Mortality impact of the Covid-19 epidemic on immigrant populations in Spain

Aldea-Ramos, Néstor

doi:10.1016/j.ssmph.2022.101291

Cited by 7 publications

(6 citation statements)

References 39 publications

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“…The disproportionate burden of the COVID-19 pandemic on foreign-born mortality compared to US-born mortality is not unique to the United States. A similar pattern has been documented in Western Europe in that foreign-born individuals from Asia, sub-Saharan Africa, and the Americas had higher mortality than immigrants from European countries during 2020 (Aldea 2022;Drefahl et al 2020;Indseth et al 2021;Khlat et al 2022;Vanthomme et al 2021). There are several common explanations for the greater burden of the pandemic on foreign-born residents, including less access to health care, occupational exposures, economic hardship, more crowded living arrangements, and concentration in urban areas.…”

Section: Discussionsupporting

confidence: 73%

Immigrant mortality advantage in the United States during the first year of the COVID-19 pandemic

Paglino,

Elo

2024

DemRes

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OBJECTIVESTo investigate the mortality impact of the COVID-19 pandemic on US-born and foreignborn populations by race and Hispanic origin in the United States in 2020. METHODSDeath records from the National Center for Health Statistics and population data from CDC WONDER were used to estimate (1) age-standardized all-cause and cause-specific mortality at ages 25+, 25-64, and 65+ in 2017-2019 and 2020 by nativity, race, Hispanic origin, and sex; (2) changes in mortality between these two periods; and (3) the causespecific contributions to these changes. RESULTSMortality increased in 2020 relative to 2017-2019 for all racial and Hispanic-origin groups. Adjusting for age, mortality increases were larger at ages 25+ among foreignborn males (390 deaths for 100,000 residents) and females (189) than among US-born males (223) and females (144). The large mortality rise among foreign-born Hispanic men (593) contributed to the narrowing of their mortality advantage relative to White men, from 426 to 134. An increase in mortality among both foreign-born and US-born Black males and females increased the Black-White mortality disparities by 318 for males and by 180 for females. Although COVID-19 mortality was the main driver of the increase among foreign-born residents, circulatory diseases and malignant neoplasms also contributed. CONTRIBUTIONWe show that the COVID-19 pandemic had a greater impact on foreign-born populations than on their US-born counterparts. These findings highlight the need to address the underlying inequalities and unique challenges faced by foreign-born populations.

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Section: Discussionsupporting

confidence: 73%

Immigrant mortality advantage in the United States during the first year of the COVID-19 pandemic

Paglino,

Elo

2024

DemRes

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“…In this regard, a study conducted in Spain – a country that, unlike Sweden, implemented strong measures of disease control (e.g. prolonged lockdowns) – highlighted that inequalities in COVID-19 mortality were lower than in Sweden [23]. The extent to which these differences can be attributed to specific public health measures deserves further research.…”

Section: Discussionmentioning

confidence: 99%

COVID-19 mortality among immigrants by duration of residence in Sweden: a population-based cohort study

Juárez,

Debiasi,

Wallace

et al. 2024

Scand J Public Health

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Background: Explanations for the disproportional COVID-19 burden among immigrants relative to host-country natives include differential exposure to the virus and susceptibility due to poor health conditions. Prior to the pandemic, immigrants displayed deteriorating health with duration of residence that may be associated with increased susceptibility over time. The aim of this study was to compare immigrant–native COVID-19 mortality by immigrants’ duration of residence to examine the role of differential susceptibility. Methods: A population-based cohort study was conducted with individuals between 18 and 100 years old registered in Sweden between 1 January 2015 and 15 June 2022. Cox regression models were run to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Results: Inequalities in COVID-19 mortality between immigrants and the Swedish-born population in the working-age group were concentrated among those of non-Western origins and from Finland with more than 15 years in Sweden, while for those of retirement age, these groups showed higher COVID-19 mortality HRs regardless of duration of residence. Both age groups of immigrants from Africa and the Middle East showed consistently higher COVID-19 mortality HRs. For the working-age population: Africa: HR<15: 2.46, 95%CI: 1.78, 3.38; HR≥15: 1.49, 95%CI: 1.01, 2.19; and from the Middle East: HR<15: 1.20, 95%CI: 0.90, 1.60; HR≥15: 1.65, 95%CI: 1.32, 2.05. For the retirement-age population: Africa: HR<15: 3.94, 95%CI: 2.85, 5.44; HR≥15: 1.66, 95%CI: 1.32, 2.09; Middle East: HR<15: 3.27, 95%CI: 2.70, 3.97; HR≥15: 2.12, 95%CI: 1.91, 2.34. Conclusions: Differential exposure, as opposed to differential susceptibility, likely accounted for the higher COVID-19 mortality observed among those origins who were disproportionately affected by the pandemic in Sweden.

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“…An important limitation to explore this subject is that, generally, in EU countries it is not possible to collect data on ethnic background. Although many studies use migrant status as a proxy for ethnicity, we believe they are different determinants (24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)36).…”

Section: Limitationsmentioning

confidence: 99%

Inequalities in health outcomes of SARS-CoV-2 infection by migration status in Barcelona, Spain

Pérez-Muto,

Bertran,

Barón-Miras

et al. 2024

Front. Public Health

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BackgroundMigrants are a vulnerable population at risk of worse health outcomes due to legal status, language barriers, and socioeconomic and cultural factors. Considering the conflicting literature on the subject, it is important to further explore the extent and nature of these inequalities.ObjectiveThe aim of this study is to compare health outcomes associated with SARS-CoV-2 infection between Spanish native and migrant population living in Barcelona.MethodsObservational retrospective cohort study including all adult cases of SARS-CoV-2 infection who visited a tertiary hospital in Barcelona between the 1st March 2020 and the 31st March 2022. We established the following five health outcomes: the presence of symptomatology, hospitalisation, intensive care unit admission, use of mechanical ventilation, and in-hospital 30-day mortality (IHM). Using Spanish natives as a reference, Odds Ratios (OR) with 95% confidence interval (95%CI) were calculated for migrants by multivariate logistic regression and adjusted by sociodemographic and clinical factors.ResultsOf 11,589 patients (46.8% females), 3,914 were born outside of Spain, although 34.8% of them had legal citizenship. Most migrants were born in the Americas Region (20.3%), followed by other countries in Europe (17.2%). Migrants were younger than natives (median 43 [IQR 33–55] years vs. 65 [49–78] years) and had a higher socioeconomic privation index, less comorbidities, and fewer vaccine doses. Adjusted models showed migrants were more likely to report SARS-CoV-2 symptomatology with an adjusted OR of 1.36 (95%CI 1.20–1.54), and more likely to be hospitalised (OR 1.11 [IC95% 1.00–1.23], p < 0.05), but less likely to experience IHM (OR 0.67 [IC95% 0.47–0.93], p < 0.05).ConclusionCharacteristics of migrant and native population differ greatly, which could be translated into different needs and health priorities. Native population had higher odds of IHM, but migrants were more likely to present to care symptomatic and to be hospitalised. This could suggest disparities in healthcare access for migrant population. More research on health disparities beyond SARS-CoV-2 in migrant populations is necessary to identify gaps in healthcare access and health literacy.

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Mortality impact of the Covid-19 epidemic on immigrant populations in Spain

Cited by 7 publications

References 39 publications

Immigrant mortality advantage in the United States during the first year of the COVID-19 pandemic

Immigrant mortality advantage in the United States during the first year of the COVID-19 pandemic

COVID-19 mortality among immigrants by duration of residence in Sweden: a population-based cohort study

Inequalities in health outcomes of SARS-CoV-2 infection by migration status in Barcelona, Spain

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