Healthy migrants but unhealthy offspring? A retrospective cohort study among Italians in Switzerland.
Healthy migrants but unhealthy offspring? A retrospective cohort study among Italians in Switzerland.
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DOI：
10.1186/1471-2458-12-1104
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发表时间：
2012-12-22
影响因子：
4.5
通讯作者：
SNC Study Group
中科院分区：
文献类型：
--
作者：
Tarnutzer S;Bopp M;SNC Study Group
在许多国家，来自意大利的移徙者构成了一个庞大、明确界定的群体，有着独特的生活方式和饮食习惯。然而，几乎没有任何关于意大利移民及其后代全因死亡模式的信息。在本文中，我们比较了意大利移民，他们的后代和瑞士国民。我们比较了1990 - 2008年观察期内，在瑞士国家队列（SNC）中登记的瑞士和意大利国民（居住在瑞士德语或法语区，年龄范围为40 - 89岁）的年龄特异性和年龄标准化死亡率和风险比（经教育，婚姻状况，语言地区和时期调整）。总体而言，3，175，288名瑞士本地人（48%为男性）和224，372名具有意大利移民背景的人（57%为男性）累计死亡698，779人，44，836，189人年。具有意大利背景的个人按国籍、出生国和语言分类。第一代意大利人的死亡风险低于瑞士本地人（参考组），但第二代意大利人的死亡风险较高。在第一代意大利人中，主要讲意大利语的男性和女性的风险比（HR）分别为0.89（95% CI：0.88 - 0.91）和0.90（0.87 - 0.92），而采用当地语言的男性和女性的HR分别为0.93（0.88 - 0.98）和0.96（0.88 - 1.04）。在第二代意大利人中，HR分别为1.16（1.03 - 1.31）、1.06（0.89 - 1.26）、1.10（1.05 - 1.16）和0.97（0.89 - 1.05）。第一代意大利人的死亡率优势随着年龄的增长而下降。第一代和第二代意大利人的死亡风险差异很大。第二代意大利人的健康移民的影响和健康的劣势表现出特征的年龄/性别模式。未来需要对健康行为和死因特异性死亡率进行调查，以更好地了解不同的死亡风险。这些见解将有助于适当的预防和健康促进工作。
In many countries, migrants from Italy form a substantial, well-defined group with distinct lifestyle and dietary habits. There is, however, hardly any information about all-cause mortality patterns among Italian migrants and their offspring. In this paper, we compare Italian migrants, their offspring and Swiss nationals. We compared age-specific and age-standardized mortality rates and hazard ratios (adjusted for education, marital status, language region and period) for Swiss and Italian nationals registered in the Swiss National Cohort (SNC), living in the German- or French-speaking part of Switzerland and falling into the age range 40–89 during the observation period 1990–2008. Overall, 3,175,288 native Swiss (48% male) and 224,372 individuals with an Italian migration background (57% male) accumulated 698,779 deaths and 44,836,189 person-years. Individuals with Italian background were categorized by nationality, country of birth and language. First-generation Italians had lower mortality risks than native Swiss (reference group), but second-generation Italians demonstrated higher mortality risks. Among first-generation Italians, predominantly Italian-speaking men and women had hazard ratios (HRs) of 0.89 (95% CI: 0.88-0.91) and 0.90 (0.87-0.92), respectively, while men and women having adopted the regional language had HRs of 0.93 (0.88-0.98) and 0.96 (0.88-1.04), respectively. Among second-generation Italians, the respective HRs were 1.16 (1.03-1.31), 1.06 (0.89-1.26), 1.10 (1.05-1.16) and 0.97 (0.89-1.05). The mortality advantage of first-generation Italians decreased with age. The mortality risks of first- and second-generation Italians vary substantially. The healthy migrant effect and health disadvantage among second-generation Italians show characteristic age/sex patterns. Future investigation of health behavior and cause-specific mortality is needed to better understand different mortality risks. Such insights will facilitate adequate prevention and health promotion efforts.
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