Our findings support the results of previous studies, implying that action recommendations within IPV prevention are still not evidence based. Methodological problems of the papers reviewed should be solved to obtain more useful data. Scientific evidence about the aetiology of IPV should be increased to guide effective prevention programmes.
Between 2006 and 2012, immigrants who arrived in Spain before 2006 appeared to worsen their health status when compared with natives. The loss of the healthy immigrant effect in the context of a worse impact of the economic crisis on immigrants appears as potential explanation. Employment, social protection and re-universalization of healthcare would prevent further deterioration of immigrants' health status.
BackgroundDiscrimination is an important determinant of health inequalities, and immigrants may be more vulnerable to certain types of discrimination than the native-born. This study analyses the relationship between immigrants' perceived discrimination and various self-reported health indicators.MethodsA cross-sectional survey was conducted (2008) amongst a non-random sample of 2434 immigrants from Ecuador, Morocco, Romania and Colombia in four Spanish cities: Barcelona, Huelva, Madrid and Valencia. A factorial analysis of variables revealed three dimensions of perceived discrimination (due to immigrant status, due to physical appearance, and workplace-related). The association of these dimensions with self-rated health, mental health (GHQ-12), change in self-rated health between origin and host country, and other self-reported health outcomes was analysed. Logistic regression was used adjusting for potential confounders (aOR-95%CI). Subjects with worsening self-reported health status potentially attributable to perceived discrimination was estimated (population attributable proportion, PAP %).Results73.3% of men and 69.3% of women immigrants reported discrimination due to immigrant status. Moroccans showed the highest prevalence of perceived discrimination. Immigrants reporting discrimination were at significantly higher risk of reporting health problems than those not reporting discrimination. Workplace-related discrimination was associated with poor mental health (aOR 2.97 95%CI 2.45-3.60), and the worsening of self-rated health (aOR 2.20 95%CI 1.73- 2.80). 40% (95% CI 24-53) PAP of those reporting worse self-rated health could be attributable to discrimination due to immigrant status.ConclusionsDiscrimination may constitute a risk factor for health in immigrant workers in Spain and could explain some health inequalities among immigrant populations in Spanish society.
ObjectivesThe effect of age on intimate partner violence (IPV) against women has received little attention. The objective of this study is to analyze the prevalence, risk factors and health impact of current IPV in different life stages.MethodsWe analyzed a sub-sample of 8,935 ever-partnered women aged 16 years and older from the Spanish Macrosurvey on Gender Violence of 2014. Main outcomes: current physical/ sexual IPV and current psychological-only IPV. The impact of IPV on health was analyzed using the variables self-perceived health, mental health and activity limitations. Risk factors were assessed using the prevalence ratio (PR) from Poisson regression models with robust variance. Analyses were stratified by age (young people, adults, and elderly people).ResultsAbuse in childhood increases the likelihood of IPV in any life stage. A higher education level decreases the probability of physical/sexual IPV across all ages. Unemployment increases the probability of IPV in adult women (physical/sexual-IPV, PR:1.7; psychological-IPV, PR:1.3). Being an immigrant increases the likelihood of physical/sexual IPV in adult women (PRwomen:1.91). Women exposed to current physical/sexual IPV have a greater likelihood of reporting poor self-perceived health (PRyoungpeople:2.59; PRadults:1.68; PRelderly:1.28), poor mental health (PRyoungpeople:3.10; PRadults:2.61; PRedlerly:2.17) and activity limitations (PRyoungpeople:2.44; PRadults:1.98). For psychological IPV only, there is an increase in the probability of poor self-perceived health (PRadults:1.37; PRelderly:1.19), poor mental health (PRyoungpeople:2.24; PRadults:2.16; PRelderly:1.69), and activity limitations (PRadults:1.30; PRelderly:1.18).ConclusionsWe found both common factors and differential factors when looking at IPV by age group. This shows the need to link gender violence prevention with the social circumstances of the population across different life stages.
BackgroundAccess to health services is an important health determinant. New research in health equity is required, especially amongst economic migrants from developing countries. Studies conducted on the use of health services by migrant populations highlight existing gaps in understanding which factors affect access to these services from a qualitative perspective. We aim to describe the views of the migrants regarding barriers and determinants of access to health services in the international literature (1997–2011).MethodsA systematic review was conducted for Qualitative research papers (English/Spanish) published in 13 electronic databases. A selection of articles that accomplished the inclusion criteria and a quality evaluation of the studies were carried out. The findings of the selected studies were synthesised by means of metasynthesis using different analysis categories according to Andersen’s conceptual framework of access and use of health services and by incorporating other emergent categories.ResultsWe located 3,025 titles, 36 studies achieved the inclusion criteria. After quality evaluation, 28 articles were definitively synthesised. 12 studies (46.2%) were carried out in the U.S and 11 studies (42.3%) dealt with primary care services. The participating population varied depending mainly on type of host country. Barriers were described, such as the lack of communication between health services providers and migrants, due to idiomatic difficulties and cultural differences. Other barriers were linked to the economic system, the health service characteristics and the legislation in each country. This situation has consequences for the lack of health control by migrants and their social vulnerability.ConclusionsEconomic migrants faced individual and structural barriers to the health services in host countries, especially those with undocumented situation and those experimented idiomatic difficulties. Strategies to improve the structures of health systems and social policies are needed.
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