European University Institute, Robert Schuman Centre for Advanced Studies, Via Giovanni Boccaccio 121, 50133, Florence, Italy.
University of Geneva, Institute of Demography and Socioeconomics, 24 rue du Général-Dufour, 1211, Geneva, Switzerland.
BMC Public Health. 2022 Apr 22;22(1):804. doi: 10.1186/s12889-022-13188-8.
The health of undocumented immigrants is an important concern in most societies. However, there is no conclusive evidence that inclusive health care policies lead to better outcomes for this group of the population. The aim of this study is to analyse whether there is an association between inclusive health care policies and the mortality patterns of undocumented immigrants, or the distribution of different causes of death among those who have died.
We analyse individual data concerning the deceased in Switzerland between 2011 and 2017. We proceed in two steps. First, we estimate and compare the patterns of mortality of Swiss citizens, documented immigrants, and undocumented immigrants. Second, we test whether there is an association between cantonal authorities' policies and differing mortality patterns. We use logistic regressions and multinomial regressions to estimate the relationship between legal status and mortality patterns both in Switzerland and across different cantons.
We find a difference in the patterns of mortality between undocumented immigrants and the other groups of the population. Specifically, death from circulatory system diseases is twice as frequent among undocumented immigrants compared to documented immigrants and Swiss citizens. However, this difference is smaller in the Swiss cantons that have more inclusive health care policies towards undocumented immigrants.
We interpret these results as an indication that policies that expand access to health services lead to better outcomes for undocumented immigrants. This finding has implications for research on civic stratification and public health. Further analysis is needed to evaluate the effects of extending public health care for undocumented immigrants in different contexts.
在大多数社会中，无证移民的健康是一个重要关注点。然而，并没有确凿的证据表明包容性的医疗保健政策会给这一人群带来更好的结果。本研究旨在分析包容性的医疗保健政策是否与无证移民的死亡率模式相关，或者与已死亡者的死因分布相关。
我们分析了 2011 年至 2017 年期间瑞士死亡者的个人数据。我们分两步进行。首先，我们估计并比较了瑞士公民、有证移民和无证移民的死亡率模式。其次，我们测试了州政府政策与不同死亡率模式之间是否存在关联。我们使用逻辑回归和多项回归来估计合法身份与瑞士和不同州死亡率模式之间的关系。
我们发现无证移民和其他人群的死亡率模式存在差异。具体来说，与有证移民和瑞士公民相比，无证移民死于循环系统疾病的概率是其两倍。然而，在对无证移民更具包容性的医疗保健政策的瑞士州，这种差异较小。
我们将这些结果解释为表明扩大获得医疗服务机会的政策会给无证移民带来更好的结果。这一发现对公民分层和公共卫生研究具有启示意义。需要进一步分析，以评估在不同背景下为无证移民扩大公共医疗保健的效果。
