Agència de Salut Pública de Barcelona, Barcelona, Spain.
Soc Sci Med. 2010 Nov;71(9):1610-9. doi: 10.1016/j.socscimed.2010.07.043. Epub 2010 Sep 6.
In this paper, we briefly review theories and findings on migration and health from the health equity perspective, and then analyse migration-related health inequalities taking into account gender, social class and migration characteristics in the adult population aged 25-64 living in Catalonia, Spain. On the basis of the characterisation of migration types derived from the review, we distinguished between immigrants from other regions of Spain and those from other countries, and within each group, those from richer or poorer areas; foreign immigrants from low-income countries were also distinguished according to duration of residence. Further stratification by sex and social class was applied. Groups were compared in relation to self-assessed health in two cross-sectional population-based surveys, and in relation to indicators of socio-economic conditions (individual income, an index of material and financial assets, and an index of employment precariousness) in one survey. Social class and gender inequalities were evident in both health and socio-economic conditions, and within both the native and immigrant subgroups. Migration-related health inequalities affected both internal and international immigrants, but were mainly limited to those from poor areas, were generally consistent with their socio-economic deprivation, and apparently more pronounced in manual social classes and especially for women. Foreign immigrants from poor countries had the poorest socio-economic situation but relatively better health (especially men with shorter length of residence). Our findings on immigrants from Spain highlight the transitory nature of the 'healthy immigrant effect', and that action on inequality in socio-economic determinants affecting migrant groups should not be deferred.
本文从健康公平的角度简要回顾了迁移与健康的理论和研究发现，然后分析了居住在西班牙加泰罗尼亚 25-64 岁成年人中与迁移有关的健康不平等现象，考虑了性别、社会阶层和迁移特征。基于对迁移类型的描述，我们将移民分为来自西班牙其他地区的移民和来自其他国家的移民，并在每个群体中，根据其所在地区的贫富程度进一步细分；我们还根据居住时间对来自低收入国家的外国移民进行了区分。此外，还按性别和社会阶层进行了分层。在两项基于人群的横断面调查中，我们根据自我评估的健康状况对不同群体进行了比较，并在一项调查中根据社会经济条件的指标（个人收入、物质和金融资产指数以及就业不稳定指数）对不同群体进行了比较。在健康和社会经济条件方面，以及在本地和移民亚组中，都存在社会阶层和性别不平等现象。与迁移有关的健康不平等现象影响到国内和国际移民，但主要局限于来自贫困地区的移民，而且这些不平等现象与他们的社会经济贫困状况基本一致，在体力劳动社会阶层中更为明显，尤其是对女性而言。来自贫困国家的外国移民社会经济状况最差，但健康状况相对较好（尤其是居住时间较短的男性）。我们对来自西班牙的移民的研究结果突出了“健康移民效应”的过渡性，并且不应推迟针对影响移民群体的社会经济决定因素不平等的行动。
