患有非传染性疾病的无证移民医疗保健需求的社会决定因素:范围界定审查

J. Tenorio-Mucha, Corinne Jeffries-Tolksdorf, C. Burton-Jeangros, Jan-Erik Refle, Y. Jackson
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摘要

我们在 Medline、Embase、Web of Science 和 Google Scholar 中检索了相关文献。我们纳入了描述针对患有心血管疾病、癌症、慢性呼吸系统疾病或糖尿病的无证移民的干预措施、计划或政策的文章。对环境(如医院、社区或流动诊所)或国家没有限制。我们收录了 2000 年至 2022 年间以英文、西班牙文或法文发表的文章。数据按照健康的社会决定因素委员会的框架进行结构化处理,并在移民过程中加以区分(原籍国、过境国、离境和融入国以及目的地国)。我们从已确认的 953 篇文章中选取了 22 项研究。这些研究报告了来自意大利、美国、西班牙、瑞士、荷兰、法国、奥地利和瑞典的数据。这些研究表明,个人的决定因素(物质、生物、社会心理和行为)在整个移民过程中不断演变,并影响着医疗保健需求。这些需求的满足受制于与医疗系统相关的决定因素,如可用性和可及性。然而,个人和卫生系统的决定因素取决于原籍国和目的地国的政治和法律环境,以及无证移民在目的地国的社会经济地位。移民卫生政策应着眼于更好地应对无证移民在整个移民过程中与非传染性疾病相关的卫生保健需求,同时考虑到导致其健康脆弱性的社会、经济和法律因素。
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Social determinants of the healthcare needs of undocumented migrants living with non-communicable diseases: a scoping review
We aimed to map the social determinants of meeting the healthcare needs of undocumented migrants living with non-communicable diseases (NCDs) throughout their migration journey (from the country of origin to the country(/ies) of transit and destination).We conducted a scoping review.We searched literature in Medline, Embase, Web of Science and Google Scholar.We included articles that describe interventions, programmes or policies for undocumented migrants living with cardiovascular diseases, cancer, chronic respiratory disease, or diabetes. There were no restrictions by setting (eg, hospital, community or mobile clinic) or country. We included articles published in English, Spanish, or French between 2000 to 2022.The data were structured according to the Commission on Social Determinants of Health framework, differentiated along the migration journey (country of origin, transit, departure and integration, and country of destination). A new conceptual model emerged from data synthesis.We included 22 studies out of 953 identified articles. They reported data from Italy, the USA, Spain, Switzerland, The Netherlands, France, Austria, and Sweden. They show that individual determinants (material, biological, psychosocial and behavioural) evolve throughout the migration journey and influence healthcare needs. The satisfaction of these needs is conditioned by health system-related determinants such as availability and accessibility. However, the individual and health-system determinants depend on the political and legal context of both the country of origin and the country(/ies) of destination, as well as on the socioeconomic position of undocumented migrants in the destination country.Migrant health policies should aim at better responding to NCDs-related healthcare needs of undocumented migrants throughout their migration journey, taking into account the social, economic and legal factors that underlie their health vulnerability.
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