Migrant health in Italy: a better health status difficult to maintain—country of origin and assimilation effects studied from the Italian risk factor surveillance data

Abstract

BackgroundMany studies on migrant health have focused on aspects of morbidity and mortality, but very few approach the relevant issues of migrants’ health considering behavioral risk factors. Previous studies have often been limited methodologically because of sample size or lack of information on migrant country of origin. Information about risk factors is fundamental to direct any intervention, particularly with regard to non-communicable diseases that are leading causes of death and disease. Thus, the main focus of our analysis is the influence of country of origin and the assimilation process.MethodUtilizing a surveillance system that has been collecting over 30,000 interviews a year in Italy since 2008, we have studied migrants’ attitudes and behaviors by country of origin and by length of stay. Given 6 years of observation, we have obtained and analyzed 228,201 interviews of which over 9000 were migrants.ResultsWhile migrants overall present similar conditions to native-born Italians, major differences appear when country of origin or length of stay is considered. Subgroups of migrants present substantially different behaviors, some much better than native-born Italians, some worse. However, integration processes generally produce a convergence towards the behavioral prevalence observed for native-born Italians.ConclusionsHealth programs should consider the diversity of the growing migrant population: data and analyses are needed to support appropriate policies. Many migrants’ subgroups arrive with healthier behaviors than those of their adopted country. However, they are likely to have a less favorable social position in their destination countries that could lead to a change towards less healthy behaviors. Interventions capable of identifying this tendency could produce significant better health for this important part of the future (multicultural) populations.

Gendering health differences between nonmigrants and migrants by duration of stay in Italy

“…Regarding long-term migrants, their health status does not differ from that of Italians for SRH and functional limitations. Even though the analysis is cross-sectional and individuals were not followed over time, this pattern may be interpreted in light of the extensive literature on the loss of the migrant health advantage (e.g., Khlat and Darmon 2003;Newbold 2005;Antecol and Bedard 2006;Berchet and Jusot 2012;Campostrini et al 2019;Ichou and Wallace 2019;Loi and Hale 2019;Wallace, Khlat, and Guillot 2019).…”

“…Subsequent studies confirm that migrants generally show better health than natives, with some changes over time (Caselli, Loi, and Strozza 2017;Petrelli et al 2017;Loi et al 2018;Campostrini et al 2019;Loi and Hale 2019). They also exhibit lower mortality rates (Fedeli et al 2015;Pacelli et al 2016) and are less likely to report functional limitations and chronic illnesses (Caselli, Loi, and Strozza 2017).…”

“…Recently, Loi and Hale (2019) have examined how material deprivation interacts with duration of stay to affect migrants' health convergence, suggesting that the health of immigrants living in conditions of material deprivation is more similar to the natives' health at shorter durations of stay than that of their nondeprived counterparts. Another study of the association between migrants' health by country of origin and duration of stay in Italy is that of Campostrini et al (2019), who conclude that many migrant subgroups arrive with healthier behaviours than those of their adopted country. However, because they are likely to have a less favourable social position in the destination country, their situation might change towards less healthy behaviours.…”

Disparities in emergency department use between Italians and migrants residing in Rome, Italy: the Rome Dynamic Longitudinal Study from 2005 to 2015

“…This result is in line with other international studies [ 43 – 46 ]. Following the international literature, and being cautious in the interpretation of data, this finding might be due to a better migrants’ health status and migrants’ healthier lifestyles, known in literature as the healthy migrant effect [ 21 ], which have also been proven in the Italian context [ 50 , 51 , 68 , 69 ]. Nevertheless, looking at the frequency of use among those who accessed the ED, the analysis displays that migrants registered a different utilisation rate, which varies according to the origin area.…”

Sex and Gender Influences on Cancer Immunotherapy Response

“…Social dynamics, health behaviors, cultural and educational aspects, work and work environment are only some variables of this complex matter, all interrelated. Social behavioral models have shown considerable power in explaining mortality and morbidity differences on the basis of gender [ 133 , 134 , 135 ]. Cancer patients are a specific subgroup of people that encounter severe emotional, existential and physical problems.…”