POLÍTICAS DE INTEGRACIÓN Y SALUD
DE INMIGRANTES EN EUROPA: TRES
ESTUDIOS COMPARATIVOS
Davide Malmusi, Umar Ikram, Laia Pal...
Antecedentes
El efecto en salud de las políticas
de control de fronteras es hoy en
día más que evidente (>5,000
muertos en...
Objetivo general
Analizar la asociación entre los modelos de políticas de integración
del país y las desigualdades en salu...
¿Cómo clasificamos los modelos
de políticas de integración?
A pesar de existir clasificaciones sistemáticas de las polític...
MIPEX 2007 Latent Class Analysis. Bart Meuleman 2009 (Dissertation)
Inclusive
(multicultural)
Exclusionist
Political integ...
Inclusive (Multicultural)
Exclusionist
Political integration (Assimilationist)
MIPEX 2007 Latent Class Analysis. Bart Meul...
European Union Statistics on Income and Living Conditions 2011
cross-sectional database. 14 countries
Health outcomes: Sel...
Countries included by integration regime
Inclusive (Multicultural)
Exclusionist
Political integration (Assimilationist)
Im...
Poor self-rated health. Immigrants versus natives
Prevalence ratio with 95%CI (Poisson regression with robust standard err...
Study 2. Mortality
MEHO project mortality database. 3 countries:
Netherlands (inclusive) 1996-2006 open cohort
France (ass...
Results
Immigrants’ mortality by integration policy model
Immigrants had higher mortality rates than the local-born popula...
Social, economic and political determinants of inequalities by
immigrant status in depressive symptoms in Europe
Davide Ma...
Countries included
Political integration (Assimilationist)
Exclusionist
Inclusive (Multicultural)
Immigrants’ mental healt...
Immigrants
experience more
depressive
symptoms no
matter the regime.
The gap is mainly
explained by
income(adequacy)
but t...
Immigrants
experience more
depressive
symptoms no
matter the regime.
The gap is mainly
explained by
income(adequacy)
but t...
Limitations
Heterogeneity of results between countries in the same cluster
Mixing together all non-EU (or poor countries) ...
Conclusions
A pesar de los problemas de comparabilidad de
algunos datos, es sorprendentemente consistente la
asociación en...
sophie-project.eu
slideshare.net/sophieproject
@dmalmusi
@sophieproject
dmalmusi@aspb.cat
Thank you!
Gràcies!
Grazie!
Phot...
of 18

Políticas de integración y salud de inmigrantes en Europa: tres estudios comparativos

Presentada en el II Congreso Iberoamericano de Epidemiología y Salud Pública, 3 de septiembre de 2015
Published on: Mar 4, 2016
Published in: News & Politics      
Source: www.slideshare.net


Transcripts - Políticas de integración y salud de inmigrantes en Europa: tres estudios comparativos

  • 1. POLÍTICAS DE INTEGRACIÓN Y SALUD DE INMIGRANTES EN EUROPA: TRES ESTUDIOS COMPARATIVOS Davide Malmusi, Umar Ikram, Laia Palència, Anton Kunst, Carme Borrell Congreso Ibero-Americano de Epidemiología y Salud Pública 2015 Mesa Subprograma Inmigración y Salud CIBERESP Los autores declaran que no existen conflictos de interés.
  • 2. Antecedentes El efecto en salud de las políticas de control de fronteras es hoy en día más que evidente (>5,000 muertos en el mundo en 20141, >25,000 en camino hacia Europa desde el año 20002) Las políticas de integración/exclusión de las personas inmigradas que ya se encuentran en el país de destino pueden tener efectos sobre la salud al influir sobre las condiciones materiales de vida y el contexto psicosocial. Existen muy pocos estudios al respecto.3 1 IOM. The Missing Migrants Project. 2 The Migrants Files. 3 Omar Martinez et al. Evaluating the impact of immigration policies… J Immigr Minor Health 2013
  • 3. Objetivo general Analizar la asociación entre los modelos de políticas de integración del país y las desigualdades en salud entre población autóctona e inmigrante en Europa. Subestudios 1. Autovaloración de la salud 2. Mortalidad 3. Síntomas depresivos 4. Discriminación y su asociación con salud (Borrell et al. IJERPH 2015)
  • 4. ¿Cómo clasificamos los modelos de políticas de integración? A pesar de existir clasificaciones sistemáticas de las políticas actuales, preferimos un análisis tipológico / de modelos por considerar que el efecto sobre la salud actual de la población inmigrada se ha acumulado a lo largo del tiempo. En literatura se han descrito tradicionalmente tres modelos en Europa: multicultural, asimilacionista, exclusionista.1,2 Sin embargo muy pocos países se han clasificado de manera consistente en uno de estos modelos,1-3 por lo que finalmente utilizamos una aproximación cuantitativa basada en un análisis de clases latentes del Migrant Integration Policy Index 2007. 1 Stephen Castles. How Nation-States respond to immigration… New Community 1995 2 Steven Weldon. The institutional context of tolerance for ethnic… Am J Pol Sci 2006 3 Hans Mahnig et al. Country-specific or convergent? A typology… J Int Migr Integr 2000
  • 5. MIPEX 2007 Latent Class Analysis. Bart Meuleman 2009 (Dissertation) Inclusive (multicultural) Exclusionist Political integration (assimilationist) ¿Cómo clasificamos los modelos de políticas de integración?
  • 6. Inclusive (Multicultural) Exclusionist Political integration (Assimilationist) MIPEX 2007 Latent Class Analysis. Bart Meuleman 2009 (Dissertation) ¿Cómo clasificamos los modelos de políticas de integración?
  • 7. European Union Statistics on Income and Living Conditions 2011 cross-sectional database. 14 countries Health outcomes: Self-rated health (very good, good / fair, bad, very bad), Limiting longstanding illness, Activity limitation because of health problems Immigrant status: born in country of residence (N=177,300) / born outside the EU with 10+ years of residence (N=7,088) Study 1. Self-rated health
  • 8. Countries included by integration regime Inclusive (Multicultural) Exclusionist Political integration (Assimilationist) Immigrants’ self-rated health by integration policy model Excluded countries: No data in the 2013 release of 2011 data: EL, IE. Not classified in the typology: BG, CY, HR, RO. <0.5% immigrants: HU, CZ, SK, PL, LT. Not separating EU and non- EU immigrants: DE, EE, LV, SI, MT.
  • 9. Poor self-rated health. Immigrants versus natives Prevalence ratio with 95%CI (Poisson regression with robust standard error) UK IT ES NL BE PT SE NO FI FR CH LU AT DK UK IT ES NL BE PT SE NO FI FR CH LU AT DK Results Immigrants’ self-rated health by integration policy model Self-rated health inequality between natives and immigrants is larger in exclusionist countries (partly but not fully explained by socioeconomic differences)
  • 10. Study 2. Mortality MEHO project mortality database. 3 countries: Netherlands (inclusive) 1996-2006 open cohort France (assimilation) 2005-07 mortality register / census data Denmark (exclusionist) 1992-2001 open cohort Health outcome: Age-standardised mortality rate Immigrant status: born in country of residence (229 millions person-years) / born in Turkey (3 millions p-y) / born in Morocco (4 millions p-y) aged 20-69 years
  • 11. Results Immigrants’ mortality by integration policy model Immigrants had higher mortality rates than the local-born population in Denmark and lower in France. Age-adjusted Mortality Rate Ratio. Immigrants versus natives Poisson regression coefficient with 95%CI
  • 12. Social, economic and political determinants of inequalities by immigrant status in depressive symptoms in Europe Davide Malmusi, Laia Palència, Umar Ikram, Anton Kunst, Carme Borrell Manuscript in preparation European Social Survey 2012. 17 countries Health outcome: Depressive symptoms (CES-D scale, 8 items each ranging 0 to 3), self-rated health Immigrant status: born in country of residence excluding “second generations” (N=28,333) / born abroad excluding IMF advanced economies (N=2,019) Study 3. Depressive symptoms
  • 13. Countries included Political integration (Assimilationist) Exclusionist Inclusive (Multicultural) Immigrants’ mental health by integration policy model Excluded countries: No ESS 2012 data Not classified in the typology <1% immigrants
  • 14. Immigrants experience more depressive symptoms no matter the regime. The gap is mainly explained by income(adequacy) but the degree of explanation varies by policy regime and gender. Results Immigrants’ mental health by integration policy model Depressive symptoms. Immigrants versus natives Linear regression beta coefficient with 95%CI
  • 15. Immigrants experience more depressive symptoms no matter the regime. The gap is mainly explained by income(adequacy) but the degree of explanation varies by policy regime and gender. Results Immigrants’ mental health by integration policy model Depressive symptoms. Immigrants versus natives Linear regression beta coefficient with 95%CI
  • 16. Limitations Heterogeneity of results between countries in the same cluster Mixing together all non-EU (or poor countries) migrants of different origins and reasons for migration Different data collection methods in the mortality study Adequate cross-country samples of migrants with similar background “Natural experiments” around policy changes Qualitative studies to uncover HOW policies get under the skin Future studies…?
  • 17. Conclusions A pesar de los problemas de comparabilidad de algunos datos, es sorprendentemente consistente la asociación entre los modelos de políticas de integración y las desigualdades en salud relacionadas con el origen en Europa, siendo estas mayores en los países “excluyentes”. Políticas inclusivas hacia la población inmigrante pueden repercutir positivamente en su salud, mientras que giros más restrictivos pueden suponer un riesgo para la misma.
  • 18. sophie-project.eu slideshare.net/sophieproject @dmalmusi @sophieproject dmalmusi@aspb.cat Thank you! Gràcies! Grazie! Photos: Roberto Brancolini, Roberto Malaguti

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