox: decomposing differences in birthweight among immigrants in Spain. Global Health 2020; 16:87. [PMID: 32972424 PMCID: PMC7513521 DOI: 10.1186/s12992-020-00612-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 08/21/2020] [Indexed: 11/18/2022] Open
Abstract
Background The healthy immigrant paradox refers to the unexpected health advantages of immigrant groups settled in host countries. In this population-based study we analyze immigrant advantages in birthweight decomposing differences between infants born to immigrant mothers from specific origins. Method Using publicly available data from Spanish Vital Statistics for the period 2007–2017, differential birthweights among several groups of immigrants were estimated with an ordinary least squares regression. The Oaxaca–Blinder regression-based decomposition method was then applied to identify the extent to which differences in birthweight between groups corresponded to compositional disparities or to other factors. Results Our analysis of singleton live births to migrant mothers in Spain between 2007 and 2017 (N = 542,137) confirmed the healthy immigrant paradox for certain immigrant populations settled in Spain. Compared with infants born to mothers from high-income countries, the adjusted birthweight was higher for infants born to mothers from non-high- income European countries (33.2 g, 95% CI: 28.3–38.1, P < 0.01), mothers from African countries (52.2 g, 95% CI: 46.9–57.5, P < 0.01), and mothers from Latin American countries (57.4 g, 95% CI: 52.9–61.3, P < 0.01), but lower for infants born to mothers from Asian non-high-income countries (− 31.4 g, 95% CI: − 38.4 to − 24.3, P < 0.01). Decomposition analysis showed that when compared with infants born to mothers from high-income countries, compositional heterogeneity accounts for a substantial proportion of the difference in birthweights. For example, it accounts for 53.5% (95% CI: 24.0–29.7, P < 0.01) of the difference in birthweights for infants born to mothers from non-high-income European countries, 70.9% (95% CI: 60–66.7, P < 0.01) for those born to mothers from African countries, and 38.5% (95% CI: 26.1–29.3, P < 0.01) for those born to mothers from Latin American countries. Conclusions Our results provide strong population-based evidence for the healthy immigrant paradox in birthweight among certain migrant groups in Spain. However, birth outcomes vary significantly depending on the origins of migrant subpopulations, meaning that not all immigrant groups are unexpectedly healthier. A significant portion of the perinatal health advantage of certain immigrant groups is only a by-product of their group composition (by age, parity, marital status, socioeconomic status, and citizenship of mother, age and migratory status of father and type of delivery) and does not necessarily correspond to other medical, environmental, or behavioral factors.
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Affiliation(s)
- Mikolaj Stanek
- Department of Sociology and Communication, University of Salamanca, Edificio F.E.S. Avda Francisco Tomás y Valiente s/n Salamanca, 37007, Salamanca, Spain.
| | - Miguel Requena
- Department of Sociology II, UNED, C/Obispo Trejo 2, 28040, Madrid, Spain
| | - Alberto Del Rey
- Department of Sociology and Communication, University of Salamanca, Edificio F.E.S. Avda Francisco Tomás y Valiente s/n Salamanca, 37007, Salamanca, Spain
| | - Jesús García-Gómez
- Department of Sociology and Communication, University of Salamanca, Edificio F.E.S. Avda Francisco Tomás y Valiente s/n Salamanca, 37007, Salamanca, Spain
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13
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Seghieri G, Di Cianni G, Seghieri M, Lacaria E, Corsi E, Lencioni C, Gualdani E, Voller F, Francesconi P. Risk and adverse outcomes of gestational diabetes in migrants: A population cohort study. Diabetes Res Clin Pract 2020; 163:108128. [PMID: 32259610 DOI: 10.1016/j.diabres.2020.108128] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 02/11/2020] [Accepted: 03/23/2020] [Indexed: 12/12/2022]
Abstract
AIMS To evaluate the risk of gestational diabetes (GDM) and of neonatal/maternal complications (macrosomia, large for gestational age (LGA), cesarean sections, preterm deliveries, neonatal distress and fetal malformations) among women coming from High Migration Pressure Countries (HMPC), compared to native (Italian) mothers. METHODS Risks of GDM and related neonatal/maternal complications were evaluated in a cohort of 581,073 Italian compared with 105,111 HMPC women of age 15-45 yr, resident in Tuscany, Italy along years 2012-2017, delivering 122,652 singleton live births (18,596 from HMPC mothers). RESULTS HMPC women, compared to Italian ones, were at higher risk of GDM (OR: 1.586; 1.509-1.666;p < 0.0001), peaking for women originating from South Asia (OR:3.0.49; 2.618-3.553;p < 0.0001). GDM was associated with increased risk of preterm delivery and cesarean sections, while migrants, regardless of GDM, were burdened by a higher risk of all considered complications. The rise in all these risks, including macrosomia or LGA however, disappeared, after addition of interaction term GDM × HMPC ethnicity. CONCLUSION Compared to Italian mothers, HMPC women had higher risk of GDM and of all considered adverse events. The addiction of the interaction term GDM × HMPC ethnicity in the predictive model, however reversed the rise in risk of all HMPC associated adverse outcomes.
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Affiliation(s)
- Giuseppe Seghieri
- Epidemiology Unit, Regional Health Agency of Tuscany, Florence, Italy.
| | - Graziano Di Cianni
- Diabetes and Metabolic Diseases Unit, Health Local Unit North-West Tuscany, Livorno, Italy
| | - Marta Seghieri
- Diabetes and Metabolic Diseases Unit, "San Giovanni di Dio" Hospital, Florence, Italy
| | - Emilia Lacaria
- Diabetes and Metabolic Diseases Unit, Health Local Unit North-West Tuscany, Livorno, Italy
| | - Edoardo Corsi
- Diabetes and Metabolic Diseases Unit, Health Local Unit North-West Tuscany, Livorno, Italy
| | - Cristina Lencioni
- Diabetes and Metabolic Diseases Unit, Health Local Unit North-West Tuscany, Lucca, Italy
| | - Elisa Gualdani
- Epidemiology Unit, Regional Health Agency of Tuscany, Florence, Italy
| | - Fabio Voller
- Epidemiology Unit, Regional Health Agency of Tuscany, Florence, Italy
| | - Paolo Francesconi
- Epidemiology Unit, Regional Health Agency of Tuscany, Florence, Italy
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14
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Wändell P, Fredrikson S, Carlsson AC, Li X, Gasevic D, Sundquist J, Sundquist K. Epilepsy in second-generation immigrants: a cohort study of all children up to 18 years of age in Sweden. Eur J Neurol 2019; 27:152-159. [PMID: 31340083 DOI: 10.1111/ene.14049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 07/10/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND PURPOSE Our purpose was to study the association between country of birth and incident epilepsy in second-generation immigrants in Sweden. METHODS The study population included all children (n = 4 023 149) aged up to 18 years in Sweden. Epilepsy was defined as at least one registered diagnosis of epilepsy in the National Patient Register. The incidence of epilepsy, using individuals with Swedish-born parents as referents, was assessed by Cox regression, expressed in hazard ratios (HRs) and 95% confidence interval (95% CI). All models were stratified by sex and adjusted for age, geographical residence in Sweden, educational level, marital status, neighbourhood socioeconomic status and comorbid conditions, also using data from the Total Population Register. RESULTS A total of 26 310 individuals had a registered epilepsy event, i.e. 6.5/1000 (6.6/1000 amongst boys and 6.3/1000 amongst girls). After adjustment, the risk of epilepsy was lower than in children of Swedish-born parents. Amongst girls the significant HR was 0.85 (95% CI 0.81-0.88), but in boys only when adjusting also for comorbidity (HR 0.96, 95% CI 0.92-0.99). Amongst specific immigrant groups, a higher incidence of epilepsy was observed amongst boys with parents from Turkey and Africa, but not when adjusting for comorbidity, and a lower risk was observed in many other groups (boys with parents from Latvia, girls with parents from Finland, Iceland, Southern Europe, countries from the former Yugoslavia, and Asia). CONCLUSION The risk of epilepsy was lower in second-generation immigrant children compared to children with Swedish-born parents, but with substantial differences between different immigrant groups.
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Affiliation(s)
- P Wändell
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - S Fredrikson
- Department of Clinical Neuroscience, Division of Neurology, Karolinska Institutet Huddinge, Stockholm, Sweden
| | - A C Carlsson
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - X Li
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - D Gasevic
- Usher Institute of Population Health Sciences and Informatics, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK.,School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - J Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden.,Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Center for Community-based Healthcare Research and Education (CoHRE), Department of Functional Pathology, School of Medicine, Shimane University, Matsue, Japan
| | - K Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden.,Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Center for Community-based Healthcare Research and Education (CoHRE), Department of Functional Pathology, School of Medicine, Shimane University, Matsue, Japan
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15
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Lubotzky-Gete S, Shoham-Vardi I, Sheiner E. Comparing Pregnancy Outcomes of Immigrants from Ethiopia and the Former Soviet Union to Israel, to those of Native-Born Israelis. J Immigr Minor Health 2018; 19:1296-1303. [PMID: 27557681 DOI: 10.1007/s10903-016-0484-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
To compare pregnancy outcomes of immigrants from Former-Soviet-Union (FSUI) and Ethiopia (EI) to those of Jewish-native-born Israelis (JNB), in context of universal health insurance. Birth outcomes of all singletons born in Soroka-University Medical-Center (1998-2011) of EI (n = 1,667) and FSUI (n = 12,920) were compared with those of JNB (n = 63,405). Low birthweight rate was significantly higher among EI (11.0 %) and slightly lower (7.0 %) among FSUI, compared to JNB (7.5 %). Preterm-delivery rates were similar to those of JNB. Both immigrant groups had significantly (p < 0.001) higher rates of perinatal mortality (PM) than JNB (21/1000 in EI, and 11/1000 in FSUI, compared to 9/1000). Using multivariable GEE models both immigrant groups had significantly increased risk for PM; however, EI had twice as much FSUI origin (OR 2.3, 95 % CI 1.6-3.4, and OR 1.3, 95 % CI 1.1-1.6, respectively). Universal health care insurance does not eliminate excess PM in immigrants, nor the gaps between immigrant groups.
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Affiliation(s)
- Shakked Lubotzky-Gete
- Department of Epidemiology and Health Services Evaluation, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
| | - Ilana Shoham-Vardi
- Department of Epidemiology and Health Services Evaluation, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Eyal Sheiner
- Department of Epidemiology and Health Services Evaluation, Ben-Gurion University of the Negev, Beer-Sheva, Israel.,Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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16
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Chen W, Ling L, Renzaho AMN. Building a new life in Australia: an analysis of the first wave of the longitudinal study of humanitarian migrants in Australia to assess the association between social integration and self-rated health. BMJ Open 2017; 7:e014313. [PMID: 28298368 PMCID: PMC5353341 DOI: 10.1136/bmjopen-2016-014313] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 12/29/2016] [Accepted: 02/16/2017] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVES To assess the relationship between social integration and physical and mental health among humanitarian migrants (HMs) in Australia. DESIGN, SETTING AND PARTICIPANTS We used the recently released first wave of data from the 2013 'Building a New Life in Australia' survey, which is an ongoing nationwide longitudinal study. A total of 2399 HMs participated in the survey. MAIN OUTCOME MEASURES Self-rated physical health was measured using four items selected from the SF-36 which is a generic measure of health status. The 6-item Kessler Screening Scale for Psychological Distress (K6) was used to measure mental health. Social integration was measured using four dimensions: economic integration, acculturation, social capital and self-identity. RESULTS More than half (63%), 47% and 49% of participants self-rated well on the general health, physical function and role-physical dimensions, respectively and 46% reported not having any bodily pain. Seventeen per cent of participants had a serious mental illness. There was a positive relationship between social integration and physical and mental health. That is, factors associated with better health included less financial hardship (economic integration dimension), better English proficiency and self-sufficiency (acculturation dimension), having the capacity to communicate with locals, having friends from different ethnic/religious groups and attending a place of worship weekly or more often (social capital dimension) and feeling welcomed and having a strong sense of belonging in Australia (self-identity dimension). CONCLUSIONS Using a more comprehensive framework of social integration, we found that greater social integration was associated with better physical and mental health outcomes among HMs. Social integration should be embedded in HMs' resettlement programmes in order to reduce migration-related health inequities.
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Affiliation(s)
- Wen Chen
- School of Public Health, Faculty of Medical Statistics and Epidemiology, Sun Yat-sen University, Guangzhou, China
- Center for Migrant Health Policy, Sun Yat-sen University, Guangzhou, China
- Humanitarian and Development Research Initiative, School of Social Science and Psychology, Western Sydney University, Penrith, New South Wales, Australia
| | - Li Ling
- School of Public Health, Faculty of Medical Statistics and Epidemiology, Sun Yat-sen University, Guangzhou, China
- Center for Migrant Health Policy, Sun Yat-sen University, Guangzhou, China
| | - Andre M N Renzaho
- Humanitarian and Development Research Initiative, School of Social Science and Psychology, Western Sydney University, Penrith, New South Wales, Australia
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