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1.
Comunidad (Barc., Internet) ; 22(2): 0-0, jul.-oct. 2020. tab
Artículo en Español | IBECS | ID: ibc-193595

RESUMEN

OBJETIVOS: describir conocimientos y percepciones de profesionales de Atención Primaria sobre el acceso al Sistema Nacional de Salud (SNS) y la atención sanitaria de la población inmigrante, así como analizar diferencias entre categorías profesionales. MÉTODOS: se realizó un estudio observacional descriptivo transversal mediante una encuesta a 352 profesionales sanitarios y no sanitarios en centros de salud de la Comunidad de Madrid, y residentes de Medicina y Enfermería de la Unidad Docente Multiprofesional de Atención Familiar y Comunitaria Sur de Madrid (UDMAFyC Sur) entre febrero y marzo de 2019. RESULTADOS: respondieron 179 profesionales (50,9%). El 50,3% opinó que los inmigrantes tienen frecuentes dificultades de acceso y el 65,9% que el estatus migratorio condiciona su salud, señalando el idioma como barrera relevante el 80,4%. El 72,7% de los sanitarios afirmó que no consumen más recursos. Expresaron nulo/escaso conocimiento del Real Decreto-Ley (RDL) 16/2012 el 72%, y del RDL 7/2018, un 66,7%. Un 30,7% consideró que el RDL 16/2012 tuvo efectos negativos en salud, y el 28,5%, que el RDL 7/2018 recuperó la universalidad. Un 54,9% de sanitarios apoyó la universalidad del SNS, contrastando con el 19,1% de personal no sanitario. CONCLUSIONES: la mitad de profesionales percibe frecuentes dificultades de la población inmigrante en su acceso al SNS, aunque el conocimiento de las normativas es limitado. Una ajustada mayoría respalda la universalidad, existiendo posicionamientos restrictivos con relativa frecuencia, especialmente entre el personal no sanitario. Se reproducen ciertos mitos sobre la atención a población inmigrante, no así acerca del consumo de recursos sanitarios


OBJECTIVES: To report the knowledge and perceptions of Primary Care professionals regarding access to the Spanish National Healthcare System and healthcare assistance provided to the immigrant population, as well as to analyse differences by professional categories. METHODS: A cross-sectional study was conducted by sending a questionnaire to 352 professionals: healthcare workers (HCWs) and non-healthcare workers (non-HCWs) from primary health care centres in the southern region of the Community of Madrid and resident doctors and nurses assigned to this primary healthcare area, from February to March 2019. RESULTS: Overall, 179 professionals (50.9%) replied. Of these, 50.3% thought that migrants face frequent difficulties in access, whereas 65.9% considered that migrants' health is conditioned by their migratory status. Moreover, 80.4% identified language as a relevant barrier and 72.7% of HCWs believed that migrants do not consume more resources. Regarding the Spanish Royal Decree-laws (RDL), 72% admitted having no or little knowledge of Spanish RDL 16/2012, and 66.7% of Spanish RDL 7/2018. However, 30.7% considered that Spanish RDL 16/2012 had negative effects on health, 28.5% agreed that Spanish RDL 7/2018 recovered universal healthcare coverage (UHC). Overall, 54.9% of HCWs support UHC in comparison to 19.1% of non-HCW. CONCLUSIONS: Half the professionals perceive that immigrants encounter frequent difficulties when accessing the Spanish Healthcare System, although their knowledge of legislation is limited. A slight majority supports UHC and finds a large number of restrictive stances, especially among non-HCWs. Certain misconceptions regarding care provided to immigrants persist, but not those related to health resources consumption


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Atención Primaria de Salud , Personal de Salud , Emigrantes e Inmigrantes/estadística & datos numéricos , Estudios Transversales , Encuestas y Cuestionarios , Equidad en el Acceso a los Servicios de Salud , Sistemas Nacionales de Salud , Percepción Social , Conocimientos, Actitudes y Práctica en Salud
2.
BMC Public Health ; 20(1): 1563, 2020 Oct 16.
Artículo en Inglés | MEDLINE | ID: mdl-33066741

RESUMEN

OBJECTIVES: There is a paucity of research on patterns of cyber-victimization in minority groups, including immigrants. This study aimed to identify individual, interpersonal and contextual characteristics associated with cyber-victimization among immigrants and non-immigrants. METHODS: We drew on nationally representative data from adolescents and adults in the Canadian General Social Survey on victimization (2014). We used multivariable logistic regression to identify potential factors associated with cyber-victimization in the last 12 months, stratified by immigrant status and sex. RESULTS: Among 27,425 survey respondents, the weighted prevalence of cyber-victimization in the last 12 months was 2.1% among immigrants and 2.3% among non-immigrants. Cyber-victimization rates differed significantly by sex among immigrants (2.8% for males vs. 1.4% for females), but not among non-immigrants (2.1% for males vs. 2.4% for females). While most other factors associated with cyber-victimization were similar for immigrants and non-immigrants, there were pronounced associations of past child maltreatment (adjusted prevalence odds ratio [aPOR] 4.85, 95% confidence interval [CI] 2.76, 8.52) and residence in an unwelcoming neighbourhood (aPOR 5.08, 95% CI 2.44, 10.55) with cyber-victimization among immigrants that were diminished or absent among non-immigrants. Additionally, sex-stratified analyses among immigrants showed cyber-victimization to be strongly associated with having a mental health condition (aPOR 3.50, 95% CI 1.36, 8.97) among immigrant males only, and with perceived discrimination (aPOR 4.08, 95% CI 1.65, 10.08), as well as being under 24 years old (aPOR 3.24, 95% CI 1.09, 9.60) among immigrant females. CONCLUSIONS: Immigration status and sex were differentially associated with cyber-victimization. Findings support the salience of a social-ecological perspective and gender-stratified analyses to better elucidate complex pathways linking cyber-victimization to potential gender-based health inequities among immigrants.


Asunto(s)
Víctimas de Crimen/estadística & datos numéricos , Ciberacoso/estadística & datos numéricos , Emigrantes e Inmigrantes/estadística & datos numéricos , Adolescente , Adulto , Canadá , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Factores Sexuales , Factores Socioeconómicos , Encuestas y Cuestionarios , Adulto Joven
3.
PLoS One ; 15(10): e0240151, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33052932

RESUMEN

As of August 2020, the United States is the global epicenter of the COVID-19 pandemic. Emerging data suggests that "essential" workers, who are disproportionately more likely to be racial/ethnic minorities and immigrants, bear a disproportionate degree of risk. We used publicly available data to build a series of spatial autoregressive models assessing county level associations between COVID-19 mortality and (1) percentage of individuals engaged in farm work, (2) percentage of households without a fluent, adult English-speaker, (3) percentage of uninsured individuals under the age of 65, and (4) percentage of individuals living at or below the federal poverty line. We further adjusted these models for total population, population density, and number of days since the first reported case in a given county. We found that across all counties that had reported a case of COVID-19 as of July 12, 2020 (n = 3024), a higher percentage of farmworkers, a higher percentage of residents living in poverty, higher density, higher population, and a higher percentage of residents over the age of 65 were all independently and significantly associated with a higher number of deaths in a county. In urban counties (n = 115), a higher percentage of farmworkers, higher density, and larger population were all associated with a higher number of deaths, while lower rates of insurance coverage in a county was independently associated with fewer deaths. In non-urban counties (n = 2909), these same patterns held true, with higher percentages of residents living in poverty and senior residents also significantly associated with more deaths. Taken together, our findings suggest that farm workers may face unique risks of contracting and dying from COVID-19, and that these risks are independent of poverty, insurance, or linguistic accessibility of COVID-19 health campaigns.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Factores Socioeconómicos , Infecciones por Coronavirus/mortalidad , Demografía/estadística & datos numéricos , Emigrantes e Inmigrantes/estadística & datos numéricos , Agricultores/estadística & datos numéricos , Humanos , Cobertura del Seguro/estadística & datos numéricos , Pandemias , Neumonía Viral/mortalidad , Estados Unidos
5.
Epidemiol Prev ; 44(4): 304-307, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32921037

RESUMEN

It has been hypothesized that bacille Calmette-Guerin (BCG), the anti-tuberculosis vaccine, can be protective against Covid-19. Using data of performed swabs and RT-PCR results for SARS-CoV-2 in the Reggio Emilia province (Emilia-Romagna Region, Northern Italy) from March 6th to March 26th, 2020, we computed age, gender, and place of birth (Italy or abroad) specific risk of being tested, prevalence of positive tests, and probability of testing positive given that a swab has been taken during the epidemic peak. We report that immigrants resident in Reggio Emilia province, mostly coming from Countries with high BCG vaccination coverage, and Italians had a similar prevalence of infection (odds ratio - OR 0.99; 95%CI 0.82-1.20) and similar probability of being tested (OR 0.93; 95%CI 0.81-1.10). Our data do not support the hypothesis that immigrants from Countries where BCG vaccination is recommended have a lower risk of Covid-19 infection.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Emigrantes e Inmigrantes/estadística & datos numéricos , Pandemias , Neumonía Viral/epidemiología , Adulto , África/etnología , Anciano , Asia/etnología , Vacuna BCG , Betacoronavirus/aislamiento & purificación , Técnicas de Laboratorio Clínico , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/etnología , Infecciones por Coronavirus/prevención & control , Femenino , Humanos , Italia/epidemiología , Masculino , Persona de Mediana Edad , Nasofaringe/virología , Pandemias/prevención & control , Neumonía Viral/diagnóstico , Neumonía Viral/etnología , Neumonía Viral/prevención & control , Polonia/etnología , Prevalencia , Utilización de Procedimientos y Técnicas , Cobertura de Vacunación
6.
Ann Ist Super Sanita ; 56(3): 378-389, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32959805

RESUMEN

INTRODUCTION: The study was implemented to provide guidance to decision-makers and clinicians by describing hospital care offered to women who gave birth with confirmed SARS-CoV-2 infection. MATERIALS AND METHODS: National population-based prospective cohort study involving all women with confirmed SARS-CoV-2 infection who gave birth between February 25 and April 22, 2020 in any Italian hospital. RESULTS: The incidence rate of confirmed SARS-CoV-2 infection in women who gave birth was 2.1 per 1000 maternities at a national level and 6.9/1000 in the Lombardy Region. Overall one third of the women developed a pneumonia and 49.7% assumed at least one drug against SARS-CoV-2 infection. Caesarean rate was 32.9%, no mothers nor newborns died. Six percent of the infants tested positive for SARS-CoV-2 at birth. CONCLUSIONS: Clinical features and outcomes of COVID-19 in women who gave birth are similar to those described for the general population, most women developing mild to moderate illness.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Pandemias , Neumonía Viral/epidemiología , Complicaciones Infecciosas del Embarazo/epidemiología , Corticoesteroides/uso terapéutico , Adulto , Cesárea/estadística & datos numéricos , Infecciones por Coronavirus/congénito , Infecciones por Coronavirus/tratamiento farmacológico , Infecciones por Coronavirus/terapia , Infecciones por Coronavirus/transmisión , Emigrantes e Inmigrantes/estadística & datos numéricos , Femenino , Madurez de los Órganos Fetales/efectos de los fármacos , Humanos , Incidencia , Recién Nacido , Transmisión Vertical de Enfermedad Infecciosa/estadística & datos numéricos , Italia/epidemiología , Pulmón/embriología , Neumonía Viral/congénito , Neumonía Viral/terapia , Neumonía Viral/transmisión , Embarazo , Complicaciones Infecciosas del Embarazo/virología , Resultado del Embarazo , Nacimiento Prematuro/epidemiología , Utilización de Procedimientos y Técnicas , Estudios Prospectivos , Mortinato/epidemiología
7.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(7): 1092-1096, 2020 Jul 10.
Artículo en Chino | MEDLINE | ID: mdl-32741177

RESUMEN

Objective: To analyze the influencing factors of HIV testing behavior among foreigners in Guangzhou, and provide a reference for promoting HIV testing and intervention services in foreigners. Methods: A cross-sectional survey was conducted from November 2019 to January 2020 among 230 eligible foreigners selected in Guangzhou through convenient sampling method in the form of one-to-one questionnaire interview, HIV testing behaviors and related influencing factors were described and analyzed with χ(2) test and multivariate logistic regression model. Results: A total of 230 foreigners were included in the study, in whom 156 were males (67.8%), 217 were from Africa (94.3%), 138 (60.0%) were with education level of university and above, 169 (73.5%) were in business, 47 (20.4%) were students, 132 (57.4%) had cumulative residence >12 months in Guangzhou and 113 (49.1%) had health examination in China in the past 6 months. In these foreigners, the rate of AIDS-related knowledge awareness was 76.0%, the proportion of condom use in the last sex was 39.6%(89/225) and 47.8%(110/230) received HIV tests in the past 3 months. Multivariate logistic regression analysis showed, the influencing factors of HIV testing behavior in the past 3 months included cumulative residence ≤12 months (compared with cumulative residence >12 months, OR=3.12, 95%CI: 1.49-6.56), health examination in China in the past 6 months (compared to those who had not, OR=2.53, 95%CI: 1.17-5.48), awareness of HIV testing and consulting service in Guangzhou (compared with those who had no awareness, OR=3.65, 95%CI: 1.71-7.78). Conclusions: Some foreigners in Guangzhou had relatively low rates of HIV testing and condom use. Those who pay attention to their own health status and know well about HIV testing and consulting services are more likely to receive HIV testing, foreigners in Guangzhou should be encouraged to receive HIV testing. Their self-testing awareness should be improved.


Asunto(s)
Emigrantes e Inmigrantes/psicología , Infecciones por VIH/prevención & control , Tamizaje Masivo/psicología , África/etnología , China/epidemiología , Estudios Transversales , Emigrantes e Inmigrantes/estadística & datos numéricos , Femenino , Infecciones por VIH/epidemiología , Humanos , Masculino , Factores Socioeconómicos , Encuestas y Cuestionarios
8.
PLoS One ; 15(8): e0238281, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32853230

RESUMEN

This is a population-based prospective cohort study on archive data describing the age- and sex-specific prevalence of COVID-19 and its prognostic factors. All 2653 symptomatic patients tested positive for SARS-CoV-2 from February 27 to April 2, 2020 in the Reggio Emilia province, Italy, were included. COVID-19 cumulative incidence, hospitalization and death rates, and adjusted hazard ratios (HR) with 95% confidence interval (95% CI) were calculated according to sociodemographic and clinical characteristics. Females had higher prevalence of infection than males below age 50 (2.61 vs. 1.84 ‰), but lower in older ages (16.49 vs. 20.86 ‰ over age 80). Case fatality rate reached 20.7% in cases with more than 4 weeks follow up. After adjusting for age and comorbidities, men had a higher risk of hospitalization (HR 1.4 95% CI 1.2 to 1.6) and of death (HR 1.6, 95% CI 1.2 to 2.1). Patients over age 80 compared to age < 50 had HR 7.1 (95% CI 5.4 to 9.3) and HR 27.8 (95% CI 12.5 to 61.7) for hospitalization and death, respectively. Immigrants had a higher risk of hospitalization (HR 1.3, 95% CI 0.99 to 1.81) than Italians and a similar risk of death. Risk of hospitalization and of death were higher in patients with heart failure, arrhythmia, dementia, coronary heart disease, diabetes, and hypertension, while COPD increased the risk of hospitalization (HR 1.9, 95% CI 1.4 to 2.5) but not of death (HR 1.1, 95% CI 0.7 to 1.7). Previous use of ACE inhibitors had no effect on risk of death (HR 0.97, 95% CI 0.69 to 1.34). Identified susceptible populations and fragile patients should be considered when setting priorities in public health planning and clinical decision making.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Hospitalización/estadística & datos numéricos , Neumonía Viral/epidemiología , Distribución por Edad , Anciano , Anciano de 80 o más Años , Betacoronavirus , Comorbilidad , Infecciones por Coronavirus/mortalidad , Emigrantes e Inmigrantes/estadística & datos numéricos , Femenino , Humanos , Incidencia , Italia/epidemiología , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/mortalidad , Modelos de Riesgos Proporcionales , Estudios Prospectivos , Factores de Riesgo , Distribución por Sexo
10.
Public Health Rep ; 135(1_suppl): 82S-89S, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32735186

RESUMEN

OBJECTIVES: Correctional settings (prisons, jails, detention facilities) provide a unique opportunity to screen for sexually transmitted infections (STIs) among correctional populations with a high prevalence of infection. Immigrant detainees are a distinct and poorly described correctional population. The main objective of this study was to determine the feasibility of a national STI screening program for immigrant detainees. METHODS AND MATERIALS: We developed an opt-out STI testing program that included electronic health record integration, patient education, and staff member training. We piloted this program from June 22 through August 19, 2018, at 2 detention facilities with different operational requirements and detainee demographic characteristics. We assessed STI test positivity rates, treatment outcomes, estimated cost to conduct testing and counseling, and staff member perceptions of program value and challenges to implementation. RESULTS: Of 1041 immigrant detainees approached for testing, 526 (50.5%) declined. Of 494 detainees who were tested, 42 (8.5%) tested positive for at least 1 STI; the percentage positivity rates were 6.7% (n = 33) for chlamydia, 0.8% (n = 4) for syphilis, 0.8% (n = 4) for gonorrhea, 0.6% (n = 3) for hepatitis B, and 0.2% (n = 1) for HIV. The estimated cost to detect any STI ranged from $500 to $961; the estimated cost to identify 1 person infected with HIV ranged from $22 497 to $43 244. Forty of 42 persons who tested positive began treatment before release from custody. Medical staff members had positive views of the program but had concerns about workload. PRACTICE IMPLICATIONS: STIs are prevalent among immigrant detainees. A routine screening program is feasible if operational aspects are carefully considered and would provide counseling, education, and treatment for this vulnerable population.


Asunto(s)
Emigrantes e Inmigrantes/estadística & datos numéricos , Tamizaje Masivo/estadística & datos numéricos , Enfermedades de Transmisión Sexual/diagnóstico , Negativa del Paciente al Tratamiento/estadística & datos numéricos , Adolescente , Adulto , Anciano , Femenino , Estado de Salud , Humanos , Masculino , Tamizaje Masivo/economía , Persona de Mediana Edad , Enfermedades de Transmisión Sexual/tratamiento farmacológico , Enfermedades de Transmisión Sexual/etnología , Factores Socioeconómicos , Trastornos Relacionados con Sustancias/etnología , Adulto Joven
11.
Public Health Rep ; 135(5): 676-684, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32795209

RESUMEN

OBJECTIVE: Infants born to women with hepatitis B virus (HBV) infection are at high risk for chronic HBV infection and premature death. We examined epidemiologic trends among women with HBV infection who gave birth in New York City (NYC) to inform public health prevention activities. METHODS: We obtained data on HBV-infected women residing and giving birth in NYC during 1998-2015 from the NYC Perinatal HBV Prevention Program. We obtained citywide birth data from the NYC Office of Vital Statistics. We calculated the incidence of births to HBV-infected women per 100 000 live births and stratified by maternal race, birthplace, and age. We calculated annual percentage change (APC) in incidence of births to HBV-infected women by using joinpoint regression. RESULTS: Of 29 896 HBV-infected women included in the study, 28 195 (94.3%) were non-US-born, of whom 16 600 (58.9%) were born in China. Overall incidence of births to HBV-infected women per 100 000 live births increased from 1156 in 1998 to 1573 in 2006 (APC = 3.1%; P < .001) but declined to 1329 in 2015 (APC = -1.4%; P = .02). Incidence among US-born women declined from 1998 to 2015 (330 to 84; APC = -7.3%; P < .001) and among non-US-born women increased from 1998 to 2007 (1877 to 2864; APC = 3.6%; P < .001) but not thereafter. Incidence among women born in China increased from 1998 to 2006 (13 275 to 16 480; APC = 1.8%; P = .02) but decreased to 12 631 through 2015 (APC = -3.3%; P < .001). CONCLUSIONS: The incidence of births to HBV-infected women in NYC declined significantly among US-born women but not among non-US-born women, highlighting the need for successful vaccination programs worldwide.


Asunto(s)
Transmisión de Enfermedad Infecciosa/estadística & datos numéricos , Emigrantes e Inmigrantes/estadística & datos numéricos , Hepatitis B Crónica/epidemiología , Hepatitis B Crónica/transmisión , Vigilancia de la Población/métodos , Complicaciones Infecciosas del Embarazo/epidemiología , Mujeres Embarazadas , Adolescente , Adulto , Femenino , Hepatitis B Crónica/prevención & control , Humanos , Incidencia , Recién Nacido , Masculino , Persona de Mediana Edad , Ciudad de Nueva York/epidemiología , Embarazo , Complicaciones Infecciosas del Embarazo/prevención & control , Características de la Residencia/estadística & datos numéricos , Adulto Joven
12.
Public Health Rep ; 135(5): 611-620, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32805191

RESUMEN

OBJECTIVE: Although some studies have reported a higher incidence of HIV infection among non-US-born people than among US-born people, national data on this topic are scarce. We compared the epidemiology of HIV infection between US-born and non-US-born residents of the United States and examined the characteristics of non-US-born people with diagnosed HIV infection by region of birth (ROB). METHODS: We used a cross-sectional study design to produce national, population-based data describing HIV infection among US-born and non-US-born people. We analyzed National HIV Surveillance System data for people with HIV infection diagnosed during 2010-2017 and reported to the Centers for Disease Control and Prevention (CDC). We compared data on demographic characteristics, transmission risk category, and stage 3 infection (AIDS) classification within 3 months of HIV diagnosis, by nativity and ROB. RESULTS: During 2010-2017, 328 317 children and adult US residents were diagnosed with HIV infection and were reported to CDC: 214 973 (65.5%) were US-born, 50 301 (15.3%) were non-US-born, and 63 043 (19.2%) were missing data on country of birth. After adjusting for missing country of birth, 266 147 (81.1%) people were US-born and 62 170 (18.9%) were non-US-born. This group accounted for 15 928 of 65 645 (24.2%) HIV diagnoses among girls and women and 46 242 of 262 672 (17.6%) HIV diagnoses among boys and men. A larger percentage of non-US-born people than US-born people had stage 3 infection (AIDS) at HIV diagnosis (31.2% vs 23.9%). Among non-US-born people with HIV diagnoses, 19 876 (39.5%) resided in the South. CONCLUSIONS: Characterizing non-US-born people with HIV infection is essential for developing effective HIV interventions, particularly in areas with large immigrant populations.


Asunto(s)
Emigrantes e Inmigrantes/estadística & datos numéricos , Infecciones por VIH/etnología , Infecciones por VIH/epidemiología , Vigilancia de la Población , Características de la Residencia/estadística & datos numéricos , Migrantes/estadística & datos numéricos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Estudios Transversales , Estudios Epidemiológicos , Femenino , Humanos , Incidencia , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Factores de Riesgo , Estados Unidos/epidemiología , Adulto Joven
13.
Epidemiol Psychiatr Sci ; 29: e158, 2020 Aug 14.
Artículo en Inglés | MEDLINE | ID: mdl-32792036

RESUMEN

AIMS: Early diagnosis and treatment of depression are associated with better prognosis. We used baseline data of the Canadian Longitudinal Study on Aging (2012-2015; ages 45-85 years) to examine differences in prevalence and predictors of undiagnosed depression (UD) between immigrants and non-immigrants at baseline and persistent and/or emerging depressive symptoms (DS) 18 months later. At this second time point, we also examined if a mental health care professional (MHCP) had been consulted. METHODS: We excluded individuals with any prior mood disorder and/or current anti-depressive medication use at baseline. UD was defined as the Center for Epidemiological Studies Depression 10 score ⩾10. DS at 18 months were defined as Kessler 10 score ⩾19. The associations of interest were examined in multivariate logistic regression models. RESULTS: Our study included 4382 immigrants and 18 620 non-immigrants. The mean age (standard deviation) in immigrants was 63 (10.3) years v. 65 (10.7) years in non-immigrants and 52.1% v. 57.1% were male. Among immigrants, 12.2% had UD at baseline of whom 34.2% had persistent DS 18 months later v. 10.6% and 31.4%, respectively, among non-immigrants. Female immigrants were more likely to have UD than female non-immigrants (odds ratio 1.50, 95% confidence interval 1.25-1.80) but no difference observed for men. The risk of persistent DS and consulting an MHCP at 18 months did not differ between immigrants and non-immigrants. CONCLUSIONS: Female immigrants may particularly benefit from depression screening. Seeking mental health care in the context of DS should be encouraged.


Asunto(s)
Envejecimiento/psicología , Depresión/etnología , Emigrantes e Inmigrantes/psicología , Conocimientos, Actitudes y Práctica en Salud , Conducta de Búsqueda de Ayuda , Servicios de Salud Mental/estadística & datos numéricos , Adulto , Factores de Edad , Anciano , Canadá/epidemiología , Depresión/epidemiología , Depresión/psicología , Emigrantes e Inmigrantes/estadística & datos numéricos , Femenino , Accesibilidad a los Servicios de Salud , Humanos , Estudios Longitudinales , Masculino , Salud Mental , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , Factores Sexuales
15.
Public Health ; 186: 95-100, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32795770

RESUMEN

OBJECTIVES: The aim of the study was to characterise the existence of the healthy immigrant effect (HIE; better health initially, worsening with an increase in the length of residence) in a big city from a Western European country, particularly in a non-European Union immigrant population. STUDY DESIGN: This is a cross-sectional study. METHODS: We used data from the National Health Survey 2014 to compare the health status of the immigrant and Portuguese populations with different lengths of residence. After descriptive statistics, binary logistic regressions models, with adjusted levels and 95% confidence intervals, were used. RESULTS: Immigrants were healthier than the Portuguese population (<10 years: odds ratio [OR] = 0.07; 95% confidence interval [CI] = [0.01; 0.51]; ≥10 years: OR = 0.62; 95% CI = [0.19; 2.03]), but had an increased likelihood of suffering from chronic diseases and risk behaviours with the increase in their length of stay in Portugal. After living in Portugal for more than 10 years, the immigrants showed no statistical difference in the main health indicators. CONCLUSIONS: There was a tendency for the health status of immigrants to deteriorate over 10 years of residence in Portugal. To better understand the reasons behind the HIE, specific and tailored studies must be developed.


Asunto(s)
Emigrantes e Inmigrantes/estadística & datos numéricos , Estado de Salud , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Enfermedad Crónica/epidemiología , Estudios Transversales , Europa (Continente) , Femenino , Encuestas Epidemiológicas , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Aceptación de la Atención de Salud , Portugal , Asunción de Riesgos , Adulto Joven
16.
Public Health ; 186: 52-56, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32771661

RESUMEN

OBJECTIVES: Lockdown measures in response to the coronavirus disease 2019 (COVID-19) pandemic can have serious mental health effects on the population, especially in vulnerable groups, such as those living in poor socio-economic conditions, those who are homeless, migrant workers and asylum seekers/refugees. In addition, these vulnerable groups frequently have greater difficulty accessing health services and in treatment adherence. The aim of this study is to estimate the impact of the COVID-19-related lockdown on service utilisation and follow-up adherence in an Italian mental health outpatient service for migrants and individuals in socio-economic difficulties. STUDY DESIGN: The design of this study is a retrospective cross-sectional study. METHODS: All patients who visited the mental health outpatient service in the months of February and March in the years 2017-2020 were included in the study. To compare service utilisation before and after the lockdown, the number of patients who visited the mental health outpatient service for psychiatric interview were recorded. Follow-up adherence was calculated as the percentage of patients who visited in February and subsequently attended a follow-up visit in March of the same year. RESULTS: The number of patients who visited the outpatient service between February 2017 and February 2020 was continuously increasing. In March 2020, fewer patients visited the service for psychiatric interview, in line with the introduction of lockdown measures. In addition, the number of the patients who visited in February 2020 and returned for their follow-up visits in March 2020 declined from approximately 30% over the same months in 2017-2019 to 17.53% in March 2020. CONCLUSIONS: The lockdown-related reduction in numbers of patients accessing the mental health service makes it difficult to help vulnerable populations during a period of time in which their mental health needs are expected to increase. Moreover, the reduction seen in follow-up compliance increases the risk of treatment discontinuation and possible relapse. Proactive alternative strategies need to be developed to reach these vulnerable populations.


Asunto(s)
Infecciones por Coronavirus/prevención & control , Emigrantes e Inmigrantes/psicología , Utilización de Instalaciones y Servicios/estadística & datos numéricos , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Servicios de Salud Mental/estadística & datos numéricos , Pandemias/prevención & control , Neumonía Viral/prevención & control , Pobreza , Cumplimiento y Adherencia al Tratamiento/estadística & datos numéricos , Adulto , Infecciones por Coronavirus/epidemiología , Estudios Transversales , Emigrantes e Inmigrantes/estadística & datos numéricos , Femenino , Personas sin Hogar/psicología , Personas sin Hogar/estadística & datos numéricos , Humanos , Italia/epidemiología , Masculino , Persona de Mediana Edad , Neumonía Viral/epidemiología , Refugiados/psicología , Refugiados/estadística & datos numéricos , Estudios Retrospectivos , Poblaciones Vulnerables , Adulto Joven
17.
Am J Public Health ; 110(9): 1397-1404, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32673107

RESUMEN

Objectives. To estimate treatment rates of high cholesterol, hypertension, and diabetes among Hispanic/Latino immigrants by immigration status (i.e., naturalized citizens, documented immigrants, or undocumented immigrants).Methods. We performed a cross-sectional analyses of the Hispanic Community Health Study/Study of Latinos (visit 2, 2014-2017). We restricted our analysis to Hispanic/Latino immigrants with high cholesterol (n = 3974), hypertension (n = 3353), or diabetes (n = 2406); treatment was defined as use of statins, antihypertensives, and antidiabetics, respectively.Results. When compared with naturalized citizens, undocumented and documented immigrants were less likely to receive treatment for high cholesterol (38.4% vs 14.1%; prevalence ratio [PR] = 0.37 [95% confidence interval [CI] = 0.27, 0.51] and 25.7%; PR = 0.67 [95% CI = 0.58, 0.76]), hypertension (77.7% vs 57.7%; PR = 0.74 [95% CI = 0.62, 0.89] and 68.1%; PR = 0.88 [95% CI = 0.82, 0.94]), and diabetes (60.3% vs. 50.4%; PR = 0.84 [95% CI = 0.68, 1.02] and 55.8%; PR = 0.93 [95% CI = 0.83, 1.03]); the latter did not reach statistical significance. Undocumented and documented immigrants had less access to health care, including insurance coverage or a usual health care provider, than naturalized citizens. Therefore, adjusting for health care access largely explained treatment disparities across immigration status.Conclusions. Preventing cardiovascular disease among Hispanic/Latino immigrants should focus on undertreatment of high cholesterol, hypertension, and diabetes by increasing health care access, especially among undocumented immigrants.


Asunto(s)
Enfermedades Cardiovasculares/prevención & control , Emigrantes e Inmigrantes/estadística & datos numéricos , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Hispanoamericanos/estadística & datos numéricos , Adulto , Anciano , Antihipertensivos/uso terapéutico , Estudios Transversales , Diabetes Mellitus/tratamiento farmacológico , Femenino , Humanos , Inhibidores de Hidroximetilglutaril-CoA Reductasas/uso terapéutico , Hipercolesterolemia/tratamiento farmacológico , Hipertensión/tratamiento farmacológico , Hipoglucemiantes/uso terapéutico , Masculino , Persona de Mediana Edad , Factores de Riesgo , Inmigrantes Indocumentados/estadística & datos numéricos
18.
J Evid Based Soc Work (2019) ; 17(4): 392-405, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32692639

RESUMEN

PURPOSE: This study sought to examine gendered variations in determinants of depression and anxiety symptoms among African immigrants in the United States. METHODS: Data were drawn from a cross-sectional survey of first and second-generation immigrants from African countries living in the United States (N = 409). RESULTS: Ordinary Least Squares (OLS) regression results revealed gendered differences in factors that influence depression and anxiety symptoms. Second-generation immigrants showed decreased depression and anxiety symptoms among men, while income and marital status showed significant effects on depression and anxiety symptoms for women. Loneliness and discrimination were found to negatively impact the mental health of both female and male immigrants. Additionally, we found that gender did not moderate the effects of loneliness on depression and anxiety symptoms. CONCLUSION: Findings highlight the need for practitioners to better understand the unique risk and protective factors affecting female and male African immigrants in their efforts to provide effective mental health services to members of this population.


Asunto(s)
Grupo de Ascendencia Continental Africana/psicología , Grupo de Ascendencia Continental Africana/estadística & datos numéricos , Trastornos de Ansiedad/etnología , Trastornos de Ansiedad/epidemiología , Trastorno Depresivo/etnología , Trastorno Depresivo/epidemiología , Emigrantes e Inmigrantes/psicología , Emigrantes e Inmigrantes/estadística & datos numéricos , Adulto , África , Anciano , Anciano de 80 o más Años , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Factores Sexuales , Estados Unidos
19.
BMC Public Health ; 20(1): 1019, 2020 Jun 29.
Artículo en Inglés | MEDLINE | ID: mdl-32600296

RESUMEN

BACKGROUND: This review examines the effectiveness of diet and physical activity interventions to reduce cardiometabolic risk among Chinese immigrants and their descendants living in high income countries. The objective of this review is to provide information to help build future interventions aimed at improving diet and increasing physical activity levels among Chinese immigrants. METHODS: Outcomes included BMI, weight, waist circumference (WC), waist-hip ratio (WHR), cholesterol (LDL, HDL), systolic and diastolic blood pressure (SBP, DBP), hemoglobin A1c (HgbA1c), fasting blood glucose (FBG), and HOMA-IR. Six databases were systematically searched from database inception to date of search (February 2020). Meta-analyses used random effect models to estimate pooled effects of outcomes with 95% confidence intervals. The outcomes assessed were changes in mean outcomes (post-intervention versus baseline) among the intervention group versus control groups. RESULTS: Twenty-one articles were included for synthesis, and eight of these were included in the meta-analysis. Among children/adolescents, there were no significant effects of intervention for any of the outcomes having sufficient data for meta-analysis (BMI, WHR, SBP, and DBP). Among adults, the pooled effect including three studies showed significant changes in BMI (effect size = - 1.14 kg/m2; (95% CI: - 2.06, - 0.21), I2 = 31%). There were also significant effects of intervention among adults in terms of changes in SBP and DBP, as the pooled effect across three studies was - 6.08 mmHg (95% CI - 9.42, - 2.73), I2 = 0% and - 3.81 mmHg (95% CI: - 6.34, - 1.28), I2 = 0%, respectively. Among adults there were no other significant effects among the meta-analyses conducted (weight, WC, LDL, HgbA1c, and FBG). CONCLUSIONS: This review is the first to summarize the effectiveness of diet and physical activity interventions specifically designed for Chinese immigrants living in high income countries. There were clinically meaningful changes in BMI and blood pressure among adults, but evidence was weak for other cardiometabolic outcomes (weight, WC, LDL, HgbA1c, and FBG), and among children, there was no evidence of effect for any cardiometabolic outcomes. Given our mixed findings, more work is needed to support the design of successful interventions, particularly those targeting children and their families. TRIAL REGISTRATION: The systematic review protocol was registered in PROSPERO on December 17, 2018, the international prospective register of systematic reviews (registration number: CRD42018117842 ).


Asunto(s)
Enfermedades Cardiovasculares/prevención & control , Emigrantes e Inmigrantes/estadística & datos numéricos , Promoción de la Salud/estadística & datos numéricos , Adolescente , Adulto , Presión Sanguínea , Índice de Masa Corporal , Peso Corporal , Enfermedades Cardiovasculares/etiología , Niño , China/etnología , Colesterol/sangre , Países Desarrollados , Dieta , Ejercicio Físico , Hemoglobina A Glucada/análisis , Humanos , Evaluación de Resultado en la Atención de Salud , Factores de Riesgo , Circunferencia de la Cintura
20.
Artículo en Inglés | MEDLINE | ID: mdl-32578725

RESUMEN

In this study which is part of a research project on Chagas disease (CD) among Bolivian immigrants in Sao Paulo, we describe socioeconomic characteristics, knowledge of CD and implications for acess to health care. We applied a structured questionnaire to a sample of 472 Bolivian adults (> 18 years) living in Sao Paulo and enrolled at the Barra Funda School Health Center. Participants' median age was 28.5 years, 75.0% were from the Bolivian department of La Paz, and >90% worked in the garment industry. Respondents had lived in Sao Paulo for a median of 5.8 years. Only 169 (35.8%) were familiar with CD, while roughly half (50.4%) had lived in natural materials houses in Bolivia, 225 (47.7%) indicated familiarity with the vector, 23.9% had seen the vector in their homes in Bolivia, and 6.4% reported having been bitten by a triatomine bug. Factors associated with awareness of CD were analyzed by chi square tests, and those with p values <0.25 were included in a multivariable logistic regression model. In the multivariable logistic regression analysis, having a relative with CD (OR=4.3, 95% CI=1.5-12.0), having lived in a house with mud or wood walls (OR=0.4, 95% CI=0.2-0.8), and having heard of the triatomine bug, or vinchuca, (OR=10.0, 95% CI=5.1-19.5) were significantly associated with awareness of CD. This study shows a low familiarity with CD among Bolivian migrants living in Sao Paulo, Brazil. Raising awareness of the disease through specific communication strategies should be an essential component of public health programs to reduce the burden of CD in this and other vulnerable populations.


Asunto(s)
Enfermedad de Chagas , Emigrantes e Inmigrantes/estadística & datos numéricos , Conocimientos, Actitudes y Práctica en Salud , Adolescente , Adulto , Bolivia/etnología , Brasil , Estudios Transversales , Femenino , Humanos , Masculino , Factores Socioeconómicos , Encuestas y Cuestionarios , Adulto Joven
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