Domnich Alexander, Amicizia Daniela, Panatto Donatella, Signori Alessio, Perelli Valentina, Adamoli Sergio, Riboli Edoardo Berti, Gasparini Roberto
Department of Health Sciences, University of Genoa, via Pastore, 1-16132, Genoa, Italy.
BMC Public Health. 2013 Oct 25;13:1006. doi: 10.1186/1471-2458-13-1006.
Despite the steady growth of the immigrant population in Italy, data on the health status of immigrants are scarce. Our main goals were to measure Health-Related Quality of Life (HRQoL), Self-Rated Health (SRH) and morbidity among immigrants in Genoa. We aimed to assess the relative contribution of some social, structural and behavioral determinants to "within-group" health disparities.
We enrolled 502 subjects by means of snowball sampling. The SF-12 questionnaire, integrated with socio-demographic and health-related items, was used. Multivariate logistic and Poisson regression models were applied in order to identify characteristics associated with poor SRH, lower SF-12 scores and prevalence of self-reported morbidities.
Subjects showed relatively moderate levels of HRQoL (median physical and mental scores of 51.6 and 47.3, respectively) and about 15% of them rated their health as fair or poor. Lower scores in the physical dimension of HRQoL were associated with the presence of morbidities and immigration for work and religious reasons, while those who had migrated for religious and family reasons displayed a lower probability of lower scores in the mental dimension of HRQoL. Poor SRH was associated with female gender, overweight/obesity and presence of morbidities. Moreover, compared with immigrants from countries with a low human development index, immigrants from highly developed societies showed significantly lower odds of reporting poor SRH. About one-third of respondents reported at least one medical condition, while the prevalence of multi-morbidity was 10%. Females, over 45-year-olds, overweight and long-term immigrants had a higher prevalence of medical conditions.
Our study confirms the presence of health inequalities within a heterogeneous immigrant population. HRQoL, SRH and morbidity are valid, relatively rapid and cheap tools for measuring health inequalities, though they do so in different ways. These indicators should be used with caution and, if possible, simultaneously, as they could help to identify and to monitor more vulnerable subjects among immigrants.
尽管意大利移民人口稳步增长，但有关移民健康状况的数据却很匮乏。我们的主要目标是衡量热那亚移民的健康相关生活质量（HRQoL）、自评健康状况（SRH）和发病率。我们旨在评估一些社会、结构和行为决定因素对“群体内”健康差异的相对贡献。
我们通过滚雪球抽样招募了502名受试者。使用了与社会人口统计学和健康相关项目相结合的SF - 12问卷。应用多变量逻辑回归和泊松回归模型，以确定与自评健康状况差、SF - 12得分较低以及自我报告发病率相关的特征。
受试者的健康相关生活质量水平相对中等（身体和心理得分中位数分别为51.6和47.3），约15%的人将自己的健康状况评为一般或较差。健康相关生活质量身体维度得分较低与发病情况以及因工作和宗教原因移民有关，而因宗教和家庭原因移民的人在健康相关生活质量心理维度得分较低的可能性较小。自评健康状况差与女性、超重/肥胖和发病情况有关。此外，与来自人类发展指数较低国家的移民相比，来自高度发达社会的移民自评健康状况差的几率显著较低。约三分之一的受访者报告至少有一种疾病，而多重疾病的患病率为10%。女性、45岁以上人群、超重者和长期移民的疾病患病率较高。
我们的研究证实了异质移民群体中存在健康不平等现象。健康相关生活质量、自评健康状况和发病率是衡量健康不平等的有效、相对快速且廉价的工具，尽管它们的衡量方式不同。这些指标应谨慎使用，如有可能应同时使用，因为它们有助于识别和监测移民中更易受影响的人群。
