Health of undocumented migrants in primary care in Switzerland

Abstract

BackgroundUndocumented migrants endure adverse living conditions while facing barriers to access healthcare. Evidence is lacking regarding their healthcare needs, notably in regards to chronic diseases. Our goal was to investigate health conditions in undocumented migrants attended in primary care setting.MethodsThis study was conducted at the primary care outpatient clinic, Geneva University Hospitals, Switzerland. We retrospectively recorded and coded all medical conditions of a random sample of 731 undocumented migrants using the International Classification of Primary Care, 2nd version (ICPC-2). We dichotomized conditions as chronic or non-chronic and considered multimorbidity in the presence of three or more chronic conditions.ResultsParticipants originated from 72 countries and were mainly female (65.5%) with a mean age of 42.4 (standard deviation [SD]: 11.4) years. They presented a mean of 2.9 (SD: 2.1; range: 1–17) health conditions. In multivariable analysis, the number of conditions was associated with female gender (p = 0.011) and older age (p <0.001), but not with origin (p = 0.373). The body systems most frequently affected were endocrine, metabolic and nutritional (n = 386; 18.4%), musculoskeletal (n = 308, 14.7%) and digestive (n = 266, 12.8%). Hypertension (17.9%; 95% CI: 15.2%, 29.9%), obesity or overweight (16%; 95% CI: 13.4%, 18.9%) and gastric problems (14.1%; 95% CI: 11.6%, 16.8%) were most prevalent. Overall, 71.8% (95% CI: 68.5%, 75%) participants had at least one chronic condition while 20% (95% CI: 17.2%, 23.1%) had three or more. In multivariable analysis, age (p <0.001) was the only predictor of presenting at least one or three or more chronic conditions.ConclusionsUndocumented migrants present multiple health problems in primary care settings and bear an important burden of chronic diseases. The extent of multimorbidity highlights the need to provide and facilitate the access to comprehensive and long-term primary healthcare services.

Multimorbidity and chronic diseases among undocumented migrants: evidence to contradict the myths

“…To the best of our knowledge, only one study has previously assessed the prevalence of multimorbidity in UMs. This study of UMs treated in primary care in Switzerland [29] reported a prevalence of multimorbidity of 23% in women and 14% in men, as compared with corresponding values of 12% and 8% in the present study. One possible explanation for these contrasting findings is that our analysis included all individuals with a health card, regardless of whether they availed of public health care.…”

Self-rated health among undocumented and newly regularized migrants in Geneva: a cross-sectional study

“…Previous studies showed that undocumented migrants tend to present frequent health problems in the context of adverse living and working conditions [ 3 – 6 ]. Specifically, undocumented migrants were shown to be at high risk of occupational hazards and chronic physical illnesses [ 7 – 9 ]. Due to precarious legal and economic conditions, many are forced to perform degrading, physically demanding and low-paid jobs in under-regulated sectors of the labour economy [ 7 , 10 – 12 ].…”

Migrant and refugee populations: a public health and policy perspective on a continuing global crisis

“…Increasingly, polymorbidity, often arising at a premature life stage, becomes a challenge among forced migrants in Europe [ 48 ]. The impact of community-acquired infections leading to admission to intensive care units seems much higher in refugees in host countries than in the autochthonous population [ 49 , 50 ].…”