Chronic disease in the ethnic minority and migrant groups: time for a paradigm shift in Europe

Excerpt

In this issue of the Journal, a series of articles belonging to the Topical Collection “Focus on healthcare and non-communicable disease in migrants” addresses the health of a stably growing proportion of subjects in the European (EU) countries. In 1990, just over 2 % of the population living in Italy was born elsewhere, [1] and a physician had few opportunities to meet a person belonging to an ethnic minority in the hospital ward or outpatient clinic. Over the past few decades, this scenario has changed dramatically. The fall of the iron curtain in 1989 opened migration flows from central and eastern EU countries mainly towards Germany, Turkey, and Finland. Meanwhile, growing flows from the countries of the south created a new “migration frontier” along the northern shores of the Mediterranean. Italy, Greece, Spain, and Portugal, traditionally countries of emigration, became countries of net immigration [1]. As a result in 2015, an estimated 76 million international long-term migrants, defined by the UN as a “person who moves to a country other than that of his or her usual residence for a period of at least a year” [2], lived in the WHO European region, 8.5 million more than in 2005 [1, 3]. The possibility of meeting these new patients in the hospital ward or outpatient clinic is now high. Notwithstanding these relevant changes, scientific and cultural training of health workers on the health needs of minority groups is still limited and probably skewed [4]. The infectious disease specialists have traditionally been considered experts in the field of migration medicine, because it was thought that the large majority of the diseases affecting migrants had to be infectious or tropical (“exotic”) in nature. However, when we face people born in low-income countries who permanently live and work in Europe, we have to consider that this paradigm is probably shifted [5]. …