Effect of social integration on family doctor contracting services among migrant populations in China: a national cross-sectional survey

BACKGROUND

The family doctor (FD) contracting system is a key reform in the development of the Chinese health system, and is considered an effective way to ensure equitable access to healthcare services. This study investigates the effects of social integration on FD contracting services among migrant populations.

METHODS

In total, 120,106 respondents from the 2018 China Migrants Dynamic Survey were included in this study. Two multivariate regression models were used to estimate the effect of social integration and other factors on FD contracting services among migrant populations.

RESULTS

This study found that only 14.0% of the migrant populations had a FD. Multiple dimensions of social integration and some covariates were shown to be positively associated with FD contracting services, including average monthly household income, local medical insurance (odds ratio [OR] = 1.34, 95% confidence interval [CI] = 1.29-1.39), employment status (OR = 0.86, 95% CI = 0.82-0.91), settlement intention (OR = 1.15, 95% CI = 1.09-1.22), received health education (OR = 4.88, 95% CI = 4.51-5.27), sex (OR = 1.16, 95% CI = 1.12-1.20), age (OR = 1.66, 95% CI = 1.51-1.82), marital status (OR = 1.38, 95% CI = 1.31-1.46), sickness within a year (OR = 0.84, 95% CI = 0.79-0.89), and flow range (OR = 1.12, 95% CI = 1.07-1.16).

CONCLUSIONS

All dimensions of social integration, including economic integration, social identity, and social involvement, are associated with FD contracting services among migrant populations. Policymakers should focus on improving the signing rates of migrant populations and implement more effective measures to enhance their social integration, such as settlement incentives and encouraging social participation.

A cross-sectional survey on mother-to-child transmission of HIV among the migrant population in Dongguan, China

Introduction

The migrant population, consisting of individuals who relocate from rural to urban areas, faces unique challenges that heighten their vulnerability to HIV infection. These challenges stem from a combination of sociodemographic factors and limited access to healthcare services. Understanding the dynamics of HIV transmission within this population is crucial for the development of effective prevention strategies.

Methods

To investigate the factors contributing to HIV vulnerability among migrants, we conducted a cross-sectional study at Dongguan People's Hospital from January 1, 2018, to December 31, 2021. Our study focused on pregnant women living with HIV and their infants, with a particular emphasis on sociodemographic characteristics, HIV testing and treatment profiles, and neonatal clinical data. Data were systematically collected using standardized forms.

Results

Analysis of data from 98 participants revealed noteworthy findings. No significant associations were observed between age, marital status, and educational background regarding HIV vulnerability. Similarly, factors such as the status of sexual partners, spousal therapy, and the number of children had no significant impact. However, our analysis highlighted the critical role of treatment strategies for HIV-positive women and the timing of antiretroviral therapy initiation for women with HIV, both of which were associated with HIV transmission (P < 0.05). Additionally, factors such as feeding type, neonatal antiretroviral prophylaxis, and preventive treatment strategies showed significant associations, while the preventive treatment program for neonates demonstrated no significant impact.

Discussion

These findings provide valuable insights into the specific risk factors and barriers to HIV prevention faced by the migrant population in Dongguan. They underscore the importance of targeted interventions and policies aimed at curtailing mother-to-child HIV transmission. By addressing the unique challenges experienced by migrant mothers and their infants, this study contributes significantly to broader efforts in controlling the spread of HIV, ultimately enhancing the health outcomes and well-being of Dongguan's migrant population. Furthermore, our research introduces a distinctive perspective within the extensively examined domain of Prevention of Mother-to-Child Transmission (PMTCT) programs, focusing on the internally migrant Chinese population, an understudied demographic group in this context. This study, conducted in Dongguan, China, represents one of the pioneering investigations into pregnant women with HIV and their infants within this migrant community.

Changes in smoking due to COVID-19 pandemic among persons of migrant origin compared with the general population: a population-based study

AIMS

Prior studies have implied that smokers may have changed their smoking behaviour during the COVID-19 pandemic. However, little is known about changes in smoking behaviour and correlates of change due to the pandemic among persons of migrant origin compared with the general population.

METHODS

Population-based cross-sectional studies with comparable study protocols and measures, one focusing on persons of migrant origin living in Finland (n = 3587, response rate 60%) and the other on the general Finnish population (n = 3444, response rate 56%), were utilised. The outcome measure was self-reported change in smoking behaviour due to COVID-19 among current smokers. Explanatory factors included sociodemographic-, health-, and COVID-19-related factors. Multinomial logistic regression was used in the analyses.

RESULTS

Most of the current smokers reported no change in their smoking behaviour. In the adjusted model, younger age was positively associated with increased smoking, while region of origin (Russia, Africa, Asia, and Latin America) and worrying about getting infected with COVID-19 were associated with decreased smoking among persons of migrant origin. In the general population, younger age, female sex, being other than employed/student, increased loneliness, and decreased contact with close ones were associated with increased smoking, while reduced working capacity and worries that someone close to the respondent will be infected with COVID-19 were associated with decreased smoking.

CONCLUSIONS

The findings of this study contribute to better identification of at-risk populations in future crises situations. This will allow for more efficient targeting and tailoring of health promotion services, including smoking cessation.

Relationships between Health Education, Health Behaviors, and Health Status among Migrants in China: A Cross-Sectional Study Based on the China Migrant Dynamic Survey

Managing the health of migrants has become a crucial aspect of promoting social harmony and cohesion in China. This study investigates the impact of public health education on the health status of migrants in China using cross-sectional data from the China Migrants Dynamic Survey 2017. A total of 169,989 migrants in China were selected as samples for empirical test. Data were analyzed using descriptive statistics, logistic regression, and the structural equation model. The findings show that health education significantly influences the health status of migrants in China. Specifically, health education related to occupational diseases, venereal diseases/AIDS, and self-rescue in public emergencies had a significant positive impact on migrants' health, while health education regarding chronic diseases had a significant negative impact. Health education delivered through lectures and bulletin boards had a significant positive impact on migrants' health, but online education had a significant negative effect on the health status of migrants. The effects of health education differ by gender and age, with a stronger positive impact on female migrants and elderly migrants aged 60 and above. The mediating effect of health behaviors was significant only in the total effect. In conclusion, health education can effectively enhance the health status of migrants in China by modifying their health behaviors.

Mental, neurological and substance use disorders among the Latino migrant population in the United States who visited the Health Windows and Mobile Health Units in 2021

Background

Mental health is defined by the World Health Organization as a state of wellbeing in which people are aware of their own abilities to cope with the normal stresses of life, work productively and fruitfully, and contribute to their community. Among the minority groups that may be vulnerable to experiencing greater risks for their physical and mental health and full development is the migrant population. The mobile population's migration experience, from their place of origin to destination translates into psychosocial problems and clearly stressful conditions which could be resolved using certain coping strategies. Accordingly, numerous epidemiological studies have found differences in the prevalence of mental health problems between migrants and native-born residents of destination countries, as well as between migrants and their non-migrant co-nationals.

Purpose

To describe sociodemographic characteristics of the Latino migrant population in the United States who visited the Health Windows (HW) and Mobile Health Units (MHU) in 2021, who may have been at risk for mental, neurological or substance use disorders and agreed to a screening for signs and symptoms of mental health conditions.

Method

Users of the HW and MHU were offered preventive health services and completed a mental health screening. These variables were registered in SICRESAL. If their results showed signs and symptoms of mental health conditions, they were screened by credentialed professionals from the Psychology Faculty of the National Autonomous University of Mexico. Screened individuals received a diagnosis and specialized care remotely and/or online with the MHU and HW network partners. To analyze sociodemographic variables corresponding to neurological or substance induced mental illness among the Latino migrant population in the United States who visited the Ventanillas de Salud (VDS)/Health Windows (HW), and Unidades Móviles de Salud (UMS)/Mobile Health Units (MHU), during 2021; contingency tables were created showing percentages and chi square with a significant p < 0.05.

Findings

During 2021 HW and MHU completed a total of 794 mental health screenings of which 84% were completed at HW. Further, 59% were women with an average age of 43, ranging from 7 to 86 years of age. Twenty percent 20% of the population who voluntarily agreed to screening yielded a positive result for some type of mental health symptom or problem. This percentage (37%) was greater among those who consulted MHU. With respect to age, results showed that youth were at greatest risk for mental health problems. Among the screened population, the independent variables, type of Health Window attended, gender, age group, and place of origin are related to the existence of some type of mental health symptom or problem yielding a significance level of <0.05 for depression and anxiety symptoms.

Discussion and prospects

In this study, as in others, the migrant population that visited the HW and UMS in 2021 reported a greater risk of mental health problems, with symptoms related to depression and anxiety among the socio-demographic variables of gender, age group, and place of origin. Thus, these symptoms relate to being a female aged between 18 and 38 and originating from Mexico. Finally, the possibility of screening the migrant population for signs and symptoms of mental health conditions that attended the Health Windows or Mobile Health Units during 2021, made it possible to refer them to psychology or psychiatry services and improve the quality of life of those who accessed the services and, consequently, that of their families and communities.

Limitations

The main limitation is associated with the information source since we worked with secondary data and relied on the information provided by those who attended both the HW and the MHU.

The effect of equalization of public health services on the health China's migrant population: Evidence from 2018 China Migrants Dynamic Survey

Objectives

China has implemented an equalization of public health Services policy for migrants in 40 pilot cities since 2013. The main objective of this study is to explore the effect of this migrant-based reform policy on the health status of the migrant population in China.

Methods

Using the China Migrants Dynamic Survey (CMDS), we included 152,000 migrants aged 15 years or over in 2018. Standardized questionnaires were used to collect socio-economic information and self-reported health status. The Associations between the equalization of public health services and health status were estimated using Multiple regression estimation models and Propensity Score Matching (PSM) methods.

Results

Public health equalization reform in China has a significant and positive effect on the health status of the migrant population (β = 0.033, p < 0.001). Compared to males, higher income, under 60 years of age, inter-provincial mobility, and migrants those already living in urban areas, the equalization of public health Services had shown more significant positive effects on the groups who were inter-provincial migration (β = 0.055, p < 0.001), females (β = 0.055, p < 0.001), having low-income (β = 0.077, p < 0.001), aged over 60 years old (β = 0.191, p < 0.001), and living in rural areas (β = 0.038, p < 0.001). And multiple robustness tests prove that the above results are reliable.

Conclusions and implications

Our findings confirmed the positive health effect of the equalization of public health services reform on china's migrant population, especially among vulnerable groups such as those in low income groups, in rural areas and females. And we recommend that it is necessary to further promote the practices and experiences of the pilot cities. First, strengthen health education for the mobile population and improve their health literacy. Second, further increase the financial investment to improve the coverage of public health services and the equity in resource allocation among regions. Last, strengthen the information-based management of the migrant population and prevent and control infectious diseases.

Levels and trends of maternal death in Baoan district, Shenzhen, China, 1999-2022

Background

China had achieved impressive success in improving maternal health, while the progress of reducing maternal mortality ratio (MMR) varied across regions. Some studies had reported maternal mortality from national or provincial perspective, but researches of the MMR on long-term period at the city or county level rare been reported. Shenzhen has experienced significant socioeconomic and health changes, reflecting the typical development of China's coastal city. This study mainly introduced the levels and trends of maternal death in Baoan district, Shenzhen from 1999 to 2022.

Methods

Maternal mortality data were extracted from registration forms and the Shenzhen Maternal and Child Health Management System. Linear-by-Linear Association tests were used to evaluate the trends of MMR among different groups. The study periods were divided into three stages by 8-year interval and χ² test or Fisher's test was used to test the difference in maternal deaths of different periods.

Results

During 1999-2022, a total of 137 maternal deaths occurred in Baoan, the overall MMR was 15.91 per 100,000 live births, declined by 89.31% with an annualized rate of 9.26%. The MMR declined by 68.15% in migrant population, with an annualized rate of 5.07%, faster than that in permanent population (48.73%, 2.86%). The MMR due to direct and indirect obstetric causes shown a downward trend (P<0.001) and the gap between them narrowed to 14.29% during 2015-2022. The major causes of maternal deaths were obstetric hemorrhage (4.41 per 100,000 live births), amniotic fluid embolism (3.37 per 100,000 live births), medical complications (2.44 per 100,000 live births) and pregnancy-induced hypertension (1.97 per 100,000 live births), the MMR due to the above causes all shown decreasing trends (P < 0.01), pregnancy-induced hypertension became the leading cause of deaths during 2015-2022. The constituent ratio of maternal deaths with advanced age significantly increased by 57.78% in 2015-2022 compared with in 1999-2006.

Conclusions

Baoan district had made encouraging progress in improving maternal survival, especially in migrant population. To further reduce the MMR, strengthening professional training to improve the capacity of obstetricians and physicians, increasing the awareness and ability of self-help health care among elderly pregnant women were in urgent need.

Impact of public health education on the health status of the older migrant population

Background

Due to an increasing aging population, China has experienced a rapid expansion in its internal older migrant population who face greater health risks and who have a relatively high demand for health education. Public health education is an important means of preventing diseases and promoting health. However, many studies have focused on the utilization, with few studies examining the impact of public health education on the health of the older migrant population in China.

Objectives

This study analyzed the impact of public health education on the health of the older migrant population in China.

Methods

Based on data obtained from the National Migrant Population Health and Family Planning Dynamic Monitor Survey (2018), logistic models and propensity score matching were used to analyze the impact of public health education on the health of the older migrant population.

Results

The self-assessed health of China's older migrant population was good, and the acceptance rate of public health education was 40.81%. The public health status of the older migrant population receiving public health education significantly improved (p < 0.05). After correcting for endogeneity among the variables, public health education increased the probability of improving the older migrant population's self-assessed health by 5.4-6.1% (p < 0.01). Heterogeneity analysis found that public health education had a greater impact on the health of older men with an education level of middle school and below, and especially on the older migrant population in the eastern region of China.

Conclusions

Public health education positively affected the health status of the older migrant population. The characteristics and preferences of the older migrant population involving different genders, regions, and educational levels need to be considered, public health education needs to be standardized, and appropriate education methods need to be adopted that suit the older migrant population. Reference suggestions are provided for improving the health level of the older migrant population.

Education, Income, and Happiness: Evidence From China

Happiness is the continuous joy that people experience when they are satisfied with their lives long term, and is the ultimate goal pursued by all citizens. In this study, we investigate the relationship between education, income, and happiness in the migrant population in China. Using 1,31,186 individuals in the 2012 China Migrants Dynamic Survey (CMDS) as research samples, the estimated results of ordinal logistic regression show that education, including secondary education and higher education, has a significant and direct impact on individual happiness, and that the impact of education on happiness can also be mediated by income as an intermediary mechanism. In addition, factors such as gender, flow distance, flow time, employment status, type of housing, number of children, degree of preference for the city, and degree of discrimination by locals have obvious effects on happiness. This work provides important insights for countries seeking to implement an active education policy in order to increase economic income and thus achieve the development goal of universal happiness among their citizens.

A Multicomponent Health Education Campaign Led by Community Health Workers to Increase Influenza Vaccination among Migrants and Refugees

Objectives:

To evaluate the impact of a Community Health Worker (CHW)-led influenza campaign on knowledge and attitudes about vaccination in Latinx migrant and refugee populations.

Methods:

Twelve online workshops were conducted with 183 participants and 24 CHWs between January 12 and May 12, 2021. Participants were Latinx families living in underserved communities throughout Washington state. The initiative also included radio, animated videos, advertisements, social media, and educational materials.

Results:

Analysis of pre and post workshop surveys from 155 participants showed statistically significant improvements in all questions about the definition of influenza, symptoms, and risks: and in 7 of 9 questions about treatments and vaccines. Analysis of 2 open-ended questions showed increases in words key to understanding influenza, such as “virus,” “illness,” “death,” and “contagious.” There were significant increases in rates of participants identifying vaccination and antibiotics as cures for influenza.

Conclusions:

CHW-led workshops can be an effective way to increase knowledge about influenza and influenza vaccine. Future curriculum should emphasize the difference between viruses and bacteria, and the use of vaccination for prevention as opposed to treatment for illness.

Cabbage and Sauerkraut Consumption in Adolescence and Adulthood and Breast Cancer Risk among US-Resident Polish Migrant Women

Background: Breast cancer (BC) incidence and mortality are lower in Poland than in the United States (US). However, Polish-born migrant women to US approach the higher BC mortality rates of US women. We evaluated the association between consumption of cabbage/sauerkraut foods and BC risk in Polish-born migrants to US. Methods: We conducted a case–control study of BC among Polish-born migrants in Cook County and the Detroit Metropolitan Area. Cases (n = 131) were 20–79 years old with histological/cytological confirmation of invasive BC. Population-based controls (n = 284) were frequency matched to cases on age and residence. Food frequency questionnaires assessed diet during adulthood and age 12–13 years. Odds ratios (OR) and 95% confidence intervals (95% CI) were estimated with conditional logistic regression. Consumption of total, raw/short-cooked, and long-cooked cabbage/sauerkraut foods was categorized as low, medium, or high (frequency of servings/week). Results: Higher consumption of total and raw/short-cooked cabbage/sauerkraut foods, during both adolescence and adulthood, was associated with a significantly lower BC risk. Consumption of long-cooked cabbage/sauerkraut foods was low and not significantly associated with risk. The multivariate OR for total cabbage/sauerkraut consumption, high vs. low (>4 vs. ≤2 servings/week) during adolescence was 0.36 (95% CI = 0.18–0.71, p_trend < 0.01) and 0.50 (95% CI = 0.23–1.06, p_trend = 0.08) during adulthood. For raw/short-cooked cabbage/sauerkraut (>3 vs. ≤1.5 servings/week), the ORs were 0.35 (95% CI = 0.16–0.72, p_trend < 0.01) during adolescence and 0.37 (95% CI = 0.17–0.78, p_trend < 0.01) during adulthood. For joint adolescent/adult consumption of raw/short-cooked cabbage/sauerkraut foods, (high, high) vs. (low, low), the OR was 0.23 (95% CI = 0.07–0.65). The significant association for high adolescent consumption of raw/short-cooked cabbage/sauerkraut foods and reduced BC risk was consistent across all levels of consumption in adulthood. Conclusion: Greater consumption of total and raw/short-cooked cabbage/sauerkraut foods either during adolescence or adulthood was associated with significantly reduced BC risk among Polish migrant women. These findings contribute to the growing literature suggesting a protective effect of a potentially modifiable factor, cruciferous vegetable intake, on breast cancer risk.

Barriers in screening for dementia in elderly migrants in primary care and the use of the Rowland Universal Dementia Assessment Scale. A mixed cross-sectional and qualitative study

BACKGROUND

In the migrant population, there is a higher risk of dementia. However, dementia is underdiagnosed in this population due to the underuse of appropriate screening tools. The Rowland Universal Dementia Assessment Scale (RUDAS) is designed for culturally and linguistically diverse populations.

OBJECTIVES

To gain insights into the primary care cognitive screening strategy for dementia in migrants and to evaluate the experiences with the RUDAS tool by general practitioners (GPs).

METHODS

GPs were questioned about barriers in dementia screening in the migrant population and asked to apply the RUDAS. A mixed-methods study was conducted among Flemish GPs. In an online survey, the currently used methods for screening for dementia in migrants and the barriers were investigated. In a qualitative pilot study, the user experience of the RUDAS scale was explored.

RESULTS

A total of 122/322 GPs participated (response rate 38%), 102 (83.6%) of all responding GPs mentioned language problems as the most apparent barrier. Most GPs believed the Mini Mental State Examination was inappropriate for migrants but they were unaware of an alternative. Due to lack of time and target population, only two GPs effectively applied the RUDAS. The tool was found easy to understand and less challenging in case of language problems. The main reason for not using RUDAS was the suspected time consumption.

CONCLUSION

GPs find screening for dementia in migrant patients a challenging act, mainly due to language barriers. GPs are not confident enough with the appropriate screening strategies and tools adjusted to the needs of migrant patients. Abbreviations: GP: general practitioner; RUDAS: Rowland Universal Dementia Assessment Scale; MMSE: Mini Mental State Examination.

Labor, Health, and Marginalization: A Culture-Centered Analysis of the Challenges of Male Bangladeshi Migrant Workers in the Middle East

Based on the culture-centered approach, we examine the meanings of health and negotiations of health care structures among low socioeconomic status (SES) Bangladeshi male migrant workers in the United Arab Emirates (UAE). We engage in coconstructive problem definition and strategizing through 44 semistructured in-depth interviews/focus groups about health, migration, and well-being. Our analysis of the participants' narratives elucidates the intersectionality of health as a lived experience of migrant labor within neoliberal structures focused on labor extraction, highlighting health not as a static or purely epidemiological construct, but as a combination of the physical, mental, spiritual, and socioeconomic material realities within which they are located. These include a recognition of the importance of interconnectedness of physical and mental well-being, drawing upon one's cultural and familial roles and responsibilities, as well as locating health within structurally exploitative practices. Specifically, the participants articulate the absence of substantive health and labor protections that result in poor health outcomes for them.

The Relationship between the Migrant Population's Migration Network and the Risk of COVID-19 Transmission in China-Empirical Analysis and Prediction in Prefecture-Level Cities

The outbreak of COVID-19 in China has attracted wide attention from all over the world. The impact of COVID-19 has been significant, raising concerns regarding public health risks in China and worldwide. Migration may be the primary reason for the long-distance transmission of the disease. In this study, the following analyses were performed. (1) Using the data from the China migrant population survey in 2017 (Sample size = 432,907), a matrix of the residence-birthplace (R-B matrix) of migrant populations is constructed. The matrix was used to analyze the confirmed cases of COVID-19 at Prefecture-level Cities from February 1-15, 2020 after the outbreak in Wuhan, by calculating the probability of influx or outflow migration. We obtain a satisfactory regression analysis result (R2 = 0.826-0.887, N = 330). (2) We use this R-B matrix to simulate an outbreak scenario in 22 immigrant cities in China, and propose risk prevention measures after the outbreak. If similar scenarios occur in the cities of Wenzhou, Guangzhou, Dongguan, or Shenzhen, the disease transmission will be wider. (3) We also use a matrix to determine that cities in Henan province, Anhui province, and Municipalities (such as Beijing, Shanghai, Guangzhou, Shenzhen, Chongqing) in China will have a high risk level of disease carriers after a similar emerging epidemic outbreak scenario due to a high influx or outflow of migrant populations.

Betel quid chewing among adult male immigrants from the Indian subcontinent to Italy

OBJECTIVE

Betel quid chewing (BQC) is an important oral cancer risk factor widespread in the Indian subcontinent. This usage also is common among migrants from this region. As the number of immigrants from South-East Asia is dramatically increasing in Italy, this survey was aimed at investigating BQC prevalence among immigrants from the Indian subcontinent.

SUBJECTS AND METHODS

First-generation adult male immigrants coming from Pakistan, India, Sri Lanka, and Bangladesh, living in Rome, were consecutively selected. They were interviewed using a validated questionnaire. Descriptive statistics were performed, and factors associated to regular BQC were investigated through regression analysis.

RESULTS

A total of 211 subjects (mean age, 33.8 years) living in Rome for 11 years, on average, participated in the study. BQC prevalence was 37.9% with few differences between Pakistani, Sri Lankans, and Indians. Prevalence among Bangladeshi was 7.3%. 69% of the consumers chewed BQ at least twice daily, 90% chewed BQ with tobacco; 30.3% subjects were smokers and chewers. Chewing parents, smoking, health illiteracy were associated with BQC. Most chewers believed that BQ helps to relieve stress.

CONCLUSIONS

The number of oral cancers in Italy is expected to increase because of BQC dissemination. Therefore, specific awareness campaigns directed to residents of South-East Asian origin are needed.

A study of melanoma in Eastern European migrants in Italy

Cancer survival rates are lower in Eastern Europe. To describe, based on a single-centre database in northern Italy, clinical, histopathological, and prognostic features of melanoma in a migrant population from Eastern Europe.

MATERIALS & METHODS

We retrospectively analysed data from 18,190 consecutive foreign patients who visited our institution, with 49 cases of melanoma from Eastern Europe. The control group was represented by 1,003 Italian melanoma patients diagnosed and followed at our centre during the same time period. Patients from Eastern Europe were mainly females with lower median age, without significant differences regarding primary melanoma site, relative to the control group. Diagnosis was made at the place of birth in 30.6% and in our centre for the remainder. Median Breslow thickness was greater (p = 0.0178), and aggressive histotypes (p = 0.0017) and ulcerated melanomas (p = 0.002) were significantly over-represented, particularly when diagnosed in the patients' native country. Disease was more advanced at diagnosis (p = 0.0001), regardless of the place of initial diagnosis (51% had a progressive disease within one year which rose to 80% if diagnosed before admission to our centre), and the percentage of patients who died within one year was significantly higher (p = 0.022), relative to the control group. Our study shows a poor prognosis for melanoma patients diagnosed in Eastern Europe. Moreover, for migrant populations moving from Eastern to Western European countries, financial difficulties, poor social integration, and language barriers, with consequent late access to healthcare facilities, may account for a worse prognosis.

Epidemiology characteristics of birth defects in Shenzhen city during 2003 to 2009, China

OBJECTIVES

To explore the epidemiology characteristics of birth defects (BDs) in perinatal infants in Longgang District, Shenzhen City.

METHODS

Data used in this study was obtained from birth defects surveillance network during 2003 to 2009. The prevalence with 95% confidence interval of BDs by year, gender, household registration and type were examined. Cochran-Armitage trend tests were conducted to evaluate the tendency by year.

RESULTS

The overall prevalence of BDs in Longgang District was 13.43 (12.92, 13.95) per 1000 live births and there was an increasing trend from 2003 to 2009 in migrant and permanent population. Furthermore, the migrant population and male infant had a higher prevalence, OR = 1.22(1.09, 1.37), 1.21(1.11, 1.31) respectively. Congenital heart disease was the most common birth defect.

CONCLUSIONS

Shenzhen city is confronted with severe challenges to prevent BDs. The preventive program of BDs, especially for the migrant population, should be better performed.

Comparing sociodemographic factors associated with disability between immigrants and the Chilean-born: are there different stories to tell?

This study explored a range of sociodemographic factors associated with disability among international immigrants in Chile, and compared them to the Chilean-born. Secondary data analysis of the Chilean population-based survey CASEN-2006 was conducted (268,873 participants). Main health outcomes: any disability and six different types of disability: visual, hearing, learning, physical, psychiatric and speaking (binary outcomes). Sociodemographic variables: Demographic factors (age, sex, marital status, urban/rural, ethnicity), socioeconomic status (SES: income, education, employment status, and an integrated indicator combining the SES measures through cluster analysis for the immigrant population), material factors (overcrowding, sanitation, housing quality) and migration related (country of origin and length of stay). Immigrants reported a significantly lower prevalence of any disability (3.55%), visual (1.00%) and physical disability (0.38%). Factors associated with any disability among immigrants were age, low SES or over 20 years duration of residence in Chile; while a range of sociodemographic factors were associated with disability in the Chilean-born. Conditional regression models by age group varied between populations, but SES remained significantly associated with disability across immigrants and the Chilean-born. However, there are no similar patterns of factors associated to different types of disability between the populations under study. Factors associated with disability varied between populations under study, but SES showed a consistent association with any disability in immigrants and the Chilean-born. Types of disability showed different patterns of factors associated to them between populations, which suggest the great complexity of underlying mechanisms related to disability in Chile.