Martín Unai, Malmusi Davide, Bacigalupe Amaia, Esnaola Santiago
Departamento de Sociología 2, Universidad del País Vasco (UPV/EHU), Leioa, Bizkaia, España.
Gac Sanit. 2012 Jan-Feb;26(1):9-15. doi: 10.1016/j.gaceta.2011.06.005. Epub 2011 Aug 9.
Catalonia and the Basque Country received substantial immigration quotas from the rest of Spain during the twentieth century. This study aimed to analyze inequalities in health by birthplace (the population born in the same region or other autonomous regions) in these two geographical areas.
We conducted a cross-sectional study in the non-institutionalized population aged 50 to 79 years, with data from the health surveys of Catalonia 2006 (n=5,483) and the Basque Country 2007 (n=3,424). We used log-binomial models to estimate the prevalence ratios (PR) of poor self-rated health by birthplace, stratified by sex and social class, and successively adjusted for age, social class and educational attainment.
Immigrants from other autonomous regions had poorer self-rated health than the native-born population, both in the Basque Country (age-adjusted PR in men 1.30, 95% CI 1.11-1.54; women 1.42, 95% CI 1.25-1.62,) and in Catalonia (PR in men 1.41, 95% CI 1.26-1.62; PR in women 1.25, 95% CI 1.16-1.35). PRs were reduced but remained significant after adjustment for social class and educational attainment and stratification by manual or non-manual social class.
In both communities there are health inequalities that are detrimental to the immigrant population from the rest of Spain, which constitutes approximately half of the population in the studied age cohorts. Future studies should explore the persistence of these inequalities in other health indicators and their reproduction in second generations, and identify entry points for preventive policies.
加泰罗尼亚和巴斯克地区在20世纪从西班牙其他地区接收了大量移民配额。本研究旨在分析这两个地理区域内按出生地（出生在同一地区或其他自治区的人口）划分的健康不平等情况。
我们对50至79岁的非机构化人群进行了一项横断面研究，数据来自2006年加泰罗尼亚健康调查（n = 5483）和2007年巴斯克地区健康调查（n = 3424）。我们使用对数二项式模型来估计按出生地划分的自我健康评价差的患病率比（PR），按性别和社会阶层分层，并依次对年龄、社会阶层和教育程度进行调整。
来自其他自治区的移民自我健康评价比本地出生人口差，在巴斯克地区（男性年龄调整后的PR为1.30，95%CI为1.11 - 1.54；女性为1.42，95%CI为1.25 - 1.62）以及加泰罗尼亚（男性PR为1.41，95%CI为1.26 - 1.62；女性PR为1.25，95%CI为1.16 - 1.35）均是如此。在对社会阶层和教育程度进行调整以及按体力或非体力社会阶层分层后，PR有所降低但仍具有显著性。
在这两个地区都存在健康不平等现象，这对来自西班牙其他地区的移民人口不利，这些移民人口约占所研究年龄组人口的一半。未来的研究应探讨这些不平等在其他健康指标中的持续性及其在第二代中的再现情况，并确定预防政策的切入点。
