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1.
Scand J Public Health ; 52(3): 360-369, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38544303

RESUMO

AIMS: To study sex differences in the psychosocial and economic impact of the restrictive measures during the COVID-19 pandemic in 2020 among the migrant origin and the general population in Finland. METHODS: Cross-sectional MigCOVID Survey data (10/2020-2/2021; n=3668) were used. FinHealth 2017 Follow-up Study participants constituted the general population reference group (n=3490). Sex differences in self-perceived impact of the restrictive measures during the COVID-19 pandemic in 2020 on the psychosocial and economic situation were examined with multivariate logistic regression, adjusting for sociodemographics and self-rated health. RESULTS: The migrant origin population had higher odds for reporting weakened economic situation (odds ratio (OR) 5.41; 95% confidence interval (CI) 3.96-7.39), increased loneliness (OR 1.75; 95% CI 1.35-2.28), decrease in feelings of hope for the future (OR 1.70; 95% CI 1.33-2.19) and increased sleeping difficulties and nightmares (OR 1.98; 95% CI 1.34-2.92) than the general population. While the psychosocial and economic impact of COVID-19 was higher in women compared with men in the general population, findings were not fully replicated in the migrant origin population. CONCLUSIONS: Individuals of migrant origin faced a higher likelihood of experiencing adverse changes in both psychosocial and economic aspects during the pandemic, suggesting increased vulnerability linked to migrant origin. Additional research is required to delve into the intricate connections among gender, migrant origin, and the impact of COVID-19, aiming to enhance comprehensive understanding of the contributing factors. Vulnerabilities of different population groups should be identified and addressed when planning measures to reduce adverse societal impact in future crises.


Assuntos
COVID-19 , Migrantes , Humanos , COVID-19/epidemiologia , Masculino , Feminino , Finlândia/epidemiologia , Adulto , Migrantes/psicologia , Migrantes/estatística & dados numéricos , Pessoa de Meia-Idade , Estudos Transversais , Adulto Jovem , Fatores Sexuais , Solidão/psicologia , Adolescente , Idoso , Pandemias
2.
Eur J Public Health ; 34(4): 676-681, 2024 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-38573194

RESUMO

BACKGROUND: We aimed to explore to the possibilities of utilizing automatically accumulating data on health-owned for example by local companies and non-governmental organizations-to complement traditional health data sources in health promotion work at the local level. METHODS: Data for the PUHTI study consisted of postal code level information on sport license holders, drug purchase and sales advertisements in a TOR online underground marketplace, and grocery sales in Tampere. Additionally, open population register data were utilized. An interactive reporting tool was prepared to show the well-being profile for each postal code area. Feedback from the tool's end-users was collected in interviews. RESULTS: The study showed that buying unhealthy food and alcohol, selling or buying drugs, and participating in organized sport activities differed by postal code areas according to its socioeconomic profile in the city of Tampere. The health and well-being planners and managers of Tampere found that the new type of data brought added value for the health promotion work at the local level. They perceived the interactive reporting tool as a good tool for planning, managing, allocating resources and preparing forecasts. CONCLUSIONS: Traditional health data collection methods-administrative registers and health surveys-are the cornerstone of local health promotion work. Digital footprints, including data accumulated about people's everyday lives outside the health service system, can provide additional information on health behaviour for various population groups. Combining new sources with traditional health data opens a new perspective for health promotion work at local and regional levels.


Assuntos
Promoção da Saúde , Adulto , Feminino , Humanos , Masculino , Finlândia , Promoção da Saúde/métodos , Comércio , Coleta de Dados , Pré-Escolar , Criança , Adolescente , Adulto Jovem
3.
BMC Pregnancy Childbirth ; 23(1): 589, 2023 Aug 17.
Artigo em Inglês | MEDLINE | ID: mdl-37592250

RESUMO

BACKGROUND: Women in precarious conditions in their countries of origin, especially those who have left the country as refugees, may have been victims of serious mental and physical violence. These potentially traumatic experiences may threaten women's reproductive health. This study examines the prevalence of potentially traumatic experiences pre-migration and female genital mutilation/cutting (FGM/C) and their associations with adverse reproductive outcomes among migrant women of Somali- and Kurdish-origin who have been pregnant in Finland. METHODS: Survey and register data of the participants of the Finnish Migrant Health and Wellbeing Study (Maamu), conducted in 2010-2012, were used. Women of 18 to 64 years of age, 185 Somali- and 230 Kurdish-origin, who had at least one pregnancy or birth in Finland were included in the analysis. The survey data were linked to the Finnish Medical Birth Register, the Register of Induced Abortions, and the Care Register for Health Care until 2018. For each outcome, logistic regression was used and adjusted for age, body mass index, time lived in Finland, and the number of births. RESULTS: A total of 67% of Somali-origin and 71% of Kurdish-origin women had experienced potentially traumatic experiences pre-migration and 64% of Somali- and 32% of Kurdish-origin women had also undergone FGM/C. In Kurdish-origin women, complications during pregnancy (e.g. bleeding in the first trimester, known or suspected fetal abnormality, signs of fetal hypoxia, death of the fetus and other problems) were significantly more common among women without potentially traumatic experiences (70%) than among women with potentially traumatic experiences (48%) (p-value 0.005). No associations between potentially traumatic experiences or FGM/C and other adverse reproductive outcomes were observed among Somali- or Kurdish-origin women. CONCLUSION: Past trauma is common among Somali- and Kurdish-origin women and this needs to be evaluated in maternity care. However, we found no association between potentially traumatic experiences pre-migration and adverse reproductive outcomes.


Assuntos
Aborto Induzido , Serviços de Saúde Materna , Gravidez , Humanos , Feminino , Finlândia/epidemiologia , Somália , Índice de Massa Corporal
4.
Scand J Public Health ; : 14034948231199792, 2023 Sep 19.
Artigo em Inglês | MEDLINE | ID: mdl-37726894

RESUMO

AIMS: Prior studies have implied that smokers may have changed their smoking behaviour during the COVID-19 pandemic. However, little is known about changes in smoking behaviour and correlates of change due to the pandemic among persons of migrant origin compared with the general population. METHODS: Population-based cross-sectional studies with comparable study protocols and measures, one focusing on persons of migrant origin living in Finland (n = 3587, response rate 60%) and the other on the general Finnish population (n = 3444, response rate 56%), were utilised. The outcome measure was self-reported change in smoking behaviour due to COVID-19 among current smokers. Explanatory factors included sociodemographic-, health-, and COVID-19-related factors. Multinomial logistic regression was used in the analyses. RESULTS: Most of the current smokers reported no change in their smoking behaviour. In the adjusted model, younger age was positively associated with increased smoking, while region of origin (Russia, Africa, Asia, and Latin America) and worrying about getting infected with COVID-19 were associated with decreased smoking among persons of migrant origin. In the general population, younger age, female sex, being other than employed/student, increased loneliness, and decreased contact with close ones were associated with increased smoking, while reduced working capacity and worries that someone close to the respondent will be infected with COVID-19 were associated with decreased smoking. CONCLUSIONS: The findings of this study contribute to better identification of at-risk populations in future crises situations. This will allow for more efficient targeting and tailoring of health promotion services, including smoking cessation.

5.
Scand J Public Health ; 51(5): 792-796, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37042665

RESUMO

AIMS: The effects of COVID-19 containment measures on health-related lifestyle have been both favourable and unfavourable for health. Factors predisposing to unfavourable changes are still poorly known. In this short communication, we aimed to examine which socioeconomic and health-related factors predicted unfavourable lifestyle changes based on data from the same individuals before (2017) the pandemic and during the second wave (2020) of the pandemic in Finland. METHODS: This individual-level follow-up study was based on a nationally representative, two-stage stratified cluster sample of Finnish adults from the FinHealth 2017 Study, conducted in Spring 2017, and its follow-up survey, conducted in Autumn 2020. A total of 3834 men and women aged 25-69 years at baseline had information of selected lifestyle factors (vegetable consumption, leisure-time physical activity, sleeping problems and nightmares) available at both time points. Odds ratios and 95% confidence intervals for unfavourable lifestyle changes (yes/no) according to socioeconomic and health-related factors were calculated using logistic regression models taking into account the sampling design and non-response. RESULTS: We found that those having poor health (i.e. psychological distress, poor self-rated health or chronic diseases) or disadvantaged socioeconomic background before the pandemic were prone to unfavourable lifestyle changes during the follow-up. CONCLUSIONS: Observed unfavourable lifestyle changes in vulnerable population groups may accelerate health inequalities. Targeted health promotion actions are needed to prevent this unfavourable development.


Assuntos
COVID-19 , Pandemias , Adulto , Masculino , Humanos , Feminino , Seguimentos , COVID-19/epidemiologia , Estilo de Vida , Nível de Saúde
6.
J Med Internet Res ; 25: e42287, 2023 05 05.
Artigo em Inglês | MEDLINE | ID: mdl-37145836

RESUMO

BACKGROUND: The rapidly increasing role of the internet in obtaining basic services poses challenges, especially for older adults' capabilities of getting the services they need. Research on the predictors of older adults' internet use and digital competence is especially relevant given that people are living longer than before, and the age profile of many societies is changing rapidly. OBJECTIVE: We aimed to examine the associations of objective measures of physical and cognitive impairment with the nonuse of the internet for services and low digital competence among older adults. METHODS: A longitudinal population-based design was used that combined data from performance tests and self-rated questionnaires. Data were gathered in 2017 and 2020 among 1426 older adults aged between 70 and 100 years in Finland. Logistic regression analyses were used to examine the associations. RESULTS: Those who had poor near (odds ratio [OR] 1.90, 95% CI 1.36-2.66) or distant vision (OR 1.81, 95% CI 1.21-2.71), restricted or failed abduction of upper arms (OR 1.81, 95% CI 1.28-2.85), and poor results from the word list memory (OR 3.77, 95% CI 2.65-5.36) or word list delayed recall (OR 2.12, 95% CI 1.48-3.02) tests had greater odds for nonuse of the internet for services than their counterparts. Moreover, those who had poor near (OR 2.18, 95% CI 1.57-3.02) or distant vision (OR 2.14, 95% CI 1.43-3.19), poor results from the chair stand test (OR 1.57, 95% CI 1.06-2.31), restricted or failed abduction of upper arms (OR 1.74, 95% CI 1.10-2.76), and poor results from the word list memory (OR 3.41, 95% CI 2.32-5.03) or word list delayed recall (OR 2.05, 95% CI 1.39-3.04) tests had greater odds of low digital competence than their counterparts. CONCLUSIONS: According to our results, older adults' impaired physical and cognitive functioning may hamper their possibilities of accessing internet services such as digital health care services. Our results should be considered when planning digital health care services intended to be used by older adults; that is, digital solutions should also be suitable for older adults with impairments. Furthermore, face-to-face services should be provided for those who cannot use digital services, even if they are assisted properly.


Assuntos
Serviços de Saúde , Uso da Internet , Humanos , Idoso , Idoso de 80 Anos ou mais , Inquéritos e Questionários , Cognição , Finlândia , Internet
7.
BMC Med Res Methodol ; 22(1): 309, 2022 12 02.
Artigo em Inglês | MEDLINE | ID: mdl-36460964

RESUMO

BACKGROUND: Reliable information on the use of health services is important for health care planning, monitoring and policy. It is critical to assess the validity of the sources used for this purpose, including register and survey-based data. Studies on foreign-born populations' health care use have usually implemented either survey or register data. The concordance of such data among groups of different cultural background remains largely unknown. In this study, we presented an approach to examine routinely how survey and register-related characteristics may explain disagreement found between the two information sources. METHODS: We linked register- and survey-based data pertaining to the Finnish Register of Primary Health Care general physician visits and the Survey on Well-Being among Foreign Born Population (FinMonik, 2018-2019), a nationally representative survey. The sample comprised n = 5,800 informants for whom registered general physician visits were tracked in the 12-month period preceding their participation in the survey. Cohen's kappa was used as measure of multisource concordance, hierarchical loglinear models for the association between single predictors and multisource discrepancy, and a logistic regression model for examining source-related predictors of source discrepancy. Survey weights were used in all sample analyses. RESULTS: Source concordance was poor. When dichotomizing general physician visits (zero vs one or more), 35% of informants had reported one or more visits while none were found from register. Both register- and informant-related predictors were associated to this discrepancy (i.e. catchment area, private health care use, inability to work, region of origin and reason for migration). CONCLUSIONS: We found high discrepancy between the reported and the registered physician visits among the foreign-born population in Finland, with a particularly high number of reported physician visits when none were found in the register. There was a strong association between the specific catchment area and mismatch, indicating that both register under-coverage and survey over-report are plausible and may coexist behind the discrepancy. However, associations of informant's characteristics and mismatch were less pronounced. Implications on the validity of medical information sources are discussed.


Assuntos
Clínicos Gerais , Internacionalidade , Humanos , Autorrelato , Finlândia , Atenção à Saúde
8.
Acta Obstet Gynecol Scand ; 101(1): 127-134, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34761373

RESUMO

INTRODUCTION: Hypertensive disorders of pregnancy are a leading cause of maternal and perinatal mortality and morbidity worldwide. We studied the prevalence of hypertensive disorders of pregnancy among women of migrant origin in Finland. MATERIAL AND METHODS: This study used data from the nationwide Medical Birth Register. Information on the most recent singleton birth of women who delivered between 2004 and 2014 (n = 382 233) was included. Women were classified into nine regional categories based on the country of origin. Women of Finnish origin were the reference group. Generalized linear models adjusted for maternal age, socioeconomic position, smoking in pregnancy, parity, pre-pregnancy body mass index, preexisting diabetes and delivery year were used to study the association between region/country of origin and hypertensive disorders of pregnancy. RESULTS: Among the study population, almost 8% were of migrant origin. The prevalence of hypertensive disorders of pregnancy varied from 1.3% (women of East Asian origin) to 4.2% (women of Sub-Saharan African origin), compared with 4.6% in the Finnish origin reference group. Compared with women of Finnish origin, the risk for any hypertensive disorders of pregnancy after adjustment for confounders was lower for women of migrant origin, with an exception for women of Sub-Saharan African origin. When analyzing gestational hypertension and preeclampsia outcomes separately, Sub-Saharan African origin women had a lower risk for gestational hypertension (risk ratio [RR] 0.41, 95% confidence interval [CI] 0.30-0.56) but a higher risk for preeclampsia (RR 1.77, 95% CI 1.44-2.17) than women of Finnish origin. CONCLUSIONS: In general, women of migrant origin in Finland had a lower risk for any hypertensive disorders of pregnancy and gestational hypertension. The risk for preeclampsia was higher among women of Sub-Saharan African origin and may warrant special attention.


Assuntos
Emigrantes e Imigrantes , Hipertensão Induzida pela Gravidez/epidemiologia , Adulto , África Subsaariana/etnologia , Ásia Oriental/etnologia , Feminino , Finlândia/epidemiologia , Humanos , Hipertensão Induzida pela Gravidez/etnologia , Vigilância da População , Gravidez , Prevalência , Sistema de Registros
9.
Scand J Public Health ; 50(8): 1214-1220, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35130774

RESUMO

AIMS: Young adulthood is a life stage that is vulnerable to detrimental lifestyle changes and excessive weight gain, which may have major effects on health later in life. This study aimed to examine the changes in lifestyle-related factors in the 2000s and sociodemographic differences in lifestyle in Finnish young adults. METHODS: The study was based on the cross-sectional data from two representative samples of Finnish young adults aged 18-29 years from the Health 2000 Survey (n = 1894; 90% participated) and the FinHealth 2017 Study (n = 1162; 54% participated). Sociodemographic factors, lifestyle choices (smoking, alcohol consumption, intake of vegetables, physical activity), and anthropometrics were self-reported. Weighted prevalence based on predictive margins and odds ratios were analyzed using logistic regression, taking into account the sampling design and non-response. RESULTS: The prevalence of daily cigarette smoking decreased between the years 2000 and 2017 from 34% to 12% (p < 0.01) and from 23% to 11% (p < 0.01) in men and women, respectively. There was a decline in the prevalence of daily intake of fresh vegetables, especially in men. The prevalence of obesity (BMI ⩾ 30 kg/m2) doubled being 15% in men and 18% in women in 2017. Health-endangering lifestyles, measured by a lifestyle sum score, were more common among young adults with lower education compared to those with higher. CONCLUSIONS: This study showed both favorable and unfavorable changes in the lifestyles of Finnish young adults in the 2000s. Health-endangering lifestyles were more common among young adults with lower education, suggesting the need for tailored health-promoting actions. Special attention should be given to obesity prevention.


Assuntos
Obesidade , Sobrepeso , Masculino , Adulto Jovem , Feminino , Humanos , Adulto , Sobrepeso/epidemiologia , Finlândia/epidemiologia , Índice de Massa Corporal , Estudos Transversais , Obesidade/epidemiologia , Estilo de Vida , Prevalência , Verduras
10.
Eur J Public Health ; 31(4): 784-789, 2021 10 11.
Artigo em Inglês | MEDLINE | ID: mdl-34059900

RESUMO

BACKGROUND: Migrant women may have a higher risk for gestational diabetes mellitus (GDM) and the related adverse outcomes. We studied the prevalence of GDM among migrant-origin women in Finland. METHODS: This study used data from the nationwide Medical Birth Register. Information on the most recent singleton births of women delivering between 2004 and 2014 (N = 379 634) was included. Women were classified into nine regional categories based on the country of origin. Finnish origin women were the reference group. Generalized linear models adjusted for maternal age, parity, socioeconomic position, pre-pregnancy body mass index and year of delivery were used to study the association between region/country of origin and GDM. RESULTS: Among the study population, almost 8% were of migrant origin. The prevalence of GDM varied from 6.1% (women of Latin American/Caribbean origin) to 18.4% (South Asian origin), compared to 8.7% in the Finnish reference group. When adjusted for confounders, women of South Asian, East Asian, Middle Eastern/North African and Russian/former USSR origin had a higher risk for GDM than Finnish origin women. By country of origin, women originating from Pakistan, Bangladesh, Sri Lanka, India, Afghanistan, Nepal, China, Philippines, Vietnam, Thailand, Morocco, Turkey, Iran, Iraq and former USSR had a higher risk for GDM than Finnish origin women. CONCLUSIONS: There is substantial variation in the prevalence of GDM by country of origin. Women of South Asian, East Asian and Middle Eastern/North African origin had the highest risk for GDM and may warrant special attention.


Assuntos
Diabetes Gestacional , Migrantes , Diabetes Gestacional/epidemiologia , Feminino , Finlândia/epidemiologia , Humanos , Idade Materna , Gravidez , Fatores de Risco
11.
Paediatr Perinat Epidemiol ; 34(1): 12-20, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31960477

RESUMO

BACKGROUND: In Finland, limited information is available on neonatal disparities among women of migrant origin. OBJECTIVE: This study investigated differences in caesarean delivery and neonatal outcomes between women of migrant origin and Finnish women in Finland. METHODS: The study was based on nationwide data from the Medical Birth Register of Finland. Our study included information on the most recent singleton birth of women delivering between January 2004 and December 2014 (N = 382 233). Women were classified into nine regional categories based on their country of origin. Generalized linear models were used to describe associations between country of origin and pregnancy outcomes adjusted for maternal age, socio-economic status, pre-pregnancy body mass index, parity, marital status, smoking during pregnancy, and delivery year. Finnish women were the reference group. RESULTS: Among the study population, almost 92% of women were of Finnish origin; the remaining 8% were of migrant origin. Among the migrant women, those of Russian/former USSR origin were the largest group (n = 11 994); the smallest group was women of Latin American/Caribbean origin (n = 739). Compared with Finnish women, women of sub-Saharan African, South Asian, and East Asian origin were at greater risk of emergency caesarean delivery, preterm birth, low birthweight, and lower five-minute Apgar scores for newborns. Latin American/Caribbean-origin women were at increased risk of both elective and emergency caesarean delivery and lower five-minute Apgar scores compared with Finnish women. Women of Russian/former USSR origin overall had a lower risk of caesarean delivery and poor neonatal outcomes compared with Finnish women. CONCLUSIONS: We identified sub-Saharan African, South Asian, and East Asian women as higher-risk groups, and women from Russia/former USSR as a lower-risk group, for emergency caesarean delivery and poor neonatal outcome compared with Finnish women. More research is needed to identify the reasons for these differences by country of origin in Finland.


Assuntos
Peso ao Nascer , Cesárea/estatística & dados numéricos , Emigrantes e Imigrantes/estatística & dados numéricos , Disparidades em Assistência à Saúde/estatística & dados numéricos , Unidades de Terapia Intensiva Neonatal/estatística & dados numéricos , Nascimento Prematuro/epidemiologia , Adulto , África Subsaariana/etnologia , Índice de Apgar , Ásia/etnologia , Região do Caribe/etnologia , Procedimentos Cirúrgicos Eletivos/estatística & dados numéricos , Emergências , Feminino , Finlândia/epidemiologia , Idade Gestacional , Disparidades em Assistência à Saúde/etnologia , Humanos , Recém-Nascido de Baixo Peso , Recém-Nascido , América Latina/etnologia , Modelos Lineares , Idade Materna , Gravidez , Resultado da Gravidez , Nascimento Prematuro/etnologia , Federação Russa/etnologia , U.R.S.S./etnologia , Adulto Jovem
12.
Public Health Nutr ; 23(7): 1254-1265, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32188532

RESUMO

OBJECTIVE: We investigated the determinants of serum 25-hydroxyvitamin D [S-25(OH)D] and dietary vitamin D sources among three immigrant groups in Finland and compared their S-25(OH)D to the general Finnish population. DESIGN: Cross-sectional population-based Migrant Health and Wellbeing Study and the nationally representative Finnish Health 2011 Survey. S-25(OH)D was standardised according to the Vitamin D Standardisation Program. Vitamin D sources were assessed by interview. SETTING: Six different municipalities in Finland (60°-63°N). PARTICIPANTS: Immigrants aged 18-64 years (446 Russians, 346 Somalis, 500 Kurds), 798 Finns aged 30-64 years. RESULTS: The mean of S-25(OH)D was 64 (95 % CI 62, 66), 44 (95 % CI 41, 46), 35 (95 % CI 34, 37) and 64 (95 % CI 62, 66) nmol/l for Russians, Somalis, Kurds and Finns, respectively. S-25(OH)D among Somalis and Kurds was lower compared with Finns (P < 0·001). The prevalence of vitamin D deficiency (S-25(OH)D <30 nmol/l) and insufficiency (S-25(OH)D <50 nmol/l) was higher among immigrants than Finns (P < 0·001). Vitamin D-rich foods differed between the groups; vitamin D-fortified fat spread consumption was higher among Somalis (91 %) than among Russians (73 %) and Kurds (60 %); fish was less consumed among Kurds (17 %) than among Russians (43 %) and Somalis (38 %); and 57 % Russians, 56 % Kurds and 36 % Somalis consumed vitamin D-fortified dairy daily (P < 0·001 for all). Daily smoking, alcohol consumption and winter blood sampling were determinants of vitamin D insufficiency (P ≤ 0·03). Older age, physical activity, fish and vitamin D-fortified dairy consumption were associated with lower odds of insufficiency (P ≤ 0·04). CONCLUSIONS: Vitamin D status differed among immigrant groups and the determinants are, to some degree, associated with learned or existing cultural behaviours.


Assuntos
Dieta , Emigrantes e Imigrantes/estatística & dados numéricos , Deficiência de Vitamina D/epidemiologia , Vitamina D/análogos & derivados , Adolescente , Adulto , Estudos Transversais , Suplementos Nutricionais , Feminino , Finlândia/epidemiologia , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Estado Nutricional , Prevalência , Federação Russa , Estações do Ano , Somália , Vitamina D/administração & dosagem , Vitamina D/sangue , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/tratamento farmacológico , Vitaminas/administração & dosagem , Vitaminas/sangue , Adulto Jovem
13.
Birth ; 46(1): 35-41, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-29781088

RESUMO

INTRODUCTION: Limited information is available on delivery and its complications among migrant women in Finland. We compared mode of delivery, delivery complications, and use of pain medication during delivery between migrant women of Somali, Kurdish, and Russian origin and women in the general population in Finland. METHODS: The women were of Russian (n = 318), Somali (n = 583), and Kurdish (n = 373) origin and 243 women from the general population (reference group) who had given birth in Finland between 2004 and 2014. The data were obtained from the National Medical Birth Register and the Hospital Discharge Register. The most recent birth of each woman was included in the analyses. The main statistical methods were logistic regression analyses adjusting for age, parity, body mass index, gestational age, and smoking during pregnancy. RESULTS: Vaginal delivery was the most common mode of delivery among all study groups (79%-89%). The prevalence of any delivery complications varied between 15% and 19% among all study groups. When adjusted for confounders, Russian women had lower odds (OR 0.49; CI 0.29-0.82) of having a cesarean delivery, whereas Somali and Kurdish women did not differ from the reference group. Somali women had an increased risk of any delivery complications (OR 1.62; CI 1.03-2.55) compared with the reference group. No differences were observed in the use of pain medication between the groups. CONCLUSION: Delivery complications were more common among migrant Somali women than among women in the general Finnish population. Somali women represent a high-risk group calling for special attention and care.


Assuntos
Parto Obstétrico/estatística & dados numéricos , Complicações do Trabalho de Parto/etnologia , Migrantes/estatística & dados numéricos , Adolescente , Adulto , Parto Obstétrico/métodos , Feminino , Finlândia/epidemiologia , Inquéritos Epidemiológicos , Humanos , Irã (Geográfico)/etnologia , Iraque/etnologia , Modelos Logísticos , Gravidez , Prevalência , Fatores de Risco , Federação Russa/etnologia , Fatores Socioeconômicos , Somália/etnologia , Adulto Jovem
14.
BMC Public Health ; 19(1): 391, 2019 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-30971258

RESUMO

BACKGROUND: Persons of African and Middle-Eastern origin living in European countries have a high prevalence of type 2 diabetes, accompanied by high prevalence of obesity among women but not always among men. The aim of this study was to examine whether there are differences in the association between anthropometric measures and glucose levels measured with glycated haemoglobin and fasting blood glucose among persons of migrant origin in Finland. METHODS: Cross-sectional population-based data of the 30-64 year-old participants in the health examination of the Migrant Health and Wellbeing Study was used, selecting persons without diabetes (Russian origin n = 293, Somali origin n = 184, Kurdish origin n = 275). The reference group were non-diabetic participants in the Health 2011 Survey (n = 653), representative of the general Finnish population. Anthropometric measures included body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR) and waist-to-hip ratio (WHR, available for Maamu Study participants only). RESULTS: Depending on whether continuous or categorical anthropometric measures were used, age, sex and anthropometrics explained 13-18% of variation in HbA1c among persons of Russian origin, 5-10% among persons of Somali origin, 1-3% among persons of Kurdish origin and 11-13% among the general population. Also depending on whether continuous or categorical anthropometric measures were used, age, sex and anthropometrics explained 13-19% of variation in fasting blood glucose among persons of Russian origin, 15-20% among persons of Somali origin, 13-17% among persons of Kurdish origin and 16-17% among the general population. With exception for BMI, strength of the association between continuous anthropometric measures and HbA1c was significantly lower among persons of Kurdish origin compared with the general Finnish population (p = 0.044 for WC and p = 0.040 for WHtR). CONCLUSIONS: A low degree of association between anthropometric measures and HbA1c was observed among persons of Kurdish origin. Findings of this study suggest caution is warranted when using HbA1c as a screening tool for glucose impairment among persons without diabetes in populations of diverse origin.


Assuntos
Diabetes Mellitus Tipo 2/etnologia , Diabetes Mellitus Tipo 2/epidemiologia , Etnicidade/estatística & dados numéricos , Hemoglobinas Glicadas/análise , Migrantes/estatística & dados numéricos , Adulto , Antropometria , Índice de Massa Corporal , Estudos Transversais , Feminino , Finlândia/epidemiologia , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Federação Russa/etnologia , Somália/etnologia , Circunferência da Cintura , Razão Cintura-Estatura , Relação Cintura-Quadril
15.
Eur J Public Health ; 29(5): 894-899, 2019 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-30919897

RESUMO

BACKGROUND: Migrants from low-income countries are more predisposed to diabetes and cardiovascular risks than host European natives, but how treatment targets are met in migrant patients is unclear. We examined health service use and treatment of diabetes and hypertension among selected migrant groups and the general Finnish population and compared prevalence of cardiovascular risk factors between patients and non-patients. METHODS: Cross-sectional data from randomly sampled 30- to 64-year-old participants (387 Russian, 198 Somali and 343 Kurdish origin migrants) of the Migrant Health and Wellbeing Survey (2010-2012) were used. Health 2011 survey data (n = 1086) were used as a comparison group. RESULTS: Compared with the general population, diabetes-related doctor/nurse visits were more frequent among Russian and Somali, but not the Kurdish group. Use of prescribed antidiabetic and antihypertensive drugs were significantly lower among Russians (78%/56%) and Kurdish (68%/58%), but not in Somalis (85%/62%) compared with the general population (96%/78%). Obesity, elevated blood pressure and elevated glucose levels were more prevalent in patients than non-patients, and over 60% of patients and over 70% of non-patients had elevated plasma low density lipoprotein cholesterol. Differences in cardiovascular disease (CVD) risk profiles between patients and non-patients were not associated with socio-economic factors. CONCLUSIONS: This study indicates disparities in prevalence and management of diabetes and hypertension and their associated risk factors among ethnic groups. Diabetes, CVD risks and treatment outcomes in patients were sub-optimal, especially among foreign origin groups. Comprehensive health promotion strategies are needed to improve cardiometabolic health in vulnerable populations.


Assuntos
Diabetes Mellitus Tipo 2/terapia , Emigrantes e Imigrantes/estatística & dados numéricos , Disparidades em Assistência à Saúde/etnologia , Hipertensão/terapia , Adulto , Estudos Transversais , Diabetes Mellitus Tipo 2/etnologia , Feminino , Finlândia , Disparidades em Assistência à Saúde/estatística & dados numéricos , Humanos , Hipertensão/etnologia , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Federação Russa/etnologia , Somália/etnologia
16.
BMC Infect Dis ; 18(1): 137, 2018 03 20.
Artigo em Inglês | MEDLINE | ID: mdl-29558910

RESUMO

BACKGROUND: Migrants are considered a key population at risk for sexually transmitted and blood-borne diseases in Europe. Prevalence data to support the design of infectious diseases screening protocols are scarce. We aimed to estimate the prevalence of hepatitis B and C, human immunodefiency virus (HIV) infection and syphilis in specific migrant groups in Finland and to assess risk factors for missed diagnosis. METHODS: A random sample of 3000 Kurdish, Russian, or Somali origin migrants in Finland was invited to a migrant population-based health interview and examination survey during 2010-2012. Participants in the health examination were offered screening for hepatitis B and C, HIV and syphilis. Notification prevalence in the National Infectious Diseases Register (NIDR) was compared between participants and non-participants to assess non-participation. Missed diagnosis was defined as test-positive case in the survey without previous notification in NIDR. Inverse probability weighting was used to correct for non-participation. RESULTS: Altogether 1000 migrants were screened for infectious diseases. No difference in the notification prevalence among participants and non-participants was observed. Seroprevalence of hepatitis B surface antigen (HBsAg) was 2.3%, hepatitis C antibodies 1.7%, and Treponema pallidum antibodies 1.3%. No cases of HIV were identified. Of all test-positive cases, 61% (34/56) had no previous notification in NIDR. 48% of HBsAg, 62.5% of anti-HCV and 84.6% of anti-Trpa positive cases had been missed. Among the Somali population (n = 261), prevalence of missed hepatitis B diagnosis was 3.0%. Of the 324 Russian migrants, 3.0% had not been previously diagnosed with hepatitis C and 2.4% had a missed syphilis diagnosis. In multivariable regression model missed diagnosis was associated with migrant origin, living alone, poor self-perceived health, daily smoking, and previous diagnosis of another blood-borne infection. CONCLUSIONS: More than half of chronic hepatitis and syphilis diagnoses had been missed among migrants in Finland. Undiagnosed hepatitis B among Somali migrants implies post-migration transmission that could be prevented by enhanced screening and vaccinations. Rate of missed diagnoses among Russian migrants supports implementation of targeted hepatitis and syphilis screening upon arrival and also in later health care contacts. Coverage and up-take of current screening among migrants should be evaluated.


Assuntos
Hepatite B/diagnóstico , Hepatite C/diagnóstico , Sífilis/diagnóstico , Migrantes/estatística & dados numéricos , Adolescente , Adulto , Anticorpos Antibacterianos/sangue , Feminino , Finlândia/epidemiologia , Hepatite B/epidemiologia , Antígenos de Superfície da Hepatite B/sangue , Hepatite C/epidemiologia , Anticorpos Anti-Hepatite C/sangue , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Federação Russa , Somália , Inquéritos e Questionários , Sífilis/epidemiologia , Treponema pallidum/imunologia , Adulto Jovem
17.
Int J Equity Health ; 17(1): 56, 2018 05 04.
Artigo em Inglês | MEDLINE | ID: mdl-29728104

RESUMO

BACKGROUND: Cervical cancer is currently ranked as the fourth commonly diagnosed cancer in women globally. A higher incidence has been reported in low- and-middle-income countries, and the disease poses significant public health challenges. Evidence suggests that this disease is preventable by means of regular screening using the Papanicolaou (Pap) test. However, limited knowledge exists about disparities in cervical screening participation among immigrants compared with non-immigrants, in countries with universal cervical screening programmes. We aimed to examine disparities in cervical screening participation among women of Russian, Somali, and Kurdish, origin in Finland, comparing them with the general Finnish population (Finns). We controlled for differences in several socio-demographic and health-related variables as potential confounders. METHODS: We employed data from the Finnish Migrant Health and Well-being Study 2010-2012 and the National Health 2011 Survey. Data collection involved face-to-face interviews. Data on screening participation in the previous five years from women aged 29-60 were available from 537 immigrants (257 Russians, 113 Somalis, 167 Kurds) and from 436 Finns. For statistical analyses, we used multiple logistic regression. RESULTS: Age-adjusted screening participation rates were as follows: Russians 79% (95% CI 72.9-84.4), Somalis 41% (95% CI 31.4-50.1), and Kurds 64% (95% CI 57.2-70.8), compared with 94% (95% CI 91.4-95.9) among Finns. After additionally adjusting for socio-demographic and health-related confounders, all the immigrant groups showed a significantly lower likelihood of screening participation when compared with Finns. The Odds Ratios were as follows: Russians 0.32 (95% CI 0.18-0.58), Somalis 0.10 (95% CI 0.04-0.23), and Kurds 0.17 (95% CI 0.09-0.35). However, when additionally accounting for country of origin-confounder interactions, such differences were attenuated. CONCLUSIONS: Our results indicate disparities in screening participation among these immigrants and a lower likelihood of screening participation compared with the general Finnish population. To improve equity in cervical cancer screening participation, appropriate culturally tailored intervention programmes for each immigrant group might be beneficial.


Assuntos
Detecção Precoce de Câncer/estatística & dados numéricos , Emigrantes e Imigrantes/estatística & dados numéricos , Disparidades em Assistência à Saúde/etnologia , Teste de Papanicolaou/estatística & dados numéricos , Adulto , Feminino , Finlândia/epidemiologia , Humanos , Irã (Geográfico)/etnologia , Modelos Logísticos , Programas de Rastreamento/estatística & dados numéricos , Pessoa de Meia-Idade , Federação Russa/etnologia , Somália/etnologia , Neoplasias do Colo do Útero/diagnóstico , Adulto Jovem
18.
BMC Pregnancy Childbirth ; 18(1): 296, 2018 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-29991354

RESUMO

BACKGROUND: Since reproductive health is often considered a highly sensitive topic, underreporting in surveys and under coverage of register data occurs frequently. This may lead to inaccurate information about the reproductive health. This study compares the proportion of women having births and induced abortions among migrant women of Russian, Somali and Kurdish origin in Finland to women in the general Finnish population and examines the agreement between survey- and register-based data. METHODS: The survey data from the Migrant Health and Wellbeing Study conducted in 2010-2012 and data from the Health 2011 Survey with corresponding information on women in the general population were used in this study. The respondents were women aged 18-64: 341 Russian, 176 Somali and 228 Kurdish origin women and 630 women in the general population. The survey data were linked to the Finnish Medical Birth Register and the Register of Induced Abortions. RESULTS: In the combined (survey and register) data, migrant groups aged 30-64 had a higher proportion (89-96%) compared to the general population (69%) of women with at least one birth. Under-coverage of registered births was observed in all study groups. Among women aged 18-64, 36% of the Russian group and 24% of the Kurdish group reported more births in the survey than in the register data. In the combined data, the proportions of Russian origin (69%) and Kurdish origin (38%) women who have had at least one induced abortion in their lifetime are higher than in the general population (21%). Under-reporting of induced abortions in survey was observed among Somali origin women aged 18-29 (1% vs. 18%). The level of agreement between survey and register data was the lowest for induced abortions among the Somali and Russian groups (- 0.01 and 0.27). CONCLUSION: Both survey- and register-based information are needed in studies on reproductive health, especially when comparing women with foreign origin with women in the general population. Culturally sensitive survey protocols need to be developed to reduce reporting bias.


Assuntos
Aborto Induzido/estatística & dados numéricos , Coeficiente de Natalidade/etnologia , Anticoncepção/estatística & dados numéricos , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Saúde Reprodutiva , Migrantes/estatística & dados numéricos , Adulto , Feminino , Finlândia/epidemiologia , Inquéritos Epidemiológicos/métodos , Inquéritos Epidemiológicos/estatística & dados numéricos , Humanos , Pessoa de Meia-Idade , Oriente Médio/etnologia , Gravidez , Sistema de Registros/estatística & dados numéricos , Saúde Reprodutiva/etnologia , Saúde Reprodutiva/estatística & dados numéricos , Fatores de Risco , Federação Russa/etnologia , Autorrelato , Fatores Socioeconômicos , Somália/etnologia
19.
J Public Health (Oxf) ; 40(2): 262-270, 2018 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-28505378

RESUMO

Background: Migrant background and higher parity may increase the risk of being overweight. We compared the prevalence of overweight (body mass index ≥25 kg/m2) and abdominal obesity (waist-to-height ratio ≥0.5) between non-pregnant migrant and Finnish women aged 18-45 years. Methods: The participants were 165 Russian, 164 Somali and 179 Kurdish origin women from the cross-sectional Migrant Health and Wellbeing study. The reference group included 388 women from the general Finnish population. Body anthropometrics were measured. The main statistical methods were logistic regression adjusted for sociodemographic and reproductive variables. Results: The unadjusted prevalence of overweight and obesity, respectively, were higher among Somali (32.9%, 30.9%, P < 0.001) and Kurdish women (41.1%, 19.5%, P < 0.001) than among Finnish women (19.9%, 9.8%). The adjusted odds ratios (95% CI) for overweight (including obesity) were 0.54 (0.33; 0.89) for Russian, 2.89 (1.66; 5.03) for Somali and 2.56 (1.64; 4.00) for Kurdish women compared with Finnish women. Kurdish women had 2.96-fold (1.75; 5.00) adjusted odds ratio for abdominal obesity compared with Finnish women. Being parous was associated with overweight and abdominal obesity among Kurdish women. Conclusions: Overweight and obesity were very common among Somali and Kurdish origin women. Information on diet and physical activity in these groups is needed.


Assuntos
Obesidade Abdominal/epidemiologia , Sobrepeso/epidemiologia , Adolescente , Adulto , Estudos Transversais , Feminino , Finlândia/epidemiologia , Humanos , Irã (Geográfico)/etnologia , Iraque/etnologia , Pessoa de Meia-Idade , Obesidade Abdominal/etnologia , Sobrepeso/etnologia , Federação Russa/etnologia , Somália/etnologia , Migrantes/estatística & dados numéricos , Adulto Jovem
20.
Scand J Public Health ; 46(3): 375-381, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-28720022

RESUMO

AIMS: The aims of this study were to describe the perceived work ability of unemployed individuals and to explore the association between perceived good work ability and sociodemographic, work-related and well-being factors. METHODS: The data were derived from the Finnish Regional Health and Well-being Study (ATH) collected by postal and Internet-based questionnaires in 2014-2015. The random sample was selected from the Finnish National Population Register. The present study includes data from unemployed or laid-off respondents ( n=1975) aged 20-65 years. Logistic regression was used in the statistical analysis. Perceived work ability was measured with the Work Ability Score. RESULTS: Factors significantly associated with good work ability were having young children living in the household, short-term unemployment, low or moderate physical strain in most recent job, moderate mental strain in most recent job, satisfaction with most recent job, good self-rated health and good quality of life. Good self-rated health (odds ratio=10.53, 95% confidence interval 5.90-18.80) was the most substantial factor in the multivariate model. CONCLUSIONS: The findings provide further evidence on the factors related to good work ability of the unemployed. These factors should be considered when designing interventions for promoting work ability and to minimise the harmful effects of long-term unemployment.


Assuntos
Desemprego/estatística & dados numéricos , Avaliação da Capacidade de Trabalho , Adulto , Idoso , Autoavaliação Diagnóstica , Feminino , Finlândia , Humanos , Satisfação no Emprego , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Sistema de Registros , Fatores de Risco , Fatores Socioeconômicos , Adulto Jovem
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