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1.
Artigo em Alemão | MEDLINE | ID: mdl-31802152

RESUMO

BACKGROUND AND AIM: Reasons for lower use of medical services by children and adolescents with migration background have not yet been investigated. The aim is therefore to identify factors that are related to the utilization of outpatient medical care and subjective patient satisfaction as well as explain differences according to migration background. METHODS: On the basis of the "German Health Interview and Examination Survey for Children and Adolescents" (KiGGS, baseline study: 2003-2006), in which 17,640 children and adolescents participated, prevalences with 95% confidence intervals as well as multivariate binary logistic regression analyzes on the relationship between migration background, country of origin, the use of outpatient medical care services in the last 12 months, and satisfaction with the last medical treatment were calculated. RESULTS: Children up to age 13 with two-sided migration background had lower utilization of specialist doctors compared to those without migration background (OR = 0.64 [0.56-0.74]). However, among the 14- to 17-year-olds, the utilization did not differ significantly (OR = 0.79 [0.60-1.03]). The lower use of outpatient medical care is associated with a shorter length of stay and limited German language skills. In addition, parents from Poland and the former Soviet Union are less likely to be very satisfied with the last outpatient treatment of their 0­ to 13-year-old child, even after adjustments for German language skills and length of stay. CONCLUSION: To make it easier for children with migration background to access specialist services, it is important to reduce language barriers in outpatient medical care and to promote processes of intercultural opening.


Assuntos
Pacientes Ambulatoriais , Satisfação Pessoal , Migrantes/estatística & dados numéricos , Adolescente , Criança , Pré-Escolar , Estudos Transversais , Alemanha , Inquéritos Epidemiológicos , Humanos , Lactente , Recém-Nascido , U.R.S.S.
3.
BMC Health Serv Res ; 19(1): 779, 2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31675975

RESUMO

BACKGROUND: Despite extensive research concerning the impact of health insurance on the advancement of infant health in developed countries, few studies have adjusted their results for potential confounding due to adverse selection in insurance coverage, wherein those who anticipate a need for health services tend to be the ones that acquire insurance. The presence of compulsory health insurance in China, such as the Urban Employee Basic Medical Insurance (UEBMI) scheme may provide an opportunity to estimate the effect of health insurance on infant health, by reducing the endogeneity problem into insurance due to the adverse selection. The objective is to assess the relationship between UEBMI and infant health outcomes in one sizeable municipal-level obstetrics hospital in Shanghai, East China. METHODS: Medical records data from the Shanghai First Maternity and Infant Hospital from January 1, 2013 to April 30, 2019 were used to form an analysis dataset of 160,429 live births which was comprised of Shanghai residents with UEBMI coverage (n = 101,153) and women without any insurance coverage (n = 59,276). A propensity score matching approach using conjoint quantile regression and probit regression models was used to eliminate latent endogeneity of UEBMI coverage in order to garner robust results. Further analysis stratified by maternal migrant status was conducted to further assess the sensitivity of the findings to distinct patient subgroups. RESULTS: The UEBMI scheme was shown to be associated with improvements in infant birth outcomes. The scheme was associated with: an increase in birth weight of about 30 g (p <  0.001, 95% CI 23.908-35.295). This finding was evident in other five different birth outcomes (premature birth, low birth weight, very low birth weight, low Apgar score, and an abnormal health condition at birth). After stratifying by migrant status, the UEBMI was shown to have a greater effect on migrants compared to local residents of Shanghai. CONCLUSIONS: Our findings suggest that health insurance coverage for pregnant women, especially for migrants, has the potential to significantly and directly improve infant health outcomes. Further research is required to determine whether these findings can be replicated for other Chinese jurisdictions.


Assuntos
Cobertura do Seguro/estatística & dados numéricos , Seguro Saúde/estatística & dados numéricos , Resultado da Gravidez , Adulto , China , Feminino , Humanos , Recém-Nascido , Gravidez , Migrantes/estatística & dados numéricos , População Urbana/estatística & dados numéricos
4.
BMC Public Health ; 19(1): 1397, 2019 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-31660916

RESUMO

BACKGROUND: Travellers visiting friends and relatives (VFR) define a specific population of travellers exposed to higher risks for health and safety than tourists. The aim of this study was to assess differentials in pre-travel health care in VFR travellers compared to other travellers. METHODS: A retrospective cohort study was performed including attendees of the Travel Medicine Clinic of the Hospital Universitari de Bellvitge, Barcelona, Spain, between January 2007 and December 2017. RESULTS: Over the 10-year period, 47,022 subjects presented to the travel clinic for pre-travel health care, 13.7% of whom were VFR travellers. These showed higher rates of vaccination against yellow fever and meningococcus, but lower rates for hepatitis A, hepatitis B, influenza, rabies, cholera, polio, typhoid IM vaccine and tetanus vaccine boosters. Regarding malaria prevention measures, results highlighted that VFR travellers, when compared with tourists, were more likely to be prescribed with chemoprophylaxis, particularly with mefloquine, than with atovaquone/proguanil. CONCLUSIONS: Findings from this large-scale study indicated differences in vaccination rates and completion, as well as in chemoprophylaxis for malaria, between VFR and non-VFR travellers, fostering specific interventions for promoting adherence to pre-travel health advice among migrant travellers.


Assuntos
Migrantes/psicologia , Medicina de Viagem/estatística & dados numéricos , Viagem/estatística & dados numéricos , Adulto , Família , Feminino , Amigos , Hospitais Universitários , Humanos , Malária/prevenção & controle , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Espanha , Migrantes/estatística & dados numéricos , Vacinação/estatística & dados numéricos
5.
Rev Prat ; 69(6): 679-682, 2019 Jun.
Artigo em Francês | MEDLINE | ID: mdl-31626434

RESUMO

The health of migrants is a complex issue in public health. In French Guyana, as elsewhere, globalization, through migrants in particular, has transformed the care of diseases previously geographically distant. In this context, the borders now concern the entire territory and not just the peripheries. These borders contribute to the aggravation of the migrants health determinants through the complex and sometimes risky paths that they generate. Transboundary areas are also areas of high vulnerability. However, these cross-border spaces and routes can also constitute health resources, in the original interfaces that they can produce in terms of cooperation promoting shared screening and monitoring programs.


Assuntos
Emigrantes e Imigrantes , Indicadores Básicos de Saúde , Programas de Rastreamento , Migrantes , Emigrantes e Imigrantes/estatística & dados numéricos , Guiana Francesa , Humanos , Migrantes/psicologia , Migrantes/estatística & dados numéricos , Populações Vulneráveis
6.
BMC Public Health ; 19(1): 1410, 2019 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-31664963

RESUMO

BACKGROUND: The Woman's Condom, a newly designed condom for women, has obtained market approval in China, but it remains relatively unfamiliar to the migrant population. The aim of this study is to evaluate the short-term acceptability of the Woman's Condom and influencing factors among internal migrants. METHODS: A longitudinal study was conducted among 1800 migrants in Beijing, Chongqing, and Shanghai in China between August 2013 and August 2014.Three-level model was implemented with the Statistical Analysis System software (v.9.4 SAS Institute) to analyze within-individual changes, between-individuals effects, and between-group effects. RESULTS: Three-level model analysis revealed statistically higher short-term acceptability of the Woman's Condom among subjects who lived in Shanghai (ß = 6.50, t = 2.76, p < 0.01), unmarried and not in a cohabiting relationship (ß = 3.05, t = 2.76, p < 0.01) than those who lived in Beijing, married and in a cohabiting relationship. Female (ß = - 1.69, t = - 7.55, p < 0.01) and lower educational attainment (ß = - 2.30, t = - 1.94, p = 0.05) were negatively related, while occupations of education, health, and civil staff (ß = 1.50, t = 2.92, p < 0.01) were positively related to acceptability. It was predicted that migrants' acceptability of the Woman's Condom would significantly increase over time (ß = 1.09, t = 5.54, p < 0.01). CONCLUSIONS: The findings indicate that the Woman's Condom enjoyed relatively high short-term acceptability among migrants in China. In order to popularize the Women's Condoms in migrants, more publicity, consultation and training in open and prosperous areas should be strengthened.


Assuntos
Preservativos Femininos/estatística & dados numéricos , Comportamento Sexual/psicologia , Migrantes/psicologia , Adulto , Pequim , China , Feminino , Humanos , Relações Interpessoais , Estudos Longitudinais , Estado Civil/estatística & dados numéricos , Pessoa de Meia-Idade , Características de Residência/estatística & dados numéricos , Migrantes/estatística & dados numéricos , Adulto Jovem
7.
Malar J ; 18(1): 349, 2019 Oct 16.
Artigo em Inglês | MEDLINE | ID: mdl-31619243

RESUMO

BACKGROUND: The resistance of Plasmodium falciparum to artemisinin has been identified in Asia and some parts of Africa. The drug resistance of P. falciparum will be an obstacle to the successful elimination of malaria by 2025. Whole-genome sequencing of the artemisinin-resistant parasite line revealed mutations on the k13 gene associated with drug resistance in P. falciparum. To understand the artemisinin resistance of the imported P. falciparum cases from Africa, the mutations in the k13 gene in parasites from imported malaria cases in Guangxi Province were detected and the treatment efficiency of artesunate monotherapy was observed. METHODS: DNA was extracted from 319 blood samples from migrant workers with P. falciparum infection who returned to their hometown in Guangxi Province from Africa between 2014 and 2017. The k13-propeller gene was amplified by nested PCR, and sequencing, gene mutation frequency and geographic difference of imported P. falciparum cases were analysed by comparison with the wild-type strain. Of 319 patients, 158 were P. falciparum-infected and were treated with intravenous injection of artesunate and were observed, including the time of asexual stage clearance and the dose of artesunate used. RESULTS: Of the 319 P. falciparum samples, 12 samples had the k13-propeller mutation, and 11 point mutations were detected; 5 were non-synonymous mutations (T474I, A481T, A578S, V603E, G665S) and were not associated with artemisinin resistance. The clinical treatment observation showed that the median (IQR) dose of artesunate for peripheral blood parasite asexual stage clearance was 407.55 (360-510) mg, and the D3 parasite clearance rate was 70.25%, including the five k13-propeller mutations of P. falciparum. After 7 days of treatment, 98.73% of cases were cleared. Two cases were treated with artemisinin for 8 days with a 960-mg dose to completely clear the asexual parasite, but they did not have a mutation in the k13 gene. CONCLUSIONS: Five mutations of the k13-propeller gene in 319 P. falciparum samples from patients returning from Africa were identified. The frequency of the k13-propeller mutants was low, and the mutations were not strongly associated with artemisinin resistance. The median (IQR) dose of artesunate monotherapy in actual clinical treatment to remove asexual parasite stages was 407.55 (360-510) mg, equivalent to D3-D4. Some P. falciparum cases without a k13-propeller mutation showed obvious delayed clearance of the parasite from peripheral blood. Trial registration The diagnosis of malaria and the treatment of malaria-infected patients are the routine work of Centres for Disease Control and Prevention. Information on the patients was conveyed with the patient's approval, and the research aim, methods, risks and benefits of the study were explained in detail to the patients.


Assuntos
Antimaláricos/uso terapêutico , Artemisininas/uso terapêutico , Artesunato/uso terapêutico , Plasmodium falciparum/genética , Polimorfismo Genético , Proteínas de Protozoários/genética , China , Plasmodium falciparum/metabolismo , Proteínas de Protozoários/metabolismo , Migrantes/estatística & dados numéricos
8.
Int J Equity Health ; 18(1): 157, 2019 10 16.
Artigo em Inglês | MEDLINE | ID: mdl-31619247

RESUMO

BACKGROUND: A higher risk of common mental health disorders has been found for first-generation migrants in high income countries, but few studies have examined the use of mental health care. This study aimed to identify the level of antidepressant use amongst the largest first generation migrant groups resident in Finland. METHODS: This cohort study used record-based data linkage methodology to examine the hazard of antidepressant use between migrant groups in Finland using Cox proportional hazard models. Data was derived using socio-demographic and prescription data from Statistics Finland and the Finnish Population Registry. The cohort included a random sample of 33% of the working age population in 2007 (N = 1,059,426, 49.8% women, 2.5% migrants) and dispensed antidepressant prescriptions from 2008 to 2014. RESULTS: After adjustment for socio-demographic characteristics, results show higher antidepressant use for female migrants from North Africa and the Middle East compared to the Finland-born majority, a similar level of use for migrants from Western countries, and lower use for migrants from other non-Western countries. CONCLUSIONS: The gender and country of origin dependent use of antidepressant medication is discussed in terms of socio-political and cultural between-group differences. Recommendations are made to address inequalities in accessing services, particularly for migrants from non-Western countries.


Assuntos
Antidepressivos/uso terapêutico , Transtornos Mentais/tratamento farmacológico , Migrantes/psicologia , Adolescente , Adulto , Estudos de Coortes , Feminino , Finlândia , Humanos , Armazenamento e Recuperação da Informação , Masculino , Pessoa de Meia-Idade , Migrantes/estatística & dados numéricos , Adulto Jovem
9.
Artigo em Inglês | MEDLINE | ID: mdl-31505732

RESUMO

OBJECTIVE: Our aim was to assess the changes in induced abortion in different migrant groups in China between 2007 and 2014 and the contraceptive methods used prior to induced abortion. METHODS: The studies of two population-based cross sections were conducted in urban China, involving 9146 sexually active migrant women. Within the selected sociodemographic subgroups, the changes in the percentage of women who had induced abortions, the proportion of pregnancies ending in induced abortions, the causes of induced abortions, and the methods of contraception were identified. A chi-squared test was used to calculate the differences in induced abortion in the subgroups. RESULTS: Between 2007 and 2014, in the study groups from the major cities of China, the percentage of sexually active migrant women who had induced abortions increased 10.1%, from 21.8% to 24.0%. The proportion of pregnancies ending in induced abortions increased 23.7%, from 21.5% to 26.6%. Both of the aforementioned statistics increased significantly within most of the selected sociodemographic subgroups, especially in the 18-19 and 45-49 age groups. Over 50% of pregnancies were aborted in the cohabiting group, although this figure declined by 12.3% over the course of the seven-year study period. Contraceptive failure was the primary cause of induced abortion, although its contribution to induced abortion declined from 51.3% to 42.4%. The proportion of women not using contraception prior to induced abortion increased from 30.9% to 41.2%. CONCLUSION: The prevalence of induced abortion is high and continues to increase among sexually active migrant women in China. An increasing trend is forecasted over the next few decades. Special attention should be paid to the younger cohort of migrant women, especially 18-19-year-olds, and unmarried cohabitants, who are increasingly seeking induced abortions.


Assuntos
Aborto Induzido/estatística & dados numéricos , Migrantes/estatística & dados numéricos , Adolescente , Adulto , China , Cidades , Estudos de Coortes , Anticoncepção/estatística & dados numéricos , Comportamento Contraceptivo/estatística & dados numéricos , Características da Família , Feminino , Humanos , Pessoa de Meia-Idade , Gravidez , Adulto Jovem
10.
Artigo em Inglês | MEDLINE | ID: mdl-31533209

RESUMO

Since the onset of reform and opening up in China, large cities in the nation have been experiencing problems related to limited medical resources. These resource limitations are due to rapid population growth and urban expansion. As the country's fastest growing city, Shenzhen has experienced a substantial misalignment between the supply and the demand of healthcare services. Numerous researchers have analyzed spatial inequity in healthcare services by focusing on the spatial accessibility of medical facilities, such as hospitals, clinics, and community health service centers (CHSCs). However, the issue of inequity in healthcare services for vulnerable groups has largely been ignored. We chose general hospitals (GHs) and CHSCs, which provide direct healthcare services to residents, as the study objects. By performing spatial accessibility analysis using the gravity model and the two-step floating catchment area method, we investigated healthcare services inequity for vulnerable groups based on four dimensions: residential type, age, education level, and occupation. We found that the services provided by GHs cannot meet the demand in Shenzhen. This inadequacy is characterized by spatial centralization and neglect of those who reside in urban villages, who have low education levels, and who are employed in the manufacturing industry. In contrast, CHSCs generally serve a relatively broad population. This phenomenon is related to differences in the land and capital needs between GHs and CHSCs. Our study reveals that an appropriate adjustment of GH location could significantly improve healthcare services inequity. Therefore, to alleviate this inequity, it is particularly necessary to increase the number of GHs in the peripheral circle and in areas with large vulnerable populations, accelerate the implementation of the hierarchical medical system, and promote the transfer of medical resources to grassroot institutes through CHSCs. This study helps improve our understanding of healthcare services inequity in rapid expanding cities, which is of substantial significance for improving the planning and construction of medical facilities, facilitating scientific decision-making, and promoting social equity.


Assuntos
Acesso aos Serviços de Saúde/estatística & dados numéricos , Serviços de Saúde/estatística & dados numéricos , Disparidades em Assistência à Saúde/estatística & dados numéricos , Análise Espacial , Migrantes/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , China , Cidades , Humanos , Lactente , Recém-Nascido , Pessoa de Meia-Idade , Modelos Teóricos , Adulto Jovem
11.
Int J Equity Health ; 18(1): 143, 2019 09 17.
Artigo em Inglês | MEDLINE | ID: mdl-31530283

RESUMO

BACKGROUND: Millions of poor households in India undertake short duration rural to urban migration along with their children to find work in the informal economy in the city. While literature has documented the precarity of such temporary jobs, typically characterized by low wages, insecure jobs, harsh recruitment regimes and economic vulnerability, little is known about its implications for children who migrate with their parents to the city. In this study, we draw attention to children of migrant construction workers and focus on their overall nutritional well-being, which remains under-studied. Our objectives were to categorize the current nutritional status of children under the age of five and determine the underlying causes of poor nutritional outcomes. METHODS: The field work for this study was undertaken between May 2017 and January 2018 at five construction sites in the city of Ahmedabad. We undertook anthropometric measurements of children under the age of five [N = 131; (male: 46%, female 53%); (mean age: 31.7 months)] and categorized their nutritional status. Using the UNICEF framework on undernutrition, we examined the underlying causes of poor nutritional outcomes among this group of children with the help of qualitative methods such as interviews, focused group discussions and participant observation at the field sites. RESULTS: Undernutrition was highly prevalent among the children (N = 131): stunted (40.5%); wasted (22.1%); and underweight (50.4%). We found common factors across parents interviewed such as similar misperceptions of malnutrition, long hours of work and lack of childcare provision at the worksite which resulted in disrupted quality of care. While socio-cultural beliefs and lack of information influenced breastfeeding, other factors such as inability to take breaks or lack of space further impaired infant feeding practices more broadly. Lack of dietary diversity at home, poor hygiene and sanitation, and economic inability to seek healthcare further affected child nutritional status. CONCLUSIONS: Our study addresses a critical gap in migration literature in India by building a comprehensive narrative of migrant children's experiences at construction sites. We find that parents' informal work setting exposes children to a nutritionally challenging environment. Policies and programs seeking to address undernutrition, a critical challenge in India, must pay attention to the specific needs of migrant children.


Assuntos
Transtornos da Nutrição Infantil/epidemiologia , Indústria da Construção , Migrantes/estatística & dados numéricos , Adolescente , Adulto , Pré-Escolar , Feminino , Humanos , Índia/epidemiologia , Lactente , Recém-Nascido , Masculino , Prevalência , Fatores de Risco , Adulto Jovem
12.
Artigo em Inglês | MEDLINE | ID: mdl-31509996

RESUMO

We assessed the risk of fatal occupational injuries among migrant workers with two different types of employment permits in South Korea. This observational study used national data from January 2007 to September 2018 and analyzed 42,089 cases of occupationally injured migrant workers of Chinese nationality. Fatality rates were analyzed according to year, sex, age, occupation, industry, and type of employment permit. Chinese workers were permitted to work for one employer and prohibited from changing employers, whereas Korean-Chinese workers were permitted to change their employer. The adjusted fatality rate of occupational injuries of Chinese migrant workers was significantly higher (1.80-fold, 95% confidence interval 1.31-2.46) than that of Korean-Chinese migrant workers. The prohibition on changing workplaces; male sex; age ≥ 45 years; machine operator; construction industry; and agriculture, livestock, and fisheries industry were risk factors for fatal occupational injuries. The results imply a need for revision of the migrant-worker employment permit systems and implementation of occupational safety and health policies for all workers to promote health equity.


Assuntos
Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Emprego/estatística & dados numéricos , Traumatismos Ocupacionais/etnologia , Traumatismos Ocupacionais/mortalidade , Migrantes/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Indústrias , Masculino , Pessoa de Meia-Idade , Saúde do Trabalhador , Ocupações , República da Coreia/epidemiologia , República da Coreia/etnologia , Local de Trabalho , Adulto Jovem
13.
Artigo em Inglês | MEDLINE | ID: mdl-31540046

RESUMO

The proportion of migrating females has increased, and more often, old females are left in rural regions. Resources are needed to provide suitable hospitalization service to females in underdeveloped rural regions. Using multi-stage hierarchical cluster random sampling method, nine towns from three counties were enrolled in five-time points between 2006 and 2014 in this study. The research subjects of this study were females age 15 and up. Data regarding the utilization of inpatient services were collected and analyzed. Complex sampling logistic regression was conducted to analyze influencing factors. This study reveals that for both permanent females and migrant females, the older their age, the higher their hospitalization rate. The utilization of hospitalization service for permanent females was associated with the occurrence of chronic diseases (adjusted Odds Ratio (aOR) = 5.402). In addition, permanent females suffering from chronic diseases were more likely to avoid hospitalization despite their doctor's advice (aOR = 34.657) or leave the hospital early against medical advice (AMA) (aOR = 10.009). Interventions to combat chronic diseases and adjust compensation schemes for permanent females need to be provided.


Assuntos
Utilização de Instalações e Serviços , Hospitalização/estatística & dados numéricos , Serviços de Saúde Rural/estatística & dados numéricos , População Rural/estatística & dados numéricos , Migrantes/estatística & dados numéricos , Adolescente , Adulto , Doença Crônica , Feminino , Humanos , Modelos Logísticos , Pessoa de Meia-Idade , Razão de Chances , Inquéritos e Questionários , Adulto Jovem
14.
Psychiatr Danub ; 31(Suppl 3): 400-405, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31488760

RESUMO

BACKGROUND: Teenage pregnancies occur frequently in developing countries and are associated with social issues, including poverty, lower levels of health and educational attainment. Although frequent in European countries in the 20th century today, teenage pregnancies account for only 4% of first children. These pregnancies are usually unplanned and they are considered a vulnerability factor during the pregnancy and the postnatal period, both for the mother and the child. The purpose of our study was to evaluate the evolution of mothers and children of teenage pregnancies, several years after childbirth and to identify factors which may protect or increase the patient's vulnerability. SUBJECTS AND METHODS: We conducted a retrospective search in our patient database in order to identify all teenage pregnancies between 2010-2014 at CHU Brugmann Hospital. Outcome date data were obtained from the medical files. Mothers were contacted by phone and asked to complete our questionnaire which focused on maternal and paediatric care; and infant and child development after hospitalization. RESULTS: Out of the 342 patients identified, 84 patients were contactable and only 72 patients completed the full questionnaire. With only 4 patients originating from Belgium, our population was largely immigrant. Despite this, obstetrical, maternal and paediatric outcomes were remarkably favorable when compared to other published studies. CONCLUSION: Our study suggests that some migrant teenage mothers may have a dual advantage in terms of the wealth of a developed country in which have settled and the low social stigma related to their country of origin. More research needs to be done to further investigate this hypothesis.


Assuntos
Gravidez na Adolescência/prevenção & controle , Gravidez na Adolescência/estatística & dados numéricos , Migrantes/estatística & dados numéricos , Adolescente , Bélgica/epidemiologia , Criança , Feminino , Humanos , Lactente , Recém-Nascido , Gravidez , Fatores de Proteção , Estudos Retrospectivos
15.
Int J Equity Health ; 18(1): 139, 2019 09 03.
Artigo em Inglês | MEDLINE | ID: mdl-31481094

RESUMO

BACKGROUND: Migrant women at risk of social exclusion often experience health inequities based on gender, country of origin or socioeconomic status. Traditional health promotion programs designed for this population have focused on covering their basic needs or modifying lifestyle behaviors. The salutogenic model of health could offer a new perspective enabling health promotion programs to reduce the impact of health inequities. This study evaluated the effectiveness of a salutogenic health promotion program focused on the empowerment of migrant women at risk of social exclusion. METHODS: A four-session salutogenic health promotion program was conducted over a period of 6 months. In a quasi-experimental pre-test post-test design, an ad hoc questionnaire was administered to 26 women to collect sociodemographic data, together with 5 validated instruments: Antonovsky's Sense of Coherence (SOC-13), Duke-UNC-11 (perceived social support), Quality of Life Short Form-36 (SF-36), Rosenberg's Self-Esteem Scale, and the Cohen et al. Perceived Stress Scale (PSS-10). Descriptive analysis and multiple linear regression models were performed. Statistical tests were considered significant with a two-tailed p value < 0.05. RESULTS: Participants had a low initial SOC-13 score (60.36; SD 8.16), which did not show significant change after the health promotion program. Perceived social support (37.07; SD 6.28) and mental quality of life also remained unchanged, while physical quality of life increased from 50.84 (SD 4.60) to 53.08 (SD 5.31) (p = 0.049). Self-esteem showed an increasing trend from 30.14 (SD 4.21) to 31.92 (SD 4.38) (p = 0.120). Perceived stress decreased from 20.57 (SD 2.91) to 18.38 (SD 3.78) (p = 0.016). A greater effect was observed at the end of the program in women with lower initial scores for SOC-13 and quality of life and higher initial scores of perceived stress. CONCLUSIONS: The health promotion program reduced perceived stress, increased physical quality of life and showed a trend toward increased self-esteem, especially among migrant women with multiple vulnerability factors. The salutogenic model of health should be considered as a good practice to apply in health promotion programs and to be included in national policies to reduce health inequity in migrant populations.


Assuntos
Promoção da Saúde , Migrantes/psicologia , Adolescente , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Avaliação de Programas e Projetos de Saúde , Qualidade de Vida , Medição de Risco , Autoimagem , Distância Social , Estresse Psicológico/prevenção & controle , Estresse Psicológico/psicologia , Migrantes/estatística & dados numéricos , Adulto Jovem
17.
BMC Public Health ; 19(1): 1219, 2019 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-31484566

RESUMO

BACKGROUND: Given the urban-rural structure and the increase in rural-to-urban migration, three types of children have emerged in contemporary China: rural, urban, and migrant children. Health disparities among these types of children have caused widespread concern, being the main contributor to health inequalities among children in China. The purpose of this study was to investigate health disparities among these children and the mechanisms underlining them. METHODS: This research applied multiple linear regression to data obtained from the Chinese Education Panel Survey (CEPS), a national representative survey of 7772 students from 2014 to 2015. Multiple linear regression with interactive terms was used to explore how gender and father's education moderate the degree of health inequalities among the children. 'Height for age Z-scores' (HAZ) was deployed as the indicator of the children's health status, with larger scores indicating better health status. RESULTS: The findings of the current study were threefold: First, this study found significant health disparities among the three types of children. Urban children are generally the healthiest (M = 1.064), followed by migrant children, (M = 0.779) and rural children (M = 0.612). Second, fathers' education significantly compensates for the heath disparities among the children. Fathers' education has a larger effect in compensating a rural-migrant difference (b = - 0.018, P < 0.05) than a rural-urban difference (b = - 0.016, P < 0.1). Third, the compensating effect of the fathers' education varies by gender. The compensating effect is larger for boys (b = 0.028, P < 0.001) than for girls (b = 0.025, P < 0.01). CONCLUSIONS: This study found significant health inequalities among urban, migrant, and rural children, which might be shaped by the distinction of urban-rural structure and the process of rural-to-urban migration in contemporary China. Fathers' education also plays an important role in narrowing-but not eliminating-the health inequality between urban and rural children. Furthermore, the compensating effect of fathers' education is higher for boys than for girls, reflecting the patriarchal tradition in China. The currents study suggests that to promote the healthy growth of children, it is necessary to consider the health inequalities among different types of children when developing health-related policies. Factors like family socioeconomic status and gender may likewise play an important role in the implementation of policies.


Assuntos
Disparidades nos Níveis de Saúde , População Rural/estatística & dados numéricos , Migrantes/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Criança , China , Escolaridade , Pai/estatística & dados numéricos , Feminino , Humanos , Masculino , Fatores Sexuais , Inquéritos e Questionários
18.
Artigo em Inglês | MEDLINE | ID: mdl-31398850

RESUMO

In Taiwan, migrants come mostly for marriage and work. Several researchers have conducted health-related studies of marital migrants and migrant workers, but the access of the two groups to healthcare has not been studied. Therefore, our study investigated the factors associated with migrants' access to healthcare, with the main foci being marital migrants and migrant workers in Taiwan. A structured and cross-sectional questionnaire was anonymously self-administered by migrants recruited to participate in this survey on a voluntary basis from 11 medical centers and 11 migrant-helping associations in Taiwan between May 1st and September 21st, 2018. A total of 753 questionnaires were analyzed. The majority of marital migrants (n = 243) and migrant workers (n = 449) surveyed were enrolled in Taiwan's National Health Insurance system (92.7 vs. 93.5%, p = 0.68). More of the migrant workers (n = 205) than the marital migrants (n = 42) encountered language barriers while seeking medical services (48.0 vs. 17.1%, p < 0.001). A professional interpreter at the point of care was considered important by more of the migrant workers (n = 316) than the marital migrants (n = 89) (70.2 vs. 39.6%, p < 0.001). Although more than 90% of the surveyed migrants were enrolled in the health insurance system in Taiwan, many, especially among the migrant workers, still faced language barriers while seeking medical services.


Assuntos
Barreiras de Comunicação , Assistência à Saúde/organização & administração , Assistência à Saúde/estatística & dados numéricos , Acesso aos Serviços de Saúde/organização & administração , Acesso aos Serviços de Saúde/estatística & dados numéricos , Cônjuges/estatística & dados numéricos , Migrantes/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Taiwan , Adulto Jovem
19.
Public Health ; 174: 134-144, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31369927

RESUMO

OBJECTIVE: This article presents empirical evidence on the quality of life (QoL) of Sub-Saharan African (SSA) migrants in Germany, exploring its association with subjective integration and the influence of some socio-economic and sociodemographic characteristics. STUDY DESIGN: This is a cross-sectional study design using quantitative data from 518 SSA migrants collected across the 16 federal states of Germany, and these data were analysed in this study. METHODS: Association between participants' QoL, measured by the four domains of the Bref version of the World Health Organisation QoL measure, subjective integration and sociodemographic characteristics were evaluated using Pearson product-moment correlations. Stepwise multiple linear regressions were performed to explore the contribution of predictor variables on the QoL domain. RESULTS: Participants' age averaged 32.5 years (standard deviation [SD] 7.93). The sample reported a low QoL score with a mean score of 64.3 (SD 14.4, range 70.2). Multiple linear regression analyses revealed that subjective integration, age, education and gender had significant associations and explained up to 27% of the variance in the QoL domain scores. CONCLUSION: The findings of this study support the conclusion that subjective integration positively and significantly associates with the physical health, psychological health, social relationships and environmental domains of SSA migrants' QoL in Germany.


Assuntos
Qualidade de Vida , Migrantes/psicologia , Adulto , África ao Sul do Saara/etnologia , Estudos Transversais , Pesquisa Empírica , Feminino , Alemanha , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Socioeconômicos , Migrantes/estatística & dados numéricos , Adulto Jovem
20.
Artigo em Alemão | MEDLINE | ID: mdl-31420715

RESUMO

BACKGROUND AND OBJECTIVES: Diversity is increasing, including among workers. Traditional approaches in occupational safety and health are no longer sufficient to meet the emerging challenges in the workplace. Currently, knowledge about specific needs of workers with a migrant background is insufficient to develop suitable interventions under participatory methods. The aim of this work is to gain knowledge about diversity in the workplace and discuss considerations for suitable prevention and health promotion. MATERIALS AND METHODS: Research in reports, analyses of the German Socio-Economic Panel, as well as a review of the literature in relevant databases served to collate current findings about health indicators, stress and strain, structural conditions, and occupational prevention and health promotion. RESULTS: Differentiated results about health in the workplace and stress and strain could be identified. In particular, workers with a migrant background are more often exposed to physical stress and harsh environmental conditions. Furthermore, structural conditions are worse for these workers, e.g. due to lower employment rates, as well as enhanced atypical employment among the target group. CONCLUSION: Plausible explanations for the reported differences are discussed and useful implications are given. However, the overall lack of data and challenges in data collection must be considered.


Assuntos
Saúde do Trabalhador , Migrantes/estatística & dados numéricos , Carga de Trabalho , Local de Trabalho , Alemanha , Nível de Saúde , Humanos , Migrantes/psicologia
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