Istituti Clinici Zucchi, GSD, Monza, Italy.
Laboratory of Clinical Pharmacology and Pharmacoepidemiology, Department of Clinical Sciences and Community Health, University of Milano, Milan, Italy.
Sci Rep. 2023 May 8;13(1):7424. doi: 10.1038/s41598-023-34572-3.
Undocumented migrants represent a large part of the population in Countries of the European Union (EU) such as Italy. Their health burden is not fully understood and likely to be related mainly to chronic conditions. Information on their health needs and conditions may help to target public health interventions but is not found in national public health databases. We conducted a retrospective observational study of non-communicable disease (NCD) burden and management in undocumented migrants receiving medical care from Opera San Francesco, a non-governmental organization (NGO) in Milan, Italy. We analyzed the health records of 53,683 clients over a period of 10 years and collected data on demographics, diagnosis and pharmacological treatments prescribed. 17,292 (32.2%) of clients had one or more NCD diagnosis. The proportion of clients suffering from at least one NCD increased from 2011 to 2020. The risk of having an NCD was lower in men than women (RR = 0.88, 95% CI 0.86-0.89), increased with age (p for trend < 0.001) and changed with ethnicity. African and Asian migrants had a lower risk than Europeans of cardiovascular diseases (RR 0.62 CI 0.58-0.67, RR 0.85 CI 0.78-0.92 respectively) and mental health disorders (RR 0.66 CI 0.61-0.71, RR 0.60 CI 0.54-0.67 respectively), while the risk was higher in Latin American people (RR 1.07 CI 1.01-1.13, RR 1.18 CI 1.11-1.25). There was a higher risk of diabetes in those from Asia and Latin America (RR 1.68 CI 1.44-1.97, RR 1.39 CI 1.21-1.60). Overall, migrants from Latin America had the greatest risk of chronic disease and this was true for diabetes, cardiovascular diseases and mental health disorders. Undocumented migrants demonstrate a significantly different health burden of NCDs, which varies with ethnicity and background. Data from NGOs providing them with medical assistance should be included in structuring public health interventions aimed at the prevention and treatment of NCDs. This could help to better allocate resources and address their health needs.
无证移民在欧盟（EU）国家（如意大利）的人口中占很大比例。他们的健康负担尚未完全了解，可能主要与慢性病有关。有关他们的健康需求和状况的信息可能有助于确定公共卫生干预措施的目标，但在国家公共卫生数据库中找不到这些信息。我们对在意大利米兰非政府组织（NGO）Opera San Francesco 接受医疗服务的无证移民的非传染性疾病（NCD）负担和管理进行了回顾性观察研究。我们分析了 10 年来 53683 名患者的健康记录，并收集了人口统计学、诊断和规定的药物治疗数据。17292 名（32.2%）患者有一个或多个 NCD 诊断。2011 年至 2020 年期间，至少患有一种 NCD 的患者比例有所增加。与女性相比，男性患 NCD 的风险较低（RR=0.88，95%CI 0.86-0.89），且随年龄增长而增加（p<0.001），并随种族而变化。与欧洲人相比，非洲和亚洲移民患心血管疾病（RR 0.62 CI 0.58-0.67，RR 0.85 CI 0.78-0.92）和精神健康障碍（RR 0.66 CI 0.61-0.71，RR 0.60 CI 0.54-0.67）的风险较低，而拉丁美洲人的风险较高（RR 1.07 CI 1.01-1.13，RR 1.18 CI 1.11-1.25）。来自亚洲和拉丁美洲的人患糖尿病的风险更高（RR 1.68 CI 1.44-1.97，RR 1.39 CI 1.21-1.60）。总体而言，来自拉丁美洲的移民患慢性病的风险最高，这对糖尿病、心血管疾病和精神健康障碍都是如此。无证移民的 NCD 负担明显不同，这与种族和背景有关。应将为他们提供医疗援助的非政府组织的数据纳入旨在预防和治疗 NCD 的公共卫生干预措施的结构中。这有助于更好地分配资源并满足他们的健康需求。
