Background : exclusive breastfeeding has been shown to protect infants from contracting various diseases. The aims of this study were: to examine the relationships between infant feeding patterns and the risk of Acute Respiratory Infections (ARI), and to assess the importance of some factors that can increase such risk. Methods : a case-control study was carried out during the period between February 1st 2005 - May 1st 2005. The study included 137 infants who were hospitalized in the Children Welfare Teaching Hospital for ARIs during the period of study (a case definition of acute lower respiratory infection as given by the WHO (1995) was used). The Control group included 157 healthy infants who were randomly selected from two primary health care centers of the AI-Karkh sector of Baghdad for immunization. The risk of various factors thought to be associated to ARI were studied, these being: non-modifiable (age, gender, birth order, parent education, crowded residence, family history of asthma and history of ARIs in household members in previous 2 weeks) and modifiable (short duration of breastfeeding, cigarette smoking in proximity to the infant, delayed immunization and malnutrition). Logistic regression was used to adjust for confounders and for calculating adjusted odds ratios. Results : formula fed infants had a 2.7 times higher risk (CI:1.6-4.68) for ARIs compared to breast fed infants. Infants who had undergone a short duration of breastfeeding (<3 months) had a 1.4 times increased risk or ARI (CI: 0.89—2.23). Additional factors that were associated with higher ARIs were, female gender (OR= 2.0, CI:1.3-3.3), low educational level of mothers (OR= 6.4, CI:3.2-12.7) and fathers (OR=4.5, CI:2.27-8.78), crowded residence (OR= 4.5, CI: 2.6-7.8), positive history of ARIs in household members in the 2 weeks prior to the study (OR= 5.5, CI:3.3-9.3), family history of asthma (OR = 2.6, CI:1.4-4.9), and daily smoking of ≥7 cigarettes in proximity to the infant (OR = 2.0, CI:1.1-3.4). Age, birth order, delayed immunization and malnutrition, were not found to significantly increase the infants’ risk of ARIs. Multiple logistic regression showed that ARIs in household members during the 2 weeks prior to the study, low educational level of mothers, short duration of breastfeeding, living in a crowded residence, and family history of asthma or allergy were all significantly associated with an increase in the risk of ARIs. Conclusions : short duration of breastfeeding is the only modifiable factor which showed a significant relationship with ARIs. The Promotion of breastfeeding is highly recommended as a strategy to reduce the risk of ARIs in infants.
{"title":"Infant feeding patterns and risk of acute respiratory infections in Baghdad/Iraq","authors":"S. Al-Sharbatti, Lubna I. AlJumaa","doi":"10.2427/7534","DOIUrl":"https://doi.org/10.2427/7534","url":null,"abstract":"Background : exclusive breastfeeding has been shown to protect infants from contracting various diseases. The aims of this study were: to examine the relationships between infant feeding patterns and the risk of Acute Respiratory Infections (ARI), and to assess the importance of some factors that can increase such risk. Methods : a case-control study was carried out during the period between February 1st 2005 - May 1st 2005. The study included 137 infants who were hospitalized in the Children Welfare Teaching Hospital for ARIs during the period of study (a case definition of acute lower respiratory infection as given by the WHO (1995) was used). The Control group included 157 healthy infants who were randomly selected from two primary health care centers of the AI-Karkh sector of Baghdad for immunization. The risk of various factors thought to be associated to ARI were studied, these being: non-modifiable (age, gender, birth order, parent education, crowded residence, family history of asthma and history of ARIs in household members in previous 2 weeks) and modifiable (short duration of breastfeeding, cigarette smoking in proximity to the infant, delayed immunization and malnutrition). Logistic regression was used to adjust for confounders and for calculating adjusted odds ratios. Results : formula fed infants had a 2.7 times higher risk (CI:1.6-4.68) for ARIs compared to breast fed infants. Infants who had undergone a short duration of breastfeeding (<3 months) had a 1.4 times increased risk or ARI (CI: 0.89—2.23). Additional factors that were associated with higher ARIs were, female gender (OR= 2.0, CI:1.3-3.3), low educational level of mothers (OR= 6.4, CI:3.2-12.7) and fathers (OR=4.5, CI:2.27-8.78), crowded residence (OR= 4.5, CI: 2.6-7.8), positive history of ARIs in household members in the 2 weeks prior to the study (OR= 5.5, CI:3.3-9.3), family history of asthma (OR = 2.6, CI:1.4-4.9), and daily smoking of ≥7 cigarettes in proximity to the infant (OR = 2.0, CI:1.1-3.4). Age, birth order, delayed immunization and malnutrition, were not found to significantly increase the infants’ risk of ARIs. Multiple logistic regression showed that ARIs in household members during the 2 weeks prior to the study, low educational level of mothers, short duration of breastfeeding, living in a crowded residence, and family history of asthma or allergy were all significantly associated with an increase in the risk of ARIs. Conclusions : short duration of breastfeeding is the only modifiable factor which showed a significant relationship with ARIs. The Promotion of breastfeeding is highly recommended as a strategy to reduce the risk of ARIs in infants.","PeriodicalId":89162,"journal":{"name":"Italian journal of public health","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2012-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68881188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background : adolescent migrants are in a state of double vulnerability because of their age and migration experience. The purpose of this review was to identify risk and protective factors serving as a base for health promotion of young recent migrants. Methods : we assessed 95 papers identified through a MEDLINE search. Thirty-five papers were retained for review and analysed within the following themes: general health, mental health, cigarette smoking and sexual health. Results : young migrants’ health was considered good at arrival, but deteriorated with length of stay due to factors linked to migration. Mental health was determined by pre-migration factors, such as violence, and was strongly related to post-migration factors, such as asylum procedures, discrimination and low socio-economic status. Social support and family cohesion were identified as protective factors. We found a lack in epidemiologic data about tobacco use and sexual health issues. Results from North America indicated less frequent smoking in certain groups of immigrants. Some data suggested more frequent teenage pregnancies and abortions in young refugee women as compared to the host population. We also found some evidence about increased risk of sexually transmitted infections and HIV/AIDS in certain immigrant populations. Conclusions : migrant adolescents are generally healthy at arrival. The migration process and social inequalities after arrival influence their long-term health. A comprehensive approach to health promotion is necessary, taking into account risk and protective factors. More research is needed, in order to obtain more specific epidemiologic data about adolescent migrants, as well as longitudinal and qualitative data.
{"title":"Determinants of health in recently arrived young migrants and refugees: a review of the literature","authors":"E. Pfarrwaller, J. Suris","doi":"10.2427/7529","DOIUrl":"https://doi.org/10.2427/7529","url":null,"abstract":"Background : adolescent migrants are in a state of double vulnerability because of their age and migration experience. The purpose of this review was to identify risk and protective factors serving as a base for health promotion of young recent migrants. Methods : we assessed 95 papers identified through a MEDLINE search. Thirty-five papers were retained for review and analysed within the following themes: general health, mental health, cigarette smoking and sexual health. Results : young migrants’ health was considered good at arrival, but deteriorated with length of stay due to factors linked to migration. Mental health was determined by pre-migration factors, such as violence, and was strongly related to post-migration factors, such as asylum procedures, discrimination and low socio-economic status. Social support and family cohesion were identified as protective factors. We found a lack in epidemiologic data about tobacco use and sexual health issues. Results from North America indicated less frequent smoking in certain groups of immigrants. Some data suggested more frequent teenage pregnancies and abortions in young refugee women as compared to the host population. We also found some evidence about increased risk of sexually transmitted infections and HIV/AIDS in certain immigrant populations. Conclusions : migrant adolescents are generally healthy at arrival. The migration process and social inequalities after arrival influence their long-term health. A comprehensive approach to health promotion is necessary, taking into account risk and protective factors. More research is needed, in order to obtain more specific epidemiologic data about adolescent migrants, as well as longitudinal and qualitative data.","PeriodicalId":89162,"journal":{"name":"Italian journal of public health","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2012-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68881602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background : the prevalence of child obesity is increasing rapidly worldwide. In developing countries such as India, especially in urban populations, childhood obesity is emerging as a major health problem. In view of these contexts, the present study was undertaken to estimate the prevalence of overweight and obesity in an urban population of girl adolescent students attending the English Medium School in Kolkata, India. Methods : a total of 571 girl students, aged 12-18 years, were evaluated. Cole et al. (2000) recommended cut-off points were utilized to assess overweight and obesity. Results : the overall prevalence rates of overweight and obesity were 28.5% and 4.2% respectively. The rate of overweight was the highest when compared with that of different parts of India, including Kolkata, and also when compared to rates from the USA and Great Britain. Conclusions : in the context of the present study, it can be presumed that, the higher prevalence of overweight in these school children may be due to their eating habits, as well as to their lack of awareness on proper eating habits. In addition, low involvement in physical activities may also have influenced the rate of overweight and obesity. Thus, it can be concluded that the study definitely highlighted the existence of an obesity threat, which is likely to persist among Bengalee school children of wealthier families.
{"title":"Prevalence of overweight and obesity among the urban adolescent English Medium School girls of Kolkata, India","authors":"A. Mandal, G. Mandal","doi":"10.2427/7535","DOIUrl":"https://doi.org/10.2427/7535","url":null,"abstract":"Background : the prevalence of child obesity is increasing rapidly worldwide. In developing countries such as India, especially in urban populations, childhood obesity is emerging as a major health problem. In view of these contexts, the present study was undertaken to estimate the prevalence of overweight and obesity in an urban population of girl adolescent students attending the English Medium School in Kolkata, India. Methods : a total of 571 girl students, aged 12-18 years, were evaluated. Cole et al. (2000) recommended cut-off points were utilized to assess overweight and obesity. Results : the overall prevalence rates of overweight and obesity were 28.5% and 4.2% respectively. The rate of overweight was the highest when compared with that of different parts of India, including Kolkata, and also when compared to rates from the USA and Great Britain. Conclusions : in the context of the present study, it can be presumed that, the higher prevalence of overweight in these school children may be due to their eating habits, as well as to their lack of awareness on proper eating habits. In addition, low involvement in physical activities may also have influenced the rate of overweight and obesity. Thus, it can be concluded that the study definitely highlighted the existence of an obesity threat, which is likely to persist among Bengalee school children of wealthier families.","PeriodicalId":89162,"journal":{"name":"Italian journal of public health","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2012-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68881218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background : parameter uncertainty in the Markov model’s description of a disease course was addressed. Probabilistic sensitivity analysis (PSA) is now considered the only tool that properly permits parameter uncertainty’s examination. This consists in sampling values from the parameter’s probability distributions. Methods : Markov models fitted with microsimulation were considered and methods for carrying out a PSA on transition probabilities were studied. Two Bayesian solutions were developed: for each row of the modeled transition matrix the prior distribution was assumed as a product of Beta or a Dirichlet. The two solutions differ in the source of information: several different sources for each transition in the Beta approach and a single source for each transition from a given health state in the Dirichlet. The two methods were applied to a simple cervical cancer’s model. Results : differences between posterior estimates from the two methods were negligible. Results showed that the prior variability highly influence the posterior distribution. Conclusions : the novelty of this work is the Bayesian approach that integrates the two distributions with a product of Binomial distributions likelihood. Such methods could be also applied to cohort data and their application to more complex models could be useful and unique in the cervical cancer context, as well as in other disease modeling.
{"title":"Bayesian probabilistic sensitivity analysis of Markov models for natural history of a disease: an application for cervical cancer","authors":"G. Carreras, M. Baccini, G. Accetta, A. Biggeri","doi":"10.2427/7537","DOIUrl":"https://doi.org/10.2427/7537","url":null,"abstract":"Background : parameter uncertainty in the Markov model’s description of a disease course was addressed. Probabilistic sensitivity analysis (PSA) is now considered the only tool that properly permits parameter uncertainty’s examination. This consists in sampling values from the parameter’s probability distributions. Methods : Markov models fitted with microsimulation were considered and methods for carrying out a PSA on transition probabilities were studied. Two Bayesian solutions were developed: for each row of the modeled transition matrix the prior distribution was assumed as a product of Beta or a Dirichlet. The two solutions differ in the source of information: several different sources for each transition in the Beta approach and a single source for each transition from a given health state in the Dirichlet. The two methods were applied to a simple cervical cancer’s model. Results : differences between posterior estimates from the two methods were negligible. Results showed that the prior variability highly influence the posterior distribution. Conclusions : the novelty of this work is the Bayesian approach that integrates the two distributions with a product of Binomial distributions likelihood. Such methods could be also applied to cohort data and their application to more complex models could be useful and unique in the cervical cancer context, as well as in other disease modeling.","PeriodicalId":89162,"journal":{"name":"Italian journal of public health","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2012-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68881440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gesthimani Misirli, C. Bamia, V. Dilis, V. Benetou, Dimosthenis Zilis, A. Trichopoulou
Background : the aim of the study is to investigate the validity of self-reported incident cardiovascular disease in the Greek EPIC cohort during follow up. Methods : cardiovascular disease was considered in 4 groups: Myocardial infarction (MI), Angina, Cerebrovascular disease, and other coronary heart disease (other CHD). Validation for all reported incident cardiovascular events was sought through medical records of hospitals around the country and local death registries. Results : in total, there had been 121 self reported incident cases of angina, 683 of MI, 622 of other CHD and 855 of cerebrovascular disease. Records were searched for 926 participants with reported cardiovascular disease (CVD), and from those, medical records for the 832 (90%) were obtained from the respective hospitals. Examination of the medical records that were obtained confirmed the self report in 72% of incident strokes, 65% of MIs, 55% of other CHD cases and 32% of angina. Conclusions : it appears that in our study self reported MI and stroke (or transient ischemic attacks) had a higher validity, compared to self reported angina and other CHD. Our results are comparable to those in other cohort studies.
{"title":"Validation of self-reported incident cardiovascular disease events in the Greek EPIC cohort study","authors":"Gesthimani Misirli, C. Bamia, V. Dilis, V. Benetou, Dimosthenis Zilis, A. Trichopoulou","doi":"10.2427/7538","DOIUrl":"https://doi.org/10.2427/7538","url":null,"abstract":"Background : the aim of the study is to investigate the validity of self-reported incident cardiovascular disease in the Greek EPIC cohort during follow up. Methods : cardiovascular disease was considered in 4 groups: Myocardial infarction (MI), Angina, Cerebrovascular disease, and other coronary heart disease (other CHD). Validation for all reported incident cardiovascular events was sought through medical records of hospitals around the country and local death registries. Results : in total, there had been 121 self reported incident cases of angina, 683 of MI, 622 of other CHD and 855 of cerebrovascular disease. Records were searched for 926 participants with reported cardiovascular disease (CVD), and from those, medical records for the 832 (90%) were obtained from the respective hospitals. Examination of the medical records that were obtained confirmed the self report in 72% of incident strokes, 65% of MIs, 55% of other CHD cases and 32% of angina. Conclusions : it appears that in our study self reported MI and stroke (or transient ischemic attacks) had a higher validity, compared to self reported angina and other CHD. Our results are comparable to those in other cohort studies.","PeriodicalId":89162,"journal":{"name":"Italian journal of public health","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2012-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68881455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. Falzon, M. Zignol, G. Migliori, P. Nunn, M. Raviglione
Migration, both within and between countries, has increased worldwide in recent years. While migration in itself need not present a risk to health, it is often characterized by increased stress and individual vulnerability to disease and inequalities in access to care. Migrants from high tuberculosis (TB) prevalence countries may be at risk of TB before leaving their country, during travel and after resettlement. In many high-income countries, more than half of the TB cases emerging today occur in patients born in another country. In less affluent countries, shifts in TB epidemiology associated with population movements are also being reported. Foreign-born persons often face several barriers to care in a new country as a result of inadequate knowledge of, or coverage by, the health care services, differences in culture and language, lack of money, comorbidity, concern about discrimination and fear of expulsion. National authorities apply different policies to screen migrants for TB and to provide preventive or curative treatment, with varying coverage, yield and effectiveness. If screening is to be of use, it needs to fit into a broader national strategy for TB care and management. Appropriate treatment needs to be provided in a manner conducive to its full completion. This is critical both for the individual patient and for public health. We discuss the main associations between TB and migration based on data from recent publications on surveillance, policy and practice.
{"title":"Migration: an opportunity for the improved management of tuberculosis worldwide","authors":"D. Falzon, M. Zignol, G. Migliori, P. Nunn, M. Raviglione","doi":"10.2427/7524","DOIUrl":"https://doi.org/10.2427/7524","url":null,"abstract":"Migration, both within and between countries, has increased worldwide in recent years. While migration in itself need not present a risk to health, it is often characterized by increased stress and individual vulnerability to disease and inequalities in access to care. Migrants from high tuberculosis (TB) prevalence countries may be at risk of TB before leaving their country, during travel and after resettlement. In many high-income countries, more than half of the TB cases emerging today occur in patients born in another country. In less affluent countries, shifts in TB epidemiology associated with population movements are also being reported. Foreign-born persons often face several barriers to care in a new country as a result of inadequate knowledge of, or coverage by, the health care services, differences in culture and language, lack of money, comorbidity, concern about discrimination and fear of expulsion. National authorities apply different policies to screen migrants for TB and to provide preventive or curative treatment, with varying coverage, yield and effectiveness. If screening is to be of use, it needs to fit into a broader national strategy for TB care and management. Appropriate treatment needs to be provided in a manner conducive to its full completion. This is critical both for the individual patient and for public health. We discuss the main associations between TB and migration based on data from recent publications on surveillance, policy and practice.","PeriodicalId":89162,"journal":{"name":"Italian journal of public health","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2012-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68881494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background : young persons are most strongly affected by displacement through political/military actions. This is also a European problem as well as an issue for the European Union. Applying the social-ecological model by Bronfenbrenner we concentrated on micro- and mesosystems of Austrian adolescents and migrant adolescents of war-affected countries. Methods : a questionnaire was administered to adolescents in Austria attending schools beyond the mandatory school age, yielding a sample of about 1 100 students from Austrian and immigrant background. We used analysis of variance to compare host and immigrant youth as well as regression analysis to assess the impact of risk and protective factors on youth outcomes. Results : we do find sex differences for protective factors and youth outcomes but few differences between immigrant and Austrian adolescents. Youth outcomes analysed were somatic symptoms, anxiety, depression, self-esteem, anti-social behaviour, substance use, and academic performance. Important risk factors turned out to be intergenerational conflict, exposure to violence, and social distance. Protective factors include family connectedness, parental monitoring, school connectedness, peer support, and neighbourhood attachment. Conclusions : the most important protective factor is school connectsdness. Social distance and intergenerational conflict are the dominant risk factors influencing youth outcomes. Our research leads to a better understanding of factors determining the well-being of adolescents and contributes to finding new approaches to prevent or cope with mental health problems of young immigrants. In particular it appears to be important to keep young persons in education and/or training since school connectedness influences mental health and well-being positively.
{"title":"The impact of risk and protective factors on mental health and well-being-Austrian adolescents and migrant adolescents from war-affected countries","authors":"Anita Buchegger-Traxler, Ulrike Sirsch","doi":"10.2427/7530","DOIUrl":"https://doi.org/10.2427/7530","url":null,"abstract":"Background : young persons are most strongly affected by displacement through political/military actions. This is also a European problem as well as an issue for the European Union. Applying the social-ecological model by Bronfenbrenner we concentrated on micro- and mesosystems of Austrian adolescents and migrant adolescents of war-affected countries. Methods : a questionnaire was administered to adolescents in Austria attending schools beyond the mandatory school age, yielding a sample of about 1 100 students from Austrian and immigrant background. We used analysis of variance to compare host and immigrant youth as well as regression analysis to assess the impact of risk and protective factors on youth outcomes. Results : we do find sex differences for protective factors and youth outcomes but few differences between immigrant and Austrian adolescents. Youth outcomes analysed were somatic symptoms, anxiety, depression, self-esteem, anti-social behaviour, substance use, and academic performance. Important risk factors turned out to be intergenerational conflict, exposure to violence, and social distance. Protective factors include family connectedness, parental monitoring, school connectedness, peer support, and neighbourhood attachment. Conclusions : the most important protective factor is school connectsdness. Social distance and intergenerational conflict are the dominant risk factors influencing youth outcomes. Our research leads to a better understanding of factors determining the well-being of adolescents and contributes to finding new approaches to prevent or cope with mental health problems of young immigrants. In particular it appears to be important to keep young persons in education and/or training since school connectedness influences mental health and well-being positively.","PeriodicalId":89162,"journal":{"name":"Italian journal of public health","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2012-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68881622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Several studies, carried out mainly in the United States and Canada, have suggested that recent immigrants are generally healthier than native-born populations in spite of the fact that they frequently have a lower socioeconomic status and less access to healthcare services. This “epidemiological paradox” has been called the “healthy immigrant” effect and is usually attributed to a self-selection process prior to migration, “cultural buffering” and official health screening and employability in receiving countries. In this paper, we have evaluated the European scientific research into the existence of the “healthy immigrant” effect.
{"title":"The “healthy immigrant” effect: does it exist in Europe today?","authors":"A. Domnich, D. Panatto, R. Gasparini, D. Amicizia","doi":"10.2427/7532","DOIUrl":"https://doi.org/10.2427/7532","url":null,"abstract":"Several studies, carried out mainly in the United States and Canada, have suggested that recent immigrants are generally healthier than native-born populations in spite of the fact that they frequently have a lower socioeconomic status and less access to healthcare services. This “epidemiological paradox” has been called the “healthy immigrant” effect and is usually attributed to a self-selection process prior to migration, “cultural buffering” and official health screening and employability in receiving countries. In this paper, we have evaluated the European scientific research into the existence of the “healthy immigrant” effect.","PeriodicalId":89162,"journal":{"name":"Italian journal of public health","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2012-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68881147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background : recent research shows that severe/very severe post-migration living difficulties (PMLD) have a negative impact on the mental health and social integration of refugees and asylum seekers. This study focuses on the role of PMLD in primary care “ordinary” immigrants. Methods : 443 primary care immigrants were asked to complete a self-administered questionnaire measuring the number and severity of pre-migratory potentially traumatic events (PTE), PMLD, and the current prevalence of a post-traumatic stress disorder (PTSD). The frequency of PMLD was assessed in the whole sample and compared in patients with and without PTSD. The effect of the number of PMLD on the risk of having a PTSD was studied by means of a regression analysis, adjusted by the number of PTE. Results : 391 patients completed the questionnaire and were enrolled into the study. The prevalence of PTSD was 10.2%. In the whole sample the most frequent PMLD were “no permission to work” (38.6%) and “poverty” (34.5%). All PMLD (except “communication difficulties”) were more frequent in patients with a PTSD. The number of PMLD significantly increased the likelihood to have a PTSD independently from PTE. Conclusions: severe/very severe post-migration living difficulties (PMLD) increase significantly the risk of PTSD in primary care “ordinary” migrants. Our hypothesis is that they have a retraumatizing effect on individuals who are already vulnerable and with a low capacity to handle resettlement stress due to their previous traumatic history. The implications in clinical practice and for immigration policies are discussed.
{"title":"Post-migration living difficulties as a significant risk factor for PTSD in immigrants: a primary care study","authors":"M. Aragona, D. Pucci, M. Mazzetti, S. Geraci","doi":"10.2427/7525","DOIUrl":"https://doi.org/10.2427/7525","url":null,"abstract":"Background : recent research shows that severe/very severe post-migration living difficulties (PMLD) have a negative impact on the mental health and social integration of refugees and asylum seekers. This study focuses on the role of PMLD in primary care “ordinary” immigrants. Methods : 443 primary care immigrants were asked to complete a self-administered questionnaire measuring the number and severity of pre-migratory potentially traumatic events (PTE), PMLD, and the current prevalence of a post-traumatic stress disorder (PTSD). The frequency of PMLD was assessed in the whole sample and compared in patients with and without PTSD. The effect of the number of PMLD on the risk of having a PTSD was studied by means of a regression analysis, adjusted by the number of PTE. Results : 391 patients completed the questionnaire and were enrolled into the study. The prevalence of PTSD was 10.2%. In the whole sample the most frequent PMLD were “no permission to work” (38.6%) and “poverty” (34.5%). All PMLD (except “communication difficulties”) were more frequent in patients with a PTSD. The number of PMLD significantly increased the likelihood to have a PTSD independently from PTE. Conclusions: severe/very severe post-migration living difficulties (PMLD) increase significantly the risk of PTSD in primary care “ordinary” migrants. Our hypothesis is that they have a retraumatizing effect on individuals who are already vulnerable and with a low capacity to handle resettlement stress due to their previous traumatic history. The implications in clinical practice and for immigration policies are discussed.","PeriodicalId":89162,"journal":{"name":"Italian journal of public health","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2012-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68881510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The issue of “immigrants’ health” has been the subject of increasing interest in recent years, both in scientific literature and in the declarations of international health institutions. Specifically, the Resolution of the 61st World Health Assembly (2008), and the Report of the European Parliament on the reduction of the inequalities in health within EU (2010) are worth highlighting. There is a clear convergence in the orientations recommended to local Governments regarding the health policies and interventions to be adopted in this sector. It may be stated that the health policies adopted in Italy in the 1980s have been pioneering in both European and international contexts. Enhanced by the unconditional recognition of the right to health, which is stated in the Italian Constitution, these orientations have been strongly suggested to the policymakers through effective lobbying efforts. Alongside ethical-legal recognition of the right to healthcare, the technical-scientific debate has also developed, especially following the publication of the WHO Report “Closing the gap in a generation” (2008). This has enabled the acknowledgement of the relevant role played by the socio-economic conditions which distinguish the different groups of immigrants. Moreover, the proposal of inter-sectorial policies and of an approach aimed at the empowerment of the community has become increasingly significant. In future, health protection for immigrants will be not only a priority as imposed by the recognition of health as a human right, but will also be more closely connected to capacities for the planning and support, at local level, of health promotion initiatives.
{"title":"Immigrants’ health protection: political, institutional and social perspectives at international and Italian level","authors":"M. Marceca, S. Geraci, G. Baglio","doi":"10.2427/7498","DOIUrl":"https://doi.org/10.2427/7498","url":null,"abstract":"The issue of “immigrants’ health” has been the subject of increasing interest in recent years, both in scientific literature and in the declarations of international health institutions. Specifically, the Resolution of the 61st World Health Assembly (2008), and the Report of the European Parliament on the reduction of the inequalities in health within EU (2010) are worth highlighting. There is a clear convergence in the orientations recommended to local Governments regarding the health policies and interventions to be adopted in this sector. It may be stated that the health policies adopted in Italy in the 1980s have been pioneering in both European and international contexts. Enhanced by the unconditional recognition of the right to health, which is stated in the Italian Constitution, these orientations have been strongly suggested to the policymakers through effective lobbying efforts. Alongside ethical-legal recognition of the right to healthcare, the technical-scientific debate has also developed, especially following the publication of the WHO Report “Closing the gap in a generation” (2008). This has enabled the acknowledgement of the relevant role played by the socio-economic conditions which distinguish the different groups of immigrants. Moreover, the proposal of inter-sectorial policies and of an approach aimed at the empowerment of the community has become increasingly significant. In future, health protection for immigrants will be not only a priority as imposed by the recognition of health as a human right, but will also be more closely connected to capacities for the planning and support, at local level, of health promotion initiatives.","PeriodicalId":89162,"journal":{"name":"Italian journal of public health","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2012-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68881400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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