Two-stage study (1990–2002) of North African immigrants in Italy

Length of residence and obesity risk among North African immigrant women in Italy

Obesity is one of the major risks for chronic health conditions. Immigrants from low- and middle-income to high-income countries show a tendency to weight gain, with the country of origin, lifestyle habits, socioeconomic status and length of residence as the main factors involved. Thus, the aim of this study was to analyze the association between fat distribution and obesity with length of residence and other socio-demographic variables in a sample of North African women migrated to Italy. Socio-demographic variables were collected by structured face-to-face interview. For the assessment of weight status and body composition, various anthropometric traits were directly measured by an expert anthropometrist. Data were analyzed using ANCOVA adjusted for age to test the differences between length of residence (divided into three groups) and logistic regression models adjusted for covariates to test the association between overweight and/or obesity and length of residence. Significant differences between the three groups were observed in waist circumference (p = 0.004), waist-to-hip ratio (p = 0.001), and upper arm muscularity (p = 0.025), with higher values in those with longer duration of residence. In the crude logistic regression model length of residence resulted positively associated with obesity with the odds of being obese increased by 2.4 times in long term immigrants [OR 2.364 (0.766; 7.296)]. After adjusting for covariate the association remained significant [OR 3.584 (0.779; 16.480)], and being poorly educated [OR 5.737 (0.641; 51.363)], unemployed [OR 6.892 (0.940; 50.528)] and not practicing regular physical activity [OR 17.736 (1.569; 200.418)] increased the odds ratio of being obese. In conclusion, length of residence, socioeconomic status, and physical activity were significantly correlated with obesity, with a longer duration of residence being positively associated with central fat adiposity and upper arm muscle area in North African migrant women.

The impact of migration on body weight: a review

Immigrants may be more vulnerable to obesity as a result of the immigration process. The aim of this article is to summarize current knowledge about the impact of immigration on body mass index (BMI). A systematic review was performed in accordance with PRISMA guidelines through a database search of scientific articles (last updated in August 2014). Thirty-nine articles were included and assessed. Results varied according to ethnic background, country of origin and host country. A consistent positive association between BMI and time since immigration was found among Hispanic, European and African immigrants. Less than half of the studies observed a positive association among Asian immigrants. The quality of the majority of the studies assessed was poor, reflecting a need to improve methodology and concept definition. Immigration appears to have a deteriorative effect on BMI. Underlying causes may include changes in nutrition and physical activity, psychological and social factors, and genetic susceptibility and these aspects should be included as moderator variables in future studies.

Prevalence of overweight and obesity in adults from North Africa

The share of North African immigrants in Europe is growing continuously. In this review, we aimed to systematically analyse and describe the literature on weight status and physical activity in North African adults, both in their home country and after immigration to Europe. Existing data on North African residents and on North African immigrants in Europe were analysed by a systematic search on PUBMED. There is a wide variation among countries in the prevalence of overweight/obesity, with immigrants showing higher values. The overall results revealed a higher prevalence of overweight and obesity in females than in males in North African residents. Females also show higher levels of obesity among immigrants. In particular, literature reports indicate that 1.3-47.8% of North African residents and 3.6-49.4% of North African immigrants in adult age are overweight or obese. Physical inactivity is higher than 20% in males and 40% in females in North African residents. The highest frequency of physically inactive or lightly active people among immigrants was observed in first-generation Sudanese and Moroccans in Amsterdam (males: 57.1%; females: 74.2%), with increasing rates in second-generation females. The results underline a higher health risk in North African immigrants than in residents. Specific public health strategies should be adopted in various populations of North African origin to control the obesity epidemic.

Immigrant health, our health

This final chapter reviews the main conclusions reached by the Special Issue articles in the areas of EUNAM (EU and North African Migrants: Health and Health Systems) activities, covering well-being, health status, disease panorama and use of health services of immigrants to the EU. The reviewed chapters show that immigrants are a vulnerable population experiencing, in some aspects, discrimination and hardship similar to the socially weakest national population groups. Immigration has changed the disease spectrum, particularly in infectious diseases and recessive conditions such as sickle cell disease and familial Mediterranean fever. Importantly, health questions of immigrants cannot be separated from those of any human health issues. An imminent new immigrant question for the EU will be the massive internal migration. Although the overall disease spectrum may not be vastly different between EU countries, the internal migrants will be exposed to lifestyle-dependent ill health and diseases probably in a similar way as did migrants from outside Europe. Migrant health research requires dedicated funding, which needs to come from central EU sources because multiple nationalities are involved. This funding should be able to project the course of health from the country of origin to the country of destination and back again, which was one of guidelines in the funding that initiated EUNAM.

Refugees in and out North Africa: a study of the Choucha refugee camp in Tunisia

In recent years, North African (NA) countries ceased to be emigration-only countries and are now on the verge of becoming immigration as well as transit countries for economic migrants and refugees. Contextual as well as structural long-term factors are driving these changes. The ongoing crises in Africa and the Middle East are prompting strong outflows of refugees, which are likely to induce NA countries to share some common public policy and public health concerns with European countries in a near future. This article highlights some aspects of these changes, from the study of the consequences of the 2011 Libyan crisis in Tunisia. It addresses individual trajectories and health concerns of refugees in and out North Africa from a study of the Choucha camp in Tunisia. The camp opened to immigrants from Libya during the 2011 crisis and accommodated the bulk of the refugees flow to Tunisia until July 2012. The study includes a monographic approach and a qualitative survey in the Choucha camp refugees. We describe the crisis history and the health response with a focus on the camp. We then address refugees' trajectories, and health needs and concerns from the interviews we collected in the camp in April 2012.

Anthropometric parameters in relation to glycaemic status and lipid profile in a multi-ethnic sample in Italy

OBJECTIVE

To examine the health status of ethnic minorities in Italy. Furthermore, we aimed to assess the association between anthropometric and blood parameters connected with health status.

DESIGN

A cross-sectional study. Anthropometric data were collected by direct measurements and blood glucose, total cholesterol and TAG were analysed.

SETTING

Bologna, northern Italy.

SUBJECTS

A multi-ethnic sample of adult immigrants and Roma.

RESULTS

Significant correlations between anthropometric and blood parameters were found. Among the ethnic groups, Roma males had the highest values of glucose, total cholesterol and TAG. In the females the situation was more balanced among ethnic groups.

CONCLUSIONS

The data from this survey indicate that poor health status is a very common problem among ethnic groups living in Italy, especially the Roma. The use of anthropometric parameters as rapid indicators of health status in screenings of a large number of subjects could be an effective and cheap method to provide preliminary indications on individuals or ethnic groups at greater risk of poor health.

Body image, body dissatisfaction and weight status in children from Emilia-Romagna (Italy): comparison between immigrant and native-born

BACKGROUND

Cross-sectional study among immigrant and native children from Emilia-Romagna (Italy).

AIM

The purpose of the present study was to examine the relative contribution of weight status, ethnicity and sex on body dissatisfaction in a sample of children from Emilia-Romagna (Italy).

SUBJECTS AND METHODS

Primary school children (226 immigrants and 1206 Italians) aged 6-11 years were measured: immigrant children were divided into Asians, Africans, Latin Americans and East Europeans. Height and weight were measured and Body Mass Index (BMI) was calculated. Body image perception was assessed using Body Silhouette Charts. A body dissatisfaction score (BDS) was derived by subtracting the "ideal self" from the "self" score.

RESULTS

Weight status disorders were higher in immigrants than in native-born males; Italian females had higher prevalence of underweight and overweight and lower prevalence of obesity than immigrants peers. BDS rose with the increase of weight status categories.

CONCLUSIONS

Awareness of body image size and increasing body dissatisfaction with higher weight status is established in childhood, regardless of ethnicity and gender.

Overweight and obesity among African immigrants in Oslo

BACKGROUND

Norway is experiencing an increase in overweight/obese adults, with immigrants from developing countries carrying a heavy burden. The aim of this study is to assess the prevalence of overweight and obesity among Somali immigrants in Oslo.

FINDINGS

A cross-sectional study involving 208 respondents aged 25 and over was conducted among Somali immigrants in Oslo, using a structured questionnaire. Prevalence of overweight/obesity varied by gender, with women having a significantly higher prevalence (66%) than men (28%). The mean BMI for females and males were 27.4 and 23.6, respectively. Similarly, 53% of women and 28% of men were abdominally obese. In a logistic regression analysis, both generalized and abdominal obesity were significantly associated with increasing duration of residence in Norway, and with being less physically active.

CONCLUSION

Public health policymakers should facilitate an environment that enables Somali immigrants, particularly women, to lead healthy lifestyles. In this time of epidemiological transition, health education in the areas of physical exercise and healthy eating should be a major focus for working with new immigrants.

Non-fatal suicidal behaviour in Padua, Italy, in two different periods: 1992-1996 and 2002-2006

PURPOSE

The WHO/EURO multicentre study on suicidal behaviour showed the lowest rates of suicide attempts in the Italian centre of Padua. Present study aims to discover changes in non-fatal suicidal behaviour rates and characteristics by comparing hospital-admitted subjects in two study periods (1992-1996 and 2002-2006).

METHODS

Data were obtained from the University Hospital of Padua. The crude prevalence rates of events and persons by year per 100,000 (subjects aged 15+ years) were calculated. Rate ratios, Chi-square tests and t tests were calculated.

RESULTS

The mean prevalence rate per year showed a significant increase during the second study period from 59.2 to 93.6 per 100,000 (RR = 1.58, 95%CI = 1.24-2.02). Changes were significant for both genders, but the increase was stronger in males. The proportion of subjects with non-fatal suicidal behaviour was highest in the youngest age group (15-29 years) in the first period and in adults (30-44 years) in the second period. The absolute number of subjects with non-fatal suicidal behaviour increased more than two times for adults aged 30-44 years. Changes in other age groups were minor. The absolute numbers of non-Italian-born subjects with non-fatal suicidal behaviour increased from 11 to 135 persons. The proportion of poisoning was significantly lower in the second period.

CONCLUSIONS

When comparing the time periods 1992-1996 and 2002-2006, there was a significant increase in suicidal events in Padua. There have been remarkable changes in the characteristics of suicide attempt(er)s. The most remarkable change was in the number of non-Italian-born subjects, who should be specifically targeted by suicide prevention activities.