BACKGROUNDGender and migrant status are important factors for health. A common finding is that women report poorer health than men and that migrants' health converges with nonmigrants' health as the duration of stay in the host country increases. However, little is known about whether gender differences in health persist within migrant groups and whether the migrant-native health convergence differs by gender, especially in the Italian context. OBJECTIVEThis study aims to include the gender dimension in the analysis of the health differences between Italians and migrants by duration of stay, focusing on how gender interacts with duration of stay in determining migrants' health. METHODSWe performed multivariate logistic regression on a sample of 70,154 residents in Italy aged 20-64, using the 2013 Italian Health Survey. We modelled the association between duration of stay and three health dimensions by gender and computed predicted probabilities to show the interaction effect of gender and duration of stay. RESULTSWe found evidence of a migrant health advantage among recent migrant men and women that becomes weaker among long-term migrants. After a long duration of stay, differences in health between migrants and nonmigrants are slightly more pronounced among women than among men. CONTRIBUTIONThis is the first study in Italy that contributes to a more comprehensive understanding of the role played by gender in determining the health differences observed. The study
There is increasing interest among researchers in the effects of social capital on the health of older adults. One of the key policy question for an ageing population concerns how do we identify the factors that influence health. Very recently, an increasing interest on social capital as a key determinant for health has developed and, surprisingly, not much is known for the European population. This paper analyzes the association between social capital and self-perceived health among older adults in Europe using a mixed effects logistic model. Social capital is considered in its two components-bonding and bridging-in order to understand if the relations inside or outside an individual inner circle have a different association with health. Our results give empirical support to the role of individual social capital in preventing a poor self-perceived health. This means that social capital, especially the bridging component of it, can be one of the key factors of ageing in good health and should be fostered by policy makers in order to give an answer to one of the most compelling challenge of our century: population ageing.
Background The Emergency Department (ED) can be considered an indicator of accessibility and quality and can be influenced in period of economic downturns. In the last fifteen years, the number of migrants in Italy has doubled (from 2.4 million in 2005 to 5.2 in 2019, 4.1 and 8.7% of the total population, respectively). However, evidence about migrants’ healthcare use is poor, and no studies focused on the ED utilisation rate during the Great Recession are available. This study aims to analyse trends in all-cause and cause-specific ED utilisation among migrants and Italians residing in Rome, Italy, before and after 2008. Methods Longitudinal study based on data from the Municipal Register of Rome linked to the Emergency Department Register from 2005 to 2015. We analysed 2,184,467 individuals, aged 25–64 in each year. We applied a Hurdle model to estimate the propensity to use the ED and to model how often individuals accessed the ED. Results Migrants were less likely to be ED users than Italians, except for Africans (RR = 1.46, 95%CI 1.40–1.52) and Latin Americans (RR = 1.04, 95%CI 1.00–1.08) who had higher all-cause utilisation rates than non-migrants. Compared to the pre-2008 period, in the post-2008 we found an increase in the likelihood of being an ED user (OR = 1.34, 95%CI 1.34–1.35), and a decrease in ED utilisation rates (RR = 0.96, 95%CI 0.96–0.97) for the whole population, with differences among migrant subgroups, regardless of cause. Conclusions This study shows differences in the ED utilisation between migrants and Italians, and within the migrant population, during the Great Recession. The findings may reflect differentials in the health status, and barriers to access primary and secondary care among migrants. In this regard, health policies and cuts in health spending measures may have played a key role, and interventions to tackle health and access disparities should include policy measures addressing the underlying factors, adopting a Health in All Policies perspective. Further researches focusing on specific groups of migrants, and on the causes and diagnoses related to the ED utilisation, may help to explain the differences observed.
Besides health and socio-economic status, the social relationships maintained during elderly play an important role in shaping the living conditions at older ages. In this part of life, the family represents the major framework in which interpersonal relationships are experienced. With population ageing, the family increasingly ensures elderly care, especially where targeted public policies are lacking, and its protective effect on survival is foreseen. In this paper we investigate the complex role of family in mortality and contribute to the debate on the ideal living condition for elderly people, exploiting a nationwide integrated survey on private and collective households in France. Following a cohort of 16,263 individuals aged 55, we investigate the effect of family relations on survival. We question whether the lack of family care connected with the absence of active relationships with family members may be at least partly compensated by institutional settings. Estimates of life expectancy show that at the age of 60, people living in institutions live on average 10 years less that those living in private households, the gap decreasing with age. Cox proportional hazards models show a protective role of children on mortality. Having no children seems to be associated with a lower risk of death, but the effect is significant only for those declaring rare or no contacts with their children. Survival analysis also suggests that institutional living arrangement may be protective for the most fragile individuals, namely the severely disabled, isolated persons.
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