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International Journal for Equity in Health
Published in: International Journal for Equity in Health 1/2017

Open Access 01-12-2017 | Research

The variation in the health status of immigrants and Italians during the global crisis and the role of socioeconomic factors

Authors: Alessio Petrelli, Anteo Di Napoli, Alessandra Rossi, Gianfranco Costanzo, Concetta Mirisola, Lidia Gargiulo

Published in: International Journal for Equity in Health | Issue 1/2017

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Abstract

Background

The effects of the recent global economic and financial crisis especially affected the most vulnerable social groups. Objective of the study was to investigate variation of self-perceived health status in Italians and immigrants during the economic global crisis, focusing on demographic and socioeconomic factors.

Methods

Through a cross-sectional design we analyzed the national sample of multipurpose surveys “Health conditions and use of health services” (2005 and 2013) conducted by the Italian National Institute of Statistics (ISTAT). Physical Component Summary (PCS) and Mental Component Summary (MCS) scores, derived from SF-12 questionnaire, were assumed as study outcome, dichotomizing variables distribution at 1st quartile. Prevalence rate ratios (PRR) were estimated through log-binomial regression models, stratified by citizenship and gender, evaluating the association between PCS and MCS with surveys’ year, adjusting for age, educational level, employment status, self-perceived economic resources, smoking habits, body mass index.

Results

From 2005 to 2013 the proportion of people not employed or reporting scarce/insufficient economic resources increased, especially among men, in particular immigrants. Compared with 2005 we observed in 2013 among Italians a significant lower probability of worse PCS (PRR = 0.96 both for males and females), while no differences were observed among immigrants; a higher probability of worse MCS was observed, particularly among men (Italians: PRR = 1.26;95%CI:1.22–1.29; immigrants: PRR = 1.19;95%CI:1.03–1.38). Self-perceived scarce/insufficient economic resources were strongly and significantly associated with worse PCS and MCS for all subgroups. Lower educational level was strongly associated with worse PCS in Italians and slightly associated with worse MCS for all subgroups. Being not employed was associated with worse health status, especially mental health among men.

Conclusions

Our findings support the hypothesis that economic global crisis could have negatively affected health status, particularly mental health, of Italians and immigrants. Furthermore, results suggest socioeconomic inequalities increase, in economic resources availability dimension. In a context of public health resources’ limitation due to financial crisis, policy decision makers and health service managers must face the challenge of equity in health.
Literature
1.
2.
3.
ISMU. Ventunesimo rapporto sulle migrazioni 2015. Angeli F, editor. Milano, Italy; 2015.
4.
Boulogne R, Jougla E, Breem Y, Kunst AE, Rey G. Mortality differences between the foreign-born and locally-born population in France (2004–2007). Soc Sci Med. 2012;74:1213–23.CrossRefPubMed
5.
Razum O, Zeeb H, Rohrmann S. The “healthy migrant effect” – not merely a fallacy of innacurate denominator figures. Int J Epidemiol. 2000;29:191–2.CrossRefPubMed
6.
Norredam M, Agyemang C, Hoejbjerg Hansen OK, Petersen JH, Byberg S, Krasnik A, et al. Duration of residence and disease occurrence among refugees and family reunited immigrants: Test of the “healthy migrant effect” hypothesis. Trop Med Int Heal. 2014;19:958–67.CrossRef
7.
Ullmann SH, Goldman N, Massey DS. Healthier before they migrate, less healthy when they return? The health of returned migrants in Mexico. Soc Sci Med. 2011;73:421–8.CrossRefPubMedPubMedCentral
8.
Vandenheede H, Willaert D, De Grande H, Simoens S, Vanroelen C. Mortality in adult immigrants in the 2000s in Belgium: a test of the “healthy-migrant” and the “migration-as-rapid-health-transition” hypotheses. Trop Med Int Heal. 2015;20:1832–45.CrossRef
9.
10.
11.
Gimeno-Feliu LA, Calderón-Larrañaga A, Diaz E, Poblador-Plou B, Macipe-Costa R, Prados-Torres A. The healthy migrant effect in primary care. Gac Sanit. 2015;29:15–20.CrossRefPubMed
12.
13.
Acevedo-Garcia D, Bates LM, Osypuk TL, McArdle N. The effect of immigrant generation and duration on self-rated health among US adults 2003–2007. Soc Sci Med. 2010;71:1161–72.CrossRefPubMed
14.
Vlachadis N, Vlachadi M, Iliodromiti Z, Kornarou E, Vrachnis N. Greece’s economic crisis and suicide rates: overview and outlook. J Epidemiol Community Health. 2014;68(12):1204–5.CrossRefPubMed
15.
ISTAT. Il mercato del lavoro negli anni della crisi. Dinamiche e divari. Rapporto Annuale. 2014. p. 81–138.
16.
17.
Hopkins S. Economic stability and health status: evidence from East Asia before and after the 1990s economic crisis. Health Policy. 2006;75:347–57.CrossRefPubMed
18.
19.
Bartoll X, Palencia L, Malmusi D, Suhrcke M, Borrell C. The evolution of mental health in Spain during the economic crisis. Eur J Public Health. 2014;24:415–8.CrossRefPubMed
20.
Eurofound. Access to healthcare in times of crisis. Luxembourg: Publications Office of the European Union; 2014.
21.
Kunst AE, Groenhof F, Mackenbach JP, Health EW. Occupational class and cause specific mortality in middle aged men in 11 European countries: comparison of population based studies. EU Working Group on Socioeconomic Inequalities in Health. BMJ. 1998;316:1636–42.CrossRefPubMedPubMedCentral
22.
Avendano M, Kunst AE, Huisman M, Lenthe FV, Bopp M, Regidor E, et al. Socioeconomic status and ischaemic heart disease mortality in 10 western European populations during the 1990s. Heart. 2006;92:461–7.CrossRefPubMed
23.
Mackenbach J, Stirbu I, Roskam A, Schaap M, Menvielle G, Leinsalu M, et al. Socioeconomic inequalities in health in 22 European countries. N Engl J Med. 2008;358:2468–81.CrossRefPubMed
24.
Dalstra JAA, Kunst AE, Borell C, Breeze E, Cambois E, Costa G, et al. Socioeconomic differences in the prevalence of common chronic diseases: an overview of eight European countries. Int J Epidemiol. 2005;34:316–26.CrossRefPubMed
25.
Hemingway H, Nicholson A, Stafford M, Roberts R, Marmot M. The impact of socioeconomic status on health functioning as assessed by the SF-36 questionnaire: the Whitehall II Study. Am J Public Health. 1997;87:1484–90.CrossRefPubMedPubMedCentral
26.
Artazcoz L, Benach J, Borrell C, Cortès I. Unemployment and mental health: understanding the interactions among gender, family roles, and social class. Am J Public Health. 2004;94:82–8.CrossRefPubMedPubMedCentral
27.
Sareen J, Afifi TO, McMillan KA, Asmundson GJG. Relationship between household income and mental disorders. Arch Gen Psychiatry. 2011;68:419–27.CrossRefPubMed
28.
29.
Pacelli B, Zengarini N, Broccoli S, Caranci N, Spadea T, Di Girolamo C, et al. Differences in mortality by immigrant status in Italy. Results of the Italian Network of Longitudinal Metropolitan Studies. Eur J Epidemiol. 2016;31:691–701.CrossRefPubMed
30.
31.
Bena A, Giraudo M. Occupational injury risk in immigrant workers in Italy: differences in work characteristics and age. Epidemiol Prev. 2014;38:208–18.PubMed
32.
33.
Ware Jr JE, Kosinski M, Bayliss MS, McHorney CA, Rogers WH, Raczek A. Comparison of methods for the scoring and statistical analysis of SF-36 health profile and summary measures: summary of results from the Medical Outcomes Study. Med Care. 1995;33:AS264–79.CrossRefPubMed
34.
Barbaglia MG, ten Have M, Dorsselaer S, Alonso J, de Graaf R. Negative socioeconomic changes and mental disorders: a longitudinal study. J Epidemiol Community Health. 2015;69:55–62.CrossRefPubMed
35.
Gotsens M, Malmusi D, Villarroel N, Vives-Cases C, Garcia-Subirats I, Hernando C, et al. Health inequality between immigrants and natives in Spain: the loss of the healthy immigrant effect in times of economic crisis. Eur J Public Health. 2015;25(6):923–9.CrossRefPubMed
36.
Suhrcke M, Stuckler D. Will the recession be bad for our health? It depends. Soc Sci Med. 2012;74:647–53.CrossRefPubMed
37.
Toffolutti V, Suhrcke M. Assessing the short term health impact of the great recession in the European Union: a cross-country panel analysis. Prev Med. 2014;64:54–62.CrossRefPubMed
38.
Kim IH, Carrasco C, Muntaner C, McKenzie K, Noh S. Ethnicity and postmigration health trajectory in new immigrants to Canada. Am J Public Health. 2013;103:96–104.CrossRef
39.
Subedi RP, Rosenberg MW. Determinants of the variations in self-reported health status among recent and more established immigrants in Canada. Soc Sci Med. 2014;115:103–10.CrossRefPubMed
40.
Nielsen SS, Krasnik A. Poorer self-perceived health among migrants and ethnic minorities versus the majority population in Europe: a systematic review. Int J Public Health. 2010;55:357–71.CrossRefPubMed
41.
Jervelund SS, Malik S, Ahlmark N, Villadsen SF, Nielsen A, Vitus K. Morbidity, Self-Perceived Health and Mortality Among non-Western Immigrants and Their Descendants in Denmark in a Life Phase Perspective. J Immigr Minor Health. 2017;19:448–476. doi:10.​1007/​s10903-016-0347-9.
42.
43.
Lara M, Gamboa C, Kahramanian MI, Morales LS, Bautista DEH. Acculturation and Latino health in the United States: a review of the literature and its sociopolitical context. Annu Rev Public Health. 2005;26:367–97.CrossRefPubMed
44.
Goldman N, Kimbro RI, Turra CM, Pebley AR. Socioeconomic gradients in health for white and Mexican-origin populations. Am J Public Health. 2006;96:2186–93.CrossRefPubMedPubMedCentral
45.
46.
Stronks K, Kunst AE. The complex interrelationship between ethnic and socio-economic inequalities in health. J Public Health. 2009;31:324–5.CrossRef
47.
Dinesen C, Nielsen SS, Mortensen LH, Krasnik A. Inequality in self-rated health among immigrants, their descendants and ethnic Danes: Examining the role of socioeconomic position. Int J Public Health. 2011;56:503–14.CrossRefPubMed
48.
Dunlavy AC, Garcy AM, Rostila M. Educational mismatch and health status among foreign-born workers in Sweden. Soc Sci Med. 2016;154:36–44.CrossRefPubMed
49.
Karlsen S, Nazroo J. Relation between racial discrimination, social class, and health among ethnic minority groups. Am J Public Health. 2002;92:624–31.CrossRefPubMedPubMedCentral
50.
Idler EL, Benyamini Y. Self-rated health and mortality: a review of twenty-seven community studies. J Health Soc Behav. 1997;38:21–37.CrossRefPubMed
51.
Rechel B, Mladovsky P, Ingleby D, Mackenbach JP, McKee M. Migration and health in an increasingly diverse Europe. Lancet. 2013;381:1235–1245.
52.
Lanari D, Bussini O, Minelli L. Self-perceived health among Eastern European immigrants over 50 living in Western Europe. Int J Public Health. 2015;60:21–31.CrossRefPubMed
53.
Metadata
Title
The variation in the health status of immigrants and Italians during the global crisis and the role of socioeconomic factors
Authors
Alessio Petrelli
Anteo Di Napoli
Alessandra Rossi
Gianfranco Costanzo
Concetta Mirisola
Lidia Gargiulo
Publication date
01-12-2017
Publisher
BioMed Central
Published in
International Journal for Equity in Health / Issue 1/2017
Electronic ISSN: 1475-9276
DOI
https://doi.org/10.1186/s12939-017-0596-9

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