海地的杜瓦利埃政权与美国的移民健康

Duvalier Regime in Haiti and Immigrant Health in the United States.

机构信息

Saint Louis University, Department of Health Management and Policy, US.

Saint Louis University, Department of Health Management and Polcy, US.

出版信息

Ann Glob Health. 2018 Nov 5;84(4):603-611. doi: 10.9204/aogh.2366.

DOI:10.9204/aogh.2366

PMID:30779507

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6748271/

Abstract

BACKGROUND

Haitians immigrate to the United States for many reasons, including the opportunity to escape political violence. The extant literature on Haitian immigrant health focuses on post-migration, rather than pre-migration, environments and experiences. Objective: In this study, we analyze health outcomes data from a nationally representative sample of Haitian immigrants in the United States from 1996 to 2015. We estimate age-adjusted associations between pre-migration residence in Haiti during the repressive regimes and generalized terror of Francois and Jean-Claude Duvalier, who ran Haiti from 1957 to 1986.

METHODS

We used ordered probit regression models to quantify age-adjusted associations between the duration of pre-migration residence in Haiti during the Duvalier regime, and the distribution of post-migration health status among Haitian immigrants in the United States. Findings: Our study sample included 2,438 males and 2,800 females ages 15 and above. The mean age of males was 43.5 (standard deviation, 15.5) and the mean age of females was 44.7 (standard deviation, 16.6). Each additional decade of pre-migration residence in Haiti during the Duvalier regime is associated with a 2.9 percentage point decrease (95% confidence interval 0.6 to 5.3) in excellent post-migration health for males, and a 2.8 percentage point decrease (95% confidence interval, 0.8 to 4.8) for females. Within the subsample of Haitian immigrants with any pre-migration residence in Haiti during the Duvalier regime, each additional decade since the regime is associated with a 3.3 percentage point increase (95% confidence interval, 1.2 to 5.5) in excellent post-migration health for males, and a 2.3 percentage point increase (95% confidence interval, 0.5 to 4.1) for females.

CONCLUSIONS

Overall, we found statistically significant and negative associations between the Duvalier regime and the post-migration distribution of health status 10 to 57 years later. We found statistically significant and positive associations between the length of time since the Duvalier regime and post-migration health.

摘要

背景

海地人移民到美国的原因有很多，包括有机会逃避政治暴力。关于海地移民健康的现有文献主要关注移民后的环境和经历，而不是移民前的环境和经历。目的：本研究分析了 1996 年至 2015 年期间美国海地移民的全国代表性样本中的健康结果数据。我们估计了在弗朗索瓦和让-克洛德·杜瓦利埃统治下的海地的移民前居住时间与对弗朗索瓦和让-克洛德·杜瓦利埃的普遍恐惧之间的年龄调整关联，弗朗索瓦和让-克洛德·杜瓦利埃从 1957 年至 1986 年统治海地。

方法

我们使用有序概率回归模型来量化在杜瓦利埃政权期间移民前在海地居住时间的长短与在美国的海地移民的移民后健康状况分布之间的年龄调整关联。

发现

我们的研究样本包括 2438 名男性和 2800 名 15 岁及以上的女性。男性的平均年龄为 43.5（标准差为 15.5），女性的平均年龄为 44.7（标准差为 16.6）。在杜瓦利埃政权期间，每增加 10 年移民前在海地的居住时间，男性的优秀移民后健康状况就会下降 2.9 个百分点（95%置信区间为 0.6 至 5.3），女性的优秀移民后健康状况就会下降 2.8 个百分点（95%置信区间为 0.8 至 4.8）。在有任何在杜瓦利埃政权期间在海地移民前居住的海地移民亚样本中，自政权以来的每增加 10 年，男性的优秀移民后健康状况就会增加 3.3 个百分点（95%置信区间为 1.2 至 5.5），女性的优秀移民后健康状况就会增加 2.3 个百分点（95%置信区间为 0.5 至 4.1）。