International Journal for Equity in Health
Volume 16, Issue 1, 2017

The variation in the health status of immigrants and Italians during the global crisis and the role of socioeconomic factors (Article) (Open Access)

Petrelli A.* , Di Napoli A. , Rossi A. , Costanzo G. , Mirisola C. , Gargiulo L.
  • a National Institute for Health, Migration and Poverty (INMP), Via San Gallicano, 25 a, Rome, 00153, Italy
  • b National Institute for Health, Migration and Poverty (INMP), Via San Gallicano, 25 a, Rome, 00153, Italy
  • c National Institute for Health, Migration and Poverty (INMP), Via San Gallicano, 25 a, Rome, 00153, Italy
  • d National Institute for Health, Migration and Poverty (INMP), Via San Gallicano, 25 a, Rome, 00153, Italy
  • e National Institute for Health, Migration and Poverty (INMP), Via San Gallicano, 25 a, Rome, 00153, Italy
  • f National Institute of Statistics (ISTAT), Viale Liegi, 13, Rome, 00198, Italy

Abstract

Background: The effects of the recent global economic and financial crisis especially affected the most vulnerable social groups. Objective of the study was to investigate variation of self-perceived health status in Italians and immigrants during the economic global crisis, focusing on demographic and socioeconomic factors. Methods: Through a cross-sectional design we analyzed the national sample of multipurpose surveys "Health conditions and use of health services" (2005 and 2013) conducted by the Italian National Institute of Statistics (ISTAT). Physical Component Summary (PCS) and Mental Component Summary (MCS) scores, derived from SF-12 questionnaire, were assumed as study outcome, dichotomizing variables distribution at 1st quartile. Prevalence rate ratios (PRR) were estimated through log-binomial regression models, stratified by citizenship and gender, evaluating the association between PCS and MCS with surveys' year, adjusting for age, educational level, employment status, self-perceived economic resources, smoking habits, body mass index. Results: From 2005 to 2013 the proportion of people not employed or reporting scarce/insufficient economic resources increased, especially among men, in particular immigrants. Compared with 2005 we observed in 2013 among Italians a significant lower probability of worse PCS (PRR = 0.96 both for males and females), while no differences were observed among immigrants; a higher probability of worse MCS was observed, particularly among men (Italians: PRR = 1.26;95%CI:1.22-1.29; immigrants: PRR = 1.19;95%CI:1.03-1.38). Self-perceived scarce/insufficient economic resources were strongly and significantly associated with worse PCS and MCS for all subgroups. Lower educational level was strongly associated with worse PCS in Italians and slightly associated with worse MCS for all subgroups. Being not employed was associated with worse health status, especially mental health among men. Conclusions: Our findings support the hypothesis that economic global crisis could have negatively affected health status, particularly mental health, of Italians and immigrants. Furthermore, results suggest socioeconomic inequalities increase, in economic resources availability dimension. In a context of public health resources' limitation due to financial crisis, policy decision makers and health service managers must face the challenge of equity in health. © 2017 The Author(s).

Author Keywords

health inequalities immigrants Italy Economic global crisis Survey socioeconomic

Index Keywords

unemployment educational status immigrant health disparity Health Status Disparities Economic Recession mental health human middle aged statistics and numerical data controlled study priority journal probability health status socioeconomic status Cross-Sectional Studies Young Adult cross-sectional study migrant Humans Adolescent male Emigrants and Immigrants Italian (citizen) female Socioeconomic Factors socioeconomics prevalence Article employment status adult gender age global health equity Italy decision making body mass Short Form 12 smoking habit immigrant population

Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85020466536&doi=10.1186%2fs12939-017-0596-9&partnerID=40&md5=bbb53b3e76e3cbbebfa847078bd79037

DOI: 10.1186/s12939-017-0596-9
ISSN: 14759276
Cited by: 4
Original Language: English