Immigrants' health and health inequality by type of integration policies in European countries
Immigrants' health and health inequality by type of integration policies in European countries
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DOI：
10.1093/eurpub/cku156
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发表时间：
2015-04-01
影响因子：
4.4
通讯作者：
Malmusi, Davide
中科院分区：
文献类型：
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作者：
Malmusi, Davide
背景资料：迄今为止，最近为描述移民融合政策的特点和比较各国移民健康状况所作的努力很少结合起来。本研究探讨了欧洲国家一级的融合政策与移民健康状况的关系。方法：横断面研究，数据来自2011年欧盟收入和生活条件调查。根据移民融合政策指数，14个国家按照融合政策的类型进行了分组：“多元文化”（最高分：联合王国、意大利、西班牙、荷兰、瑞典、比利时、葡萄牙、挪威、芬兰）、“排斥主义”（最低分：奥地利、丹麦）和“同化主义”（高或低，取决于维度：法国、瑞士、卢森堡）。包括在该国出生的人（当地人，n = 177 300）或在欧盟以外居住超过10年的人（移民，n = 7088）。在每个国家组群中，移民与移民与当地人之间的自我评估健康状况的患病率（PR）通过年龄、教育、职业和社会经济条件进行调整。结果如下：与多元文化国家相比，移民在排外主义国家的健康状况更差（年龄校正的PR，95% CI：男性1.78，1.49-2.12;女性1.58，1.37-1.82;完全校正的，男性1.78，1.50-2.11;妇女1.47、1.26-1.70）和同化主义国家（年龄调整后，男性1.21，1.03-1.41;女性1.21，1.06-1.39;完全调整后，男性1.19，1.02-1.40;女性1.22，1.07-1.40）。移民和本地人之间的健康不平等在实行排斥的国家也是最严重的，即使在调整了社会经济状况的差异之后，这种不平等仍然存在。结论：“排斥”国家的移民经历了更差的社会经济和健康结果。今后的研究应确认融合政策模式是否以及如何对移徙者的健康产生影响。
Background: Recent efforts to characterize integration policy towards immigrants and to compare immigrants' health across countries have rarely been combined so far. This study explores the relationship of country-level integration policy with immigrants' health status in Europe. Methods: Cross-sectional study with data from the 2011 European Union Survey on Income and Living Conditions. Fourteen countries were grouped according to a typology of integration policies based on the Migrant Integration Policy Index: 'multicultural' (highest scores: UK, Italy, Spain, Netherlands, Sweden, Belgium, Portugal, Norway, Finland), 'exclusionist' (lowest scores: Austria, Denmark) and 'assimilationist' (high or low depending on the dimension: France, Switzerland, Luxembourg). People born in the country (natives, n = 177 300) or outside the European Union with > 10 years of residence (immigrants, n = 7088) were included. Prevalence ratios (PR) of fair/poor self-rated health between immigrants in each country cluster, and for immigrants versus natives within each, were computed adjusting by age, education, occupation and socio-economic conditions. Results: Compared with multicultural countries, immigrants report worse health in exclusionist countries (age-adjusted PR, 95% CI: men 1.78, 1.49-2.12; women 1.58, 1.37-1.82; fully adjusted, men 1.78, 1.50-2.11; women 1.47, 1.26-1.70) and assimilationist countries (age-adjusted, men 1.21, 1.03-1.41; women 1.21, 1.06-1.39; fully adjusted, men 1.19, 1.02-1.40; women 1.22, 1.07-1.40). Health inequalities between immigrants and natives were also highest in exclusionist countries, where they persisted even after adjusting for differences in socio-economic situation. Conclusion: Immigrants in 'exclusionist' countries experience poorer socio-economic and health outcomes. Future studies should confirm whether and how integration policy models could make a difference on migrants' health.