Health in Europe 5 Migration and health in an increasingly diverse Europe
01 Jan 2013-
TL;DR: In this paper, the authors describe key aspects of migration and health in Europe, including the scale of international migration, available data for migrant health, barriers to accessing health services, ways of improving health service provision to migrants, and migrant health policies that have been adopted across Europe.
Abstract: The share of migrants in European populations is substantial and growing, despite a slowdown in immigration after the global economic crisis. This paper describes key aspects of migration and health in Europe, including the scale of international migration, available data for migrant health, barriers to accessing health services, ways of improving health service provision to migrants, and migrant health policies that have been adopted across Europe. Improvement of migrant health and provision of access for migrants to appropriate health services is not without challenges, but knowledge about what steps need to be taken to achieve these aims is increasing.
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TL;DR: The higher BP in SSA is maintained over decades, suggesting limited efficacy of prevention strategies in such group in Europe, and the lower BP in Muslim populations suggests that yet untapped lifestyle and behavioral habits may reveal advantages towards the development of hypertension.
Abstract: Background:
People of Sub Saharan Africa (SSA) and South Asians(SA) ethnic minorities living in Europe have higher risk of stroke than native Europeans(EU). Study objective is to provide an assessment of gender specific absolute differences in office systolic(SBP) and diastolic(DBP) blood pressure(BP) levels between SSA, SA, and EU.
Methods and Findings:
We performed a systematic review and meta-analysis of observational studies conducted in Europe that examined BP in non-selected adult SSA, SA and EU subjects. Medline, PubMed, Embase, Web of Science, and Scopus were searched from their inception through January 31st 2015, for relevant articles. Outcome measures were mean SBP and DBP differences between minorities and EU, using a random effects model and tested for heterogeneity. Twenty-one studies involving 9,070 SSA, 18,421 SA, and 130,380 EU were included. Compared with EU, SSA had higher values of both SBP (3.38 mmHg, 95% CI 1.28 to 5.48 mmHg; and 6.00 mmHg, 95% CI 2.22 to 9.78 in men and women respectively) and DBP (3.29 mmHg, 95% CI 1.80 to 4.78; 5.35 mmHg, 95% CI 3.04 to 7.66). SA had lower SBP than EU(-4.57 mmHg, 95% CI -6.20 to -2.93; -2.97 mmHg, 95% CI -5.45 to -0.49) but similar DBP values. Meta-analysis by subgroup showed that SA originating from countries where Islam is the main religion had lower SBP and DBP values than EU. In multivariate meta-regression analyses, SBP difference between minorities and EU populations, was influenced by panethnicity and diabetes prevalence.
Conclusions:
1) The higher BP in SSA is maintained over decades, suggesting limited efficacy of prevention strategies in such group in Europe;2) The lower BP in Muslim populations suggests that yet untapped lifestyle and behavioral habits may reveal advantages towards the development of hypertension;3) The additive effect of diabetes, emphasizes the need of new strategies for the control of hypertension in groups at high prevalence of diabetes.
792 citations
TL;DR: Policy options include prevention and health promotion, better self-care, increased coordination of care, improved management of hospital admissions and discharges, improved systems of long-term care, and new work and pension arrangements.
529 citations
University College London1, Oswaldo Cruz Foundation2, International Organization for Migration3, American University of Beirut4, Peking University5, St George's, University of London6, Imperial College London7, University of Giessen8, Cayetano Heredia University9, University of Southampton10, University of Oslo11, Columbia University12, Johns Hopkins University13, Royal Children's Hospital14, University of Melbourne15, Public Health Foundation of India16, University of the Witwatersrand17, University of London18
TL;DR: The most prominent dialogue focuses almost exclusively on migration from LMICs to high-income countries (HICs), where nationalist movements assert so-called cultural sovereignty by delineating an us versus them rhetoric, creating a moral emergency.
449 citations
TL;DR: Prevalence of Chagas in LA migrants living in Europe is high, particularly in migrants from Bolivia and Paraguay, and prevalence estimates should be used to estimate the burden of disease in European countries.
Abstract: Background Few studies have assessed the burden of Chagas disease in non-endemic countries and most of them are based on prevalence estimates from Latin American (LA) countries that likely differ from the prevalence in migrants living in Europe. The aim of this study was to systematically review the existing data informing current understanding of the prevalence of Chagas disease in LA migrants living in European countries. Methods We conducted a systematic review and meta-analysis of studies reporting prevalence of Chagas disease in European countries belonging to the European Union (EU) before 2004 in accordance with the MOOSE guidelines and based on the database sources MEDLINE and Global Health. No restrictions were placed on study date, study design or language of publication. The pooled prevalence was estimated using random effect models based on DerSimonian & Laird method. Results We identified 18 studies conducted in five European countries. The random effect pooled prevalence was 4.2% (95%CI:2.2-6.7%); and the heterogeneity of Chagas disease prevalence among studies was high (I2 = 97%,p<0.001). Migrants from Bolivia had the highest prevalence of Chagas disease (18.1%, 95%CI:13.9–22.7%).
254 citations
References
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TL;DR: The Commission on Social Determinants of Health (CSDH) as mentioned in this paper was created to marshal the evidence on what can be done to promote health equity and to foster a global movement to achieve it.
7,335 citations
TL;DR: Findings of previous studies implicating migration as a risk factor for the development of schizophrenia and a quantitative index of the associated effect size are synthesized to suggest a role for psychosocial adversity in the etiology of schizophrenia.
Abstract: OBJECTIVE: The authors synthesize findings of previous studies implicating migration as a risk factor for the development of schizophrenia and provide a quantitative index of the associated effect size. METHOD: MEDLINE was searched for population-based incidence studies concerning migrants in English-language publications appearing between the years 1977 and 2003. Article bibliographies and an Australian database were cross-referenced. Studies were included if incidence reports provided numerators and denominators and if age correction was performed or could be performed by the authors. Relative risks for migrant groups were extracted or calculated for each study. Significant heterogeneity across studies indicated the need for a mixed-effects meta-analytic model. RESULTS: The mean weighted relative risk for developing schizophrenia among first-generation migrants (40 effect sizes) was 2.7 (95% confidence interval [CI]=2.3–3.2). A separate analysis performed for second-generation migrants (seven effect siz...
1,136 citations
TL;DR: Evidence suggests that optimal communication, patient satisfaction, and outcomes and the fewest interpreter errors occur when LEP patients have access to trained professional interpreters or bilingual providers.
Abstract: Twenty-one million Americans are limited in English proficiency (LEP), but little is known about the effect of medical interpreter services on health care quality. A systematic literature review was conducted on the impact of interpreter services on quality of care. Five database searches yielded 2,640 citations and a final database of 36 articles, after applying exclusion criteria. Multiple studies document that quality of care is compromised when LEP patients need but do not get interpreters. LEP patients’ quality of care is inferior, and more interpreter errors occur with untrained ad hoc interpreters. Inadequate interpreter services can have serious consequences for patients with mental disorders. Trained professional interpreters and bilingual health care providers positively affect LEP patients’ satisfaction, quality of care, and outcomes. Evidence suggests that optimal communication, patient satisfaction, and outcomes and the fewest interpreter errors occur when LEP patients have access to trained professional interpreters or bilingual providers.
1,083 citations
TL;DR: The European review of inequities in health between and within countries across the 53 Member States of the WHO European region was commissioned to support the development of the new health policy framework for Europe: Health 2020.
1,048 citations
10 Aug 2013
TL;DR: The text of the International Covenant on Economic, Social and Cultural Rights as discussed by the authors outlined a sum of principles regarding these rights, which fall within the broad range of legal doctrine on fundamental human rights.
Abstract: The text of the International Covenant on Economic, Social and Cultural Rights - a high-class international document on the assurance and legal protection of the human rights - outlined a sum of principles regarding these rights, which fall within the broad range of legal doctrine on fundamental human rights. These principles are not contrary to the principles set out in the Charter of the United Nations and in the Universal Declaration of Human Rights, on the contrary, it were given an evident expression in its text content. That the authors of this Covenant wanted the assertion of these principle provisions, it is actually confirmed by the text of Article 24.
898 citations