1
|
Lee PC, Chen YL, Yang HJ. Effects of length of residency on the development of physical and mental illnesses in immigrant women in Taiwan: a retrospective cohort study using nationwide data. BMJ Open 2024; 14:e078259. [PMID: 38355184 PMCID: PMC10868269 DOI: 10.1136/bmjopen-2023-078259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 01/31/2024] [Indexed: 02/16/2024] Open
Abstract
OBJECTIVES The majority of female immigrants who are married in Taiwan often face a variety of stresses, which may lead to physical or mental illness. Yet few studies have validated the impact of length of residency on physical and mental health using large-scale data. This study combined five nationwide databases and explored the impact of length of residency in Taiwan on the physical and mental health of female marriage immigrants. DESIGN This is a retrospective cohort study. SETTING Taiwan. PARTICIPANTS A total of 168 202 female immigrants, who were registered in the national health insurance database from 2001 to 2017, were enrolled for analysis. MEASURE The length of residency was taken as the period from their first appearance in the national health insurance database to the end of 2017. Hypertension and diabetes were chosen as indices of physical health and depression as an index of mental health. Diagnosis standards were based on the International Classification of Disease, ninth or 10th Revision. RESULTS The physical and mental health of the immigrants deteriorated with increasing time of residence in Taiwan. Immigrants who had resided in Taiwan for 5-10 years or ≥10 years, respectively, had a 5.8-fold (95% CI: 3.46 to 9.74) or 6.29-fold (95% CI: 4.61 to 8.59) higher adjusted risk of developing hypertension; a 3.97-fold (95% CI: 2.54 to 6.21) or 9.18-fold (95% CI: 5.48 to 15.38) higher adjusted risk of developing diabetes; and a 5.01-fold (95% CI: 3.14 to 8.01) or 12.19-fold (95% CI: 8.65 to 17.18) higher adjusted risk of developing depression than their counterparts who had lived in Taiwan for ≤5 years. CONCLUSION These findings suggest the time elapsed since migration can be a factor in the deterioration of both physical and mental health among female marriage immigrants in Taiwan.
Collapse
Affiliation(s)
- Pei-Chen Lee
- Department of Public Health, Chung Shan Medical University, Taichung, Taiwan
| | - Yi-Lung Chen
- Department of Healthcare Administration, Asia University, Taichung, Taiwan
- Department of Psychology, Asia University, Taichung, Taiwan
| | - Hao-Jan Yang
- Department of Public Health, Chung Shan Medical University, Taichung, Taiwan
- Department of Family and Community Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
| |
Collapse
|
2
|
Marchesini G, Gibertoni D, Giansante C, Perlangeli V, Grilli R, Scudeller L, Descovich C, Pandolfi P. Impact of migration on diabetes burden: audit in the metropolitan area of Bologna, Italy. J Endocrinol Invest 2024; 47:411-420. [PMID: 37474878 PMCID: PMC10859330 DOI: 10.1007/s40618-023-02157-6] [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: 06/05/2023] [Accepted: 07/10/2023] [Indexed: 07/22/2023]
Abstract
PURPOSE To investigate the impact of diabetes in immigrants on the Italian healthcare system, as well as their compliance with standard protocols of control and treatment. METHODS The prevalence of immigrants with diabetes living in the metropolitan area of Bologna (about 1 million inhabitants) in 2019 was investigated using a database containing all subjects in active follow-up for diabetes, based on antidiabetic drug use, disease-specific copayment exemption, ICD-9 codes, continuous care in diabetes units. Country of origin was derived from fiscal code. RESULTS The overall prevalence of diabetes (n = 53,941; 51.8% males, median age 64) was 6.1% in both Italy-born and immigrant cohorts. Immigrant prevalence was 12.4%, moderately higher than that observed in the total population (12.2%). Diabetes risk was increased in the whole immigrant cohort (odds ratio (OR) 1.74; 95% Confidence Interval (CI) 1.69-1.79). Among cases with incident diabetes, the proportion of immigrants (median age, 49 vs. 65 in Italy-born individuals) increased progressively from 11.7% to 26.5% from 2011 to 2019 (males, 8.9-21.0%; females, 14.9-32.8%) in all age groups, particularly in young adults, but also in older subjects. Metabolic control was lower in immigrants, as was adherence to shared diagnostic and therapeutic protocols, without systematic differences in antidiabetic drug use, but much lower use of drugs for comorbid conditions. CONCLUSIONS The population with diabetes in the metropolitan area of Bologna is rapidly changing. Quality improvement initiatives are needed to reduce the burden for the universalistic Italian health care system generated by the rapidly-growing high-risk immigrant population.
Collapse
Affiliation(s)
- G Marchesini
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
| | - D Gibertoni
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - C Giansante
- Department of Public Health, Local Health Authority of Bologna, Bologna, Italy
| | - V Perlangeli
- Department of Public Health, Local Health Authority of Bologna, Bologna, Italy
| | - R Grilli
- Evaluation and Policy Unit, U.O. Health Services Research, Local Health Authority of Romagna, Ravenna, Italy
| | - L Scudeller
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - C Descovich
- Department of Public Health, Local Health Authority of Bologna, Bologna, Italy
| | - P Pandolfi
- Department of Public Health, Local Health Authority of Bologna, Bologna, Italy
| |
Collapse
|
3
|
Avancini A, Baldassari I, Gargano G, Lu M, Jing H, Zhao H, Zhang J, Sieri S, Mussa FR, Krogh V, Apolone G, Pala V. Protocol for the CHINT study: a cross-sectional observational study of risk factors for cancer and other non-communicable diseases in the Chinese community of Milan. BMJ Open 2024; 14:e073512. [PMID: 38233062 PMCID: PMC10806820 DOI: 10.1136/bmjopen-2023-073512] [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: 03/07/2023] [Accepted: 01/07/2024] [Indexed: 01/19/2024] Open
Abstract
INTRODUCTION The Chinese community in Italy is the largest in Europe. The area of Milan hosts the largest Chinese Italian community-about 41 000 people. Since little is known of the health practices of Chinese persons in Italy, we designed the CHINT study (survey of risk factors for cancer and other non-communicable diseases (NCDs) in the Chinese community of Milan) to investigate lifestyle-related risk factors for these diseases in this community. We expect the study to reveal potentially unhealthy lifestyle behaviours that may be addressed in future prevention programmes. METHODS AND ANALYSIS The CHINT study is a cross-sectional study on a sample of around 600 adults recruited from the Chinese community of Milan and surrounding areas. The non-random sample is clustered by age, sex, occupation and socioeconomic characteristics and is being recruited with the active cooperation of stakeholders within the Chinese community. The study employs face-to-face meetings, text messaging and WeChat. At the first recruitment meeting, participants' physical measurements are taken and a lifestyle questionnaire is administered which enquires about physical activity, the consumption of salt, fruit and vegetables, tobacco and alcohol, and the presence of other risk factors for NCDs. A food frequency questionnaire is in preparation. By analysis of physical data and the results of the two questionnaires, the prevalence and distribution of NCD risk factors, and characteristics associated with these factors, will be identified. Factors associated with recruitment and compliance/retention will be investigated to identify predictors of willingness to participate future intervention studies. ETHICS AND DISSEMINATION The study has been approved by the ethics committee of the Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Italy. All participants are required to provide written informed consent. Findings will be disseminated through peer-reviewed scientific publications, conferences and public meetings involving the Chinese community and the lay public.
Collapse
Affiliation(s)
- Alice Avancini
- Department of Oncology, University of Verona, Verona, Veneto, Italy
| | - Ivan Baldassari
- Department of Epidemiology and Data Science, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Giuliana Gargano
- Department of Epidemiology and Data Science, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Ming Lu
- Clinical Epidemiology Unit, Shandong University Qilu Hospital, Jinan, China
| | - Hao Jing
- China Agricultural University, Beijing, China
| | - Hongwei Zhao
- Texas A&M University, College Station, Texas, USA
| | - Ji Zhang
- Karolinska Institute, Stockholm, Sweden
| | - Sabina Sieri
- Department of Epidemiology and Data Science, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Francesca Romana Mussa
- Department of Epidemiology and Data Science, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
- Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Milano, Lombardia, Italy
| | - Vittorio Krogh
- Department of Epidemiology and Data Science, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Giovanni Apolone
- General Directorate for Scientific Research, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Lombardia, Italy
| | - Valeria Pala
- Department of Epidemiology and Data Science, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| |
Collapse
|
4
|
Rosenthal T, Touyz RM, Oparil S. Migrating Populations and Health: Risk Factors for Cardiovascular Disease and Metabolic Syndrome. Curr Hypertens Rep 2022; 24:325-340. [PMID: 35704140 PMCID: PMC9198623 DOI: 10.1007/s11906-022-01194-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2022] [Indexed: 11/09/2022]
Abstract
PURPOSE OF REVIEW To summarize results of recent studies of migrants in Europe and North America and ongoing efforts to adapt strategies to provide them with inclusive sensitive health care. RECENT FINDINGS Major predisposing factors for developing hypertension, obesity, diabetes, and the metabolic syndrome in migrating populations and refugees were identified. Susceptibility to the metabolic syndrome is predominantly due to environmental factors and psychological stress. Acculturation also contributes to the emergence of cardiovascular (CV) risk factors in first-generation adult immigrants. Increased risk for later development of hypertension and dyslipidemia has also been detected in adolescent immigrants. Targets for public health efforts were based on data that show important differences in CV risk factors and prevalence of the metabolic syndrome among ethnic immigrant groups. Studies in young adults focused on lifestyle and dietary behaviors and perceptions about weight and body image, while the focus for older adults was end-of-life issues. Two important themes have emerged: barriers to health care, with a focus on cultural and language barriers, and violence and its impact on immigrants' mental health.
Collapse
Affiliation(s)
- Talma Rosenthal
- Department of Physiology and Pharmacology, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Rhian M Touyz
- Research Institute of McGill University Health Centre, Montreal, QC, Canada
| | - Suzanne Oparil
- Vascular Biology & Hypertension Program, Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, 1720 2nd Avenue South, Birmingham, AL, 35294-0007, USA.
| |
Collapse
|
5
|
Castellini G, Pellegrino A, Tarchi L, Calabrese M, Boddi M, Ricca V, Costanzo G, Modesti PA. Body-Size Perception among First-Generation Chinese Migrants in Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:6063. [PMID: 35627600 PMCID: PMC9141417 DOI: 10.3390/ijerph19106063] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 05/09/2022] [Accepted: 05/11/2022] [Indexed: 02/04/2023]
Abstract
Body-size perception is an important factor in motivating people to lose weight. Study aim was to explore the perception of body image among first-generation Chinese migrants living in Italy. A sample of 1258 Chinese first-generation immigrants and of 285 native Italians living in Prato, Italy, underwent blood pressure measurements, blood tests (with measurement of glucose, cholesterol, and triglycerides), and anthropometric measurements. Body-size perception was investigated with Pulvers’ figure rating scale using logistic or linear multivariable regression adjusted for age, gender, BMI, education and years spent in Italy. Chinese migrants had lower BMI and discrepancy score (preferred minus current body size) than Italians (p < 0.05 for both). After a logistic regression analysis, the discrepancy score remained lower in the Chinese than in the Italian cohort independently from BMI and other confounders (OR 0.68; 95%CI 0.50 to 0.92). In the Chinese cohort, female gender, BMI and years spent in Italy were positive determinants of discrepancy score (desire to be thinner), while age showed negative impact (p < 0.05 for all). Overweight is an important risk factor for diabetes, a very prevalent condition among first-generation Chinese migrants. The present study offers useful information and suggests the need for prevention programs specifically addressed to men.
Collapse
Affiliation(s)
- Giovanni Castellini
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, 50121 Florence, Italy; (G.C.); (L.T.); (V.R.)
| | - Alessio Pellegrino
- Department of Experimental and Clinical Medicine, University of Florence, 50121 Florence, Italy; (M.B.); (P.A.M.)
| | - Livio Tarchi
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, 50121 Florence, Italy; (G.C.); (L.T.); (V.R.)
| | - Maria Calabrese
- Diabetology Unit, Ospedale Misericordia e Dolce, 59100 Prato, Italy;
| | - Maria Boddi
- Department of Experimental and Clinical Medicine, University of Florence, 50121 Florence, Italy; (M.B.); (P.A.M.)
| | - Valdo Ricca
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, 50121 Florence, Italy; (G.C.); (L.T.); (V.R.)
| | | | - Pietro Amedeo Modesti
- Department of Experimental and Clinical Medicine, University of Florence, 50121 Florence, Italy; (M.B.); (P.A.M.)
| |
Collapse
|