The academic performance of students with a migrant background: evidence from a cohort enrolled at Sapienza University of Rome

This study investigates the demographic characteristics and academic performances of foreign students with an Italian educational background in a cohort of 1st-year Bachelor students enrolled at Sapienza University of Rome, in the a.y. 2012/2013, comparing them to Italian and to International students. First, we employed a discrete-time competing risk hazard model to analyse differences in academic performances between Italian, foreign students with an Italian educational background and foreign students with a foreign educational background. Second, we applied regression trees to investigate final grades and the time-to-degree completion of Bachelor’s degree holders. Results show differences in the academic performances of foreign students with an Italian educational background compared to Italian students. Policies are needed, these results suggest, that strengthen opportunities for students from a migrant background since high school.

Mortality differences between migrants and Italians residing in Rome before, during, and in the aftermath of the great recession. A longitudinal cohort study from 2001 to 2015

Background

In Europe, one of the most consistent findings is that of migrant mortality advantage in high-income countries. Furthermore, the literature shows that economic shocks, which bring worse health outcomes, can severely affect the most disadvantaged individuals. We analyse differences and changes in all-cause mortality between Italians and migrants residing in Rome before, during, and in the aftermath of the Great Recession (2001–2015) by birth-cohort.

Methods

The analysis is a longitudinal open cohort study. Mortality data come from the Register of the Causes of Death (58,637 deaths) and the population denominator (n = 2,454,410) comes from the Municipal Register of Rome. By comparing three time-periods (2001–2005, 2006–2010, and 2011–2015), we analyse all-cause mortality of Rome residents born, respectively, in the intervals 1937–1976, 1942–1981, 1947–1986 (aged 25–64 years at entry into observation). Computing birth-cohort-specific death rates and applying parametric survival models with age as the time-scale, we compare mortality differences between migrants and Italians by gender, area of origin, and time-period.

Results

Overall, we find a lower risk of dying for migrants than Italians regardless of gender (Women: HR = 0.61, 95% CI 0.56–0.66; Men: HR = 0.49, 95% CI 0.45–0.53), and a lower death risk over time for the total population. Nevertheless, such a pattern changes according to gender and migrants’ area of origin.

Conclusion

Given the relevance of international migrations in Europe, studying migrants’ health has proved increasingly important. The deterioration in migrant health and the gradual weakening of migrants’ mortality advantage is likely to become a public health issue with important consequences for the healthcare system of all European countries.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-12176-8.

[Evaluating health care of the immigrant population in Italy through indicators of a national monitoring system]

OBJECTIVES

to evaluate maternal and child healthcare, avoidable hospitalisation, access to emergency services among immigrants in Italy.

DESIGN

cross sectional study of some health and health care indicators among Italian and foreign population residing in Italy in 2016-2017.

SETTING AND PARTICIPANTS

indicators based on the national monitoring system coordinated by the Italian National Institute for Health, Migration and Poverty (INMP) of Rome, calculated on perinatal care (CedAP), hospital discharge (SDO), emergency services (EMUR) archives for the years 2016-2017, by of the following regions: Piedmont, Trento, Bolzano, Emilia-Romagna, Tuscany, Umbria, Lazio, Basilicata, Sicily.

MAIN OUTCOME MEASURES

number and timeliness of pregnancy visits, number of ultrasounds, invasive prenatal investigations; perinatal mortality rates, birth weight, Apgar score at 5 minutes, need for neonatal resuscitation; standardized rates of avoidable hospitalisation and access to emergency services by triage code.

RESULTS

more often than Italians, immigrant women have during pregnancy: less than 5 gynaecological examination (16.3% vs 8.5%), first examination after the 12th week of gestational age (12.5% vs 3.8%), less than 2 ultrasounds (3.8% vs 1.0%). Higher perinatal mortality rates among immigrants compared to Italians (3.6 vs 2.3 x1,000). Higher standardized rates (x1,000) among immigrants compared to Italians of avoidable hospitalisation (men: 2.1 vs 1.4; women: 0.9 vs 0.7) and of white triage codes in emergency (men: 62.0 vs 32.7; women: 52.9 vs 31.4).

CONCLUSIONS

study findings show differences in access and outcomes of healthcare between Italians and immigrants. National monitoring system of indicators, coordinated by INMP, represents a useful tool for healthcare intervention policies aimed to health equity.

Co-Resident Grandparent: A Burden or a Relief? A Comparison of Gender Roles between Italians and Migrants

In the international literature, the principal task of grandparents is generally recognized as helping their children in providing childcare. Most of those studies analyzed grandparental childcare on the whole population, and few have focused on co-resident grandparent(s), which turns out to be an understudied topic in the European context. Further, most of them investigated the effect of childcare on grandparents’ health status. However, the elderly population can both provide and receive care. Using two Italian surveys released by the Italian National Institute of Statistics, the “Social Condition and Integration of Foreign Citizen (2011–2012)” and the “Multiscopo–Aspetti della vita quotidiana (2011)”, the study aims to analyze differences in grandparental childcare provided by co-resident grandparents between Italian and migrant households, considering both the role played by grandparents’ self-rated health (SRH) and gender. We identify four grandparents’ profiles by combining grandparents’ SRH and their attitude towards looking after their grandchild(ren). Subsequently, we apply multinomial logistic regressions, and we compute average marginal effects to facilitate results interpretations. Results display that migrant co-resident grandparents are less likely to declare bad SRH and no-childcare and are more likely to declare good SRH and to provide childcare than Italian grandparents. Moreover, when considering gender differences, the real role is revealed: we find that women have a higher probability to report poor health and care for their grandchild(ren) than men. Such findings illustrate that grandparents’ cohabitation decision is based upon the difference between their need for care and offer to care, and second, in addition to migrant status and SRH, gender is a determinant of grandparents’ childcare: women look after their grandchild(ren) more than men, whatever their health status.

Disparities in emergency department use between Italians and migrants residing in Rome, Italy: the Rome Dynamic Longitudinal Study from 2005 to 2015

Background

The Emergency Department (ED) can be considered an indicator of accessibility and quality and can be influenced in period of economic downturns. In the last fifteen years, the number of migrants in Italy has doubled (from 2.4 million in 2005 to 5.2 in 2019, 4.1 and 8.7% of the total population, respectively). However, evidence about migrants’ healthcare use is poor, and no studies focused on the ED utilisation rate during the Great Recession are available. This study aims to analyse trends in all-cause and cause-specific ED utilisation among migrants and Italians residing in Rome, Italy, before and after 2008.

Methods

Longitudinal study based on data from the Municipal Register of Rome linked to the Emergency Department Register from 2005 to 2015. We analysed 2,184,467 individuals, aged 25–64 in each year. We applied a Hurdle model to estimate the propensity to use the ED and to model how often individuals accessed the ED.

Results

Migrants were less likely to be ED users than Italians, except for Africans (RR = 1.46, 95%CI 1.40–1.52) and Latin Americans (RR = 1.04, 95%CI 1.00–1.08) who had higher all-cause utilisation rates than non-migrants. Compared to the pre-2008 period, in the post-2008 we found an increase in the likelihood of being an ED user (OR = 1.34, 95%CI 1.34–1.35), and a decrease in ED utilisation rates (RR = 0.96, 95%CI 0.96–0.97) for the whole population, with differences among migrant subgroups, regardless of cause.

Conclusions

This study shows differences in the ED utilisation between migrants and Italians, and within the migrant population, during the Great Recession. The findings may reflect differentials in the health status, and barriers to access primary and secondary care among migrants. In this regard, health policies and cuts in health spending measures may have played a key role, and interventions to tackle health and access disparities should include policy measures addressing the underlying factors, adopting a Health in All Policies perspective. Further researches focusing on specific groups of migrants, and on the causes and diagnoses related to the ED utilisation, may help to explain the differences observed.