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PubMed2006

[Perception of difficulties in family medicine in the delivery of health to economic immigrants].

OBJECTIVES: To find the problems, as seen by family doctors, in care for immigrants, with description of proposed solutions. DESIGN: Transversal and descriptive. PARTICIPANTS: 262 doctors from 18 health centres in a district. MEASUREMENTS: Each professional received a questionnaire containing social and demographic variables, number of immigrants seen per day, their place of origin, 6 items on accessibility, 5 on barriers to care, 6 on clinic, and 7 on solutions. RESULTS: 159 doctors, 57.2% women, replied. Average age was 41.1; 64% saw 2-3 immigrants a day. 52.3% (95% CI, 45.0%-61.4%) recognised that care for immigrants posed professional problems. They said that immigrants attended as an emergency more often (81.1%); they more often had no clinical records (74.7%); and they had difficulties obtaining a health card (53%). 67% expressed no difficulties for getting to the hospital. Perceived barriers were the mobility of immigrants (82.9%), language (82.3%), and culture (71.3%). Solutions suggested were translators (95.6%) or cultural intermediary (82.7%). Clinically, doctors saw no differences of pathology in immigrants (56.7%), and no greater psychiatric pathology (66%). Lack of skill in contagious pathologies hampered care (60.3%). 82.8% affirmed that specific protocols were needed. 80.3% argued for a unit of imported diseases. Among care priorities were information on health circuits and making the health card easier to obtain. CONCLUSIONS: The difficulties sustained by a broad range of professionals are diverse, with access and linguistic-cultural questions standing out. To palliate them, sensitivity from health staff and action from management are needed.

Adult↗

PubMed1997

Stages of acculturation as reflected by depression reduction in immigrant nursing students.

Depression amongst immigrant students from the former Soviet Union was assessed as an index of the stage of their acculturation into the new host society, Israel. At the beginning of the first year of nursing school, three groups completed the Beck Depression Inventory. The two groups of immigrants: immigrant nurses preparing for licensing (N = 26) and immigrant students (N = 16), reported mild levels of depression, while Israeli students (N = 33) were significantly less depressed, within the normal range. Six months later, both immigrant groups were within the normal range, the immigrant nurses group showing the greatest decrease in depression. This change may be explained by adaptation to the educational setting, mastering the host society's language and social anchorage. The importance of background variables for predicting depression reduction is examined. The findings are discussed within the framework of multistage models of acculturation and the implications for counseling immigrant students are presented.

Acculturation↗

PubMed1994

Changing occupational characteristics of U.S. immigrants.

"The purpose of this research is to: (1) describe changes in the occupational characteristics of immigrants to the United States between 1972 and 1986; (2) analyze immigration statistics to see how policy admission categories, source country, and individual demographic factors help determine the entry patterns of professional and technical immigrant workers in 1972 and 1986; and (3) evaluate the immigrant stream recomposition argument that the changing levels of professional and technical occupational immigration [are] due to shifts in class and visa categories, region of origin, and demographic characteristics of workers admitted to the United States. In the conclusions we discuss how changes in immigration policies during this period may have contributed to the statistical patterns on occupational skills of immigrants."

Americas↗

PubMed1996

Family stress and support among former Soviet immigrants.

The purpose of this qualitative descriptive study was to investigate types of family support and stress among former Soviet immigrants. Forty-two immigrants (14 males and 28 females) were interviewed about their immigration experiences, including description of current relationships with family in the resettlement country. Content analysis of interview data documented that immigrant families can be a valuable source of emotional and/or instrumental support. Immigrant families, however, can also be too overwhelmed by their own immigration demands to provide support or can generate additional stress for its members. Types of family stress included conflict from differing values and opinions, increased responsibility for family members who could not manage resettlement on their own, family members' emotional distress over immigration experiences, unmet expectations for family members' adjustment, and changes in household composition and living arrangements upon arrival in the United States.

Adult↗

PubMedDate not supplied

Culture care of Iranian immigrants in New South Wales, Australia: sharing transcultural nursing knowledge.

Discovery and analysis of care meanings, expressions, and practices of Iranian Immigrants in New South Wales, Australia was the focus of this ethnonursing qualitative research. The purpose of the study was to systematically discover, describe and analyse the values, beliefs, and practices of Iranian immigrants in New South Wales, Australia. The aim of the investigation was to discover transcultural nursing knowledge to guide nurses and health professionals to provide culturally congruent nursing and health care to Iranians. Leininger's theory of Culture Care Diversity and Universality (Leininger, 1991) was used as the conceptual framework for the study. It was predicted that care meanings and expressions of Iranian immigrants would be influenced by their worldview, social structure features, language, and cultural values rooted in their long ethnohistorical past and reflected in their lifeways in Australia. Using the ethnonursing qualitative research method, key and general informants were purposefully selected among Iranian immigrants residing in New South Wales. Three care themes supported by a number of universal and some diverse patterns were identified for Iranian immigrants. The three themes were: (1) Care meant family and kinship ties (hambastegie) as expressed in daily lifeways and interactions with family, friends, and community; (2) Care as expressed in carrying out traditional urban gender roles (role-zan-o-mard) (Azadie zan) as well as in fulfilling emerging new role responsibilities related to equality for female Iranian immigrants; and (3) Care as preservation of Iranian identity (inhamoni, hamonandi) as expressed in traditional cultural events and health care practices. Leininger's (1991) three modes of actions and decisions were used to develop appropriate and culturally meaningful nursing care actions and decisions which were in harmony with the cultural beliefs of Iranian immigrants.

Adult↗

PubMed1978

Pregnancy and delivery among immigrants.

Risk factors during pregnancy and delivery of immigrant women are analysed. Individual birth delivery records of 1 235 immigrant women and of 412 Swedish women are studied. Most of the immigrants--65%--were Scandinavians, while 10% had come from Southern Europe and 4% were non-Europeans. The immigrant groups differed somewhat amongst themselves, and also vis-à-vis the Swedes in some social and demographic respects. Participation in antenatal care was not lower among the immigrants than in the control group, but the former did not attend antenatal exercises to the same extent. The perinatal mortality and prematurity rates were 1.5% and 5%--about the same as among the Swedish women. The rate of premature delivery was found to be related to the duration of residence in Sweden. Women who had lived less than one year in this country more often delivered prematurely than did the more settled immigrant women. Further studies on the emotional reactions of immigrant women during pregnancy and delivery are proposed.

Adaptation, Psychological↗

PubMed1976

Attempted suicide among Asian immigrants in Birmingham.

This retrospective study describes the epidemiology of attempted suicide among Asian (Bangladesh, India and Pakistan) immigrants in Birmingham during the period 1969-1972. The hypothesis of no difference in the distribution of attempted suicide among native and immigrant groups was not upheld. The immigrant group was under-represented among all the admissions to Birmingham's hospitals. It is estimated that the crude adjusted rates for attempted suicide among the male and female Asian immigrants aged 15-64 years are 57 and 126 per 100,000 population per annum respectively. These are lower than the rates found among natives in Britain, but the female immigrant rate is higher than that found in India. Asian patients who attempt suicide in India and Birmingham are younger than 45 years of age, rarely abuse drugs and alcohol, and make repeated attempts infrequently. In Birmingham, however, immigrants and native patients swallow similar, mostly psychotropic, tablets and not insecticides as in India. It is noteworthy that an interpersonal dispute precedes attempted suicide more frequently among immigrant patients than among native ones in either area.

Adolescent↗

PubMed2002

Impact of immigration on health and human services: Florida's experience.

Florida has been the destination for large numbers of immigrants fleeing political persecution or economic hardships. Cubans and Haitians have been two of the largest immigrant groups arriving and settling in Florida. Both have received national and local attention. This article describes the immigration experience of Haitians and Cubans in Florida. The descriptions emphasize the differences between these two groups in their adjustment to life in south Florida. The article also addresses Florida's reaction to federal policies regarding immigration and highlights Florida's struggle to meet the service needs of these immigrant populations. Fiscal impacts of immigration are quantified in several service categories, including education, social services, health care, and criminal justice. Florida's action based on the documentation of the immigration fiscal impact is explained. Finally, how the state allocated the $18 million in federal funding provided as a response to Florida's documented impact is covered.

Criminal Law↗

PubMed2006

Caregiving stressors and psychological distress among veteran resident and immigrant family caregivers in Israel.

The study compared caregiving stressors and psychological distress between Israeli veteran resident and immigrant family caregivers. It examined whether psychosocial variables (appraisal of caregiving, mastery, social support and coping) mediate the differences in psychological distress between these two groups. A total of 213 veteran resident and 206 immigrant (from the former Soviet Union) caregivers of chronically ill elderly were recruited from health services. The comparisons between the two groups were examined separately for spouse and adult child caregivers. The immigrant spouse and adult child caregivers reported significantly higher levels of caregiving stressors than veteran resident caregivers, but psychological distress was significantly higher only among the immigrant adult child caregivers. In multivariate analyses, the difference in psychological distress disappeared when caregiving stressors and mediating psychosocial variables were included in the regression models. Different caregiving stressors and psychosocial variables were associated with psychological distress among the spouses and among the adult child caregivers. The findings suggest that the caregiving stressors and psychosocial variables explain differences in psychological health outcomes between veteran resident and immigrant caregivers. Social work interventions should address these factors among caregivers, take into account the relationship to the care recipient, be culturally adapted to the immigrant caregivers, and target immigrant adult child caregivers in particular.

Activities of Daily Living↗

PubMed2002

Ethnic-immigrant differentials in health behaviors, morbidity, and cause-specific mortality in the United States: an analysis of two national data bases.

This study examines the extent to which various ethnic-immigrant and US-born groups differ in their risks of all-cause and cause-specific mortality, morbidity, and health behaviors. Using data from the National Longitudinal Mortality Study, 1979-1989, we estimated, for major US racial and ethnic groups, mortality risks of immigrants relative to those of the US-born. The Cox regression model was used to adjust mortality differentials by age, sex, marital status, rural/urban residence, education, and family income. Logistic regression was fitted to the National Health Interview Survey data to determine whether health status and behaviors vary among ethnic-immigrant groups and by length of US residence. Compared with US-born whites of equivalent socioeconomic and demographic background, foreign-born blacks, Hispanics, and Asians/Pacific Islanders (APIs), US-born APIs, US-born Hispanics, and foreign-born whites had, respectively, 48%, 45%, 43%, 32%, 26%, and 16% lower mortality risks. While American Indians did not differ significantly from US-born whites, US-born blacks had an 8% higher mortality risk. Black and Hispanic immigrants experienced, respectively, 52% and 26% lower mortality risks than their US-born counterparts. Considerable differentials were also found in mortality for cancer, cardiovascular, respiratory, infectious disease, and injury, and in morbidity and health behaviors, with API and Hispanic immigrants generally experiencing the lowest risks. Consistent with the acculturation hypothesis, immigrants' risks of smoking, obesity, hypertension, and chronic condition, although substantially lower than those for the US-born, increased with increasing length of US residence. Given the substantial nativity differences in health status and mortality, future waves of immigrants of diverse ethnic and cultural backgrounds will likely have a sizeable impact on the overall health, disease, and mortality patterns in the United States.

Adult↗

PubMedDate not supplied

Adolescent Chinese immigrants in Hong Kong: a comparison with locally born students and factors associated with their psychological well-being.

The present research aims to compare the psychological well-being of young Mainland Chinese immigrants and locally born students in Hong Kong and to identify factors that are associated with the psychological well-being of young immigrants. Participants, aged from 12 to 17 years, included 1,109 youngsters born in Hong Kong and 342 new immigrants from Mainland China. Factors examined in this research included individual demographic and socio-economic factors like age, gender, length of residence in the host society and the financial situation of immigrants' immediate family, as well as personal factors including immigrants' self-concept, perceived discrimination, and educational aspiration. Findings indicated that the psychological well-being of young Mainland Chinese immigrants was on the whole better than that of the locally born students. Findings also revealed that demographic factors did not have significant correlation with the psychological functioning of young immigrants, while personal factors generally correlated significantly with their psychological well-being.

Adaptation, Psychological↗

PubMedDate not supplied

[Prevalence of tuberculosis infection among immigrants in the Toledo Health District, Spain].

BACKGROUND: The rise in the frequency of tuberculosis is due to several factors: resistance to treatment, human immunodeficiency virus infection, unemployment, poverty and migratory movements. This study is aimed at ascertaining the prevalence of tuberculosis infection among the immigrant population in the Toledo Health District. METHODS: Descriptive, cross-sectional, multi-center study conducted at the Primary Care level. The immigrants were attracted and recruited on the based of their health cards within the December 2002-September 2003 period. Mantoux intradermal reaction test was performed with 0.1 ml (2UT) of PPD RT-23, following informed consent. Other variables were collected: age, sex, weight, country of origin, work situation, BCG vaccination, number of individuals living with them, length of time residing in Europe. RESULTS: A total of 344 immigrants were included in the study, averaging 28.8 +/- 12.7 years of age. Fifty percent were females (172). They had been living in Europe for an average of 3.4 +/- 3.7 years. A total 78.8% (271) of the immigrants completed the study. The intradermal reaction was positive in 75 of them [27.7% (CI 95%: 23-32.5)]. Those immigrants showing a positive Mantoux were older (age 32.5 +/- 8.5 years) than those showing a negative result (age 27.7 +/- 13.8 years), p=0.006. Originally being from the sub-Saharan area increased the probability of showing a positive intradermal reaction. CONCLUSIONS: The immigrant population of the Toledo Health District shows a high prevalence of tuberculosis infection, which is higher than the general Spanish population. Differences exist depending upon the country of origin. These results indicate the importance of considering the Mantoux test among the preventive activities addressed toward this immigrant population.

Adolescent↗

PubMed2004

Undoing an epidemiological paradox: the tobacco industry's targeting of US Immigrants.

OBJECTIVES: We sought to ascertain whether the tobacco industry has conceptualized the US immigrant population as a separate market. METHODS: We conducted a content analysis of major tobacco industry documents. RESULTS: The tobacco industry has engaged in 3 distinct marketing strategies aimed at US immigrants: geographically based marketing directed toward immigrant communities, segmentation based on immigrants' assimilation status, and coordinated marketing focusing on US immigrant groups and their countries of origin. CONCLUSIONS: Public health researchers should investigate further the tobacco industry's characterization of the assimilated and non-assimilated immigrant markets, and its specific strategies for targeting these groups, in order to develop informed national and international tobacco control countermarketing strategies designed to protect immigrant populations and their countries of origin.

Acculturation↗

PubMed2007

Susceptibility to measles, mumps, and rubella in newly arrived adult immigrants and refugees.

BACKGROUND: Despite effective vaccination programs for measles, mumps, and rubella in the United States and Canada, outbreaks continue to occur in susceptible subgroups, such as foreign-born persons. OBJECTIVE: To determine the susceptibility of newly arrived immigrants and refugees to measles, mumps, and rubella. DESIGN: Seroprevalence study. SETTING: Two hospitals and three community clinics in Montreal, Quebec, Canada. PATIENTS: 1480 adult immigrants and refugees who were recruited from October 2002 to December 2004. MEASUREMENTS: Sociodemographic and clinical data and serology for measles, mumps, and rubella. RESULTS: Thirty-six percent (range, 22% to 54%) of the study population was nonimmune to at least 1 of the 3 diseases. This proportion varied by age, sex, and region of origin. In multivariate analysis and after adjustment for region of origin, age, and socioeconomic factors, immigrant women had higher odds (odds ratio, 2.1) of being immune to measles (95% CI, 1.2 to 3.8) and an odds ratio of 1.7 of being nonimmune to rubella (CI, 1.2 to 2.6) compared with immigrant men. LIMITATIONS: The results from the community-based convenience sample of immigrants may not be generalizable to all immigrant populations. CONCLUSIONS: Many new immigrants and refugees, particularly women, are susceptible to measles, mumps, or rubella and may benefit from targeted vaccination programs.

Adolescent↗

PubMed1993

Health based exclusion grounds in United States immigration policy: homosexuals, HIV infection and the medical examination of aliens.

The 1990 Immigration Act formally removed homosexuality from its longstanding position on the list of health-based exclusion grounds in United States immigration policy. Since the early 1900s when health-based exclusion grounds were introduced, a long history of excluding homosexuals has persisted. While the 1990 Congress clearly intended to remove the homosexual exclusion, public support for this controversial new policy is tenuous. As the HIV/AIDS pandemic spreads out of control, prejudice against homosexuals runs deeper than ever in American society. Human Immunodeficiency Virus (HIV) is a recent addition to the list of dangerous contagious diseases for which aliens may be excluded from the United States. Compelling social and economic grounds support its inclusion. The nexus between HIV and homosexuality, however, raises questions as to the immigration status of homosexuals and other persons seeking entry into the United States who, although not infected, are at a high risk of contracting HIV> Although the exclusion of HIV-infected aliens may be a reasonable means of combating the spread of HIV within the United States, it must not be used as a rationale to exclude individuals who may be at risk of contracting HIV. The medical examination of aliens must be tailored to meet the 1990 Immigration Act's objective of preventing the exclusion of homosexuals. Section I of this Note examines the factors influencing United States immigration policy as it relates to homosexuals. Section II provides background information on United States immigration policy, including the origins of the power to exclude aliens from entry into the United States and the allocation of this power within the federal government. Section II also focuses on the procedures by which aliens are excluded for health-related reasons. Section III explores both the historic exclusion of homosexuals from entry into the United States and the repudiation of this discriminatory policy in the 1990 Immigration Act. After the rational bases for this policy are discussed, this Note concludes that the policy is rational in light of the overburdened United States public health system. Section IV criticizes, as unreasonably subjective, recent revisions to the medical examination procedure that grant examining physicians broad discretion to designate an alien excludable upon a finding of a "physical abnormality."

Civil Rights↗

PubMed2000

The impact of new immigrants from the former Soviet Union on the severity of coronary angiographic findings in a public hospital in Israel.

BACKGROUND: The arrival of 610,000 new immigrants to Israel from the former Soviet republics accounted for 58% of the population growth in the early 1990's. OBJECTIVE: To compare the coronary angiographic findings and risk factors between the new immigrants and local Jewish and Arab patients in this era of cost containment. METHODS AND RESULTS: A total of 550 consecutive patients--314 Jews, 95 new immigrants and 141 Arabs--were catheterized and analyzed during a 5 month period in 1995. Of this group 403 were males (73%). The mean age was 63.6 +/- 10.2 years among new immigrants, 62.4 +/- 9.4 among Jews, and 55.1 +/- 10.9 among Arabs (P < 0.05). Immigrants, including those under age 60, had the highest prevalence of multivessel disease (88.7%). Arabs had a high prevalence of single vessel disease (34.6%) and a low prevalence of multivessel (65.4%) and left main coronary disease (5.6%). Age, gender, risk factors and ethnic origin in descending order were determinants of the extent of coronary angiographic disease as revealed by multiple regression analysis. CONCLUSION: New immigrants had the most extensive angiographic coronary involvement, while Arab patients were younger and had less severe coronary artery disease. More intensive risk factor modification may have a major impact on disease progression particularly in the new immigrant subgroup.

Aged↗

PubMed2000

An ethical analysis of the mandatory exclusion of immigrants who test HIV-positive.

On 20 September 2000, Canadian newspapers reported that Health Canada recommended to Citizenship and Immigration Canada (CIC) that testing all prospective immigrants for HIV, and excluding those testing positive, constitutes "the lowest health risk course of action." Subsequently, the Minister of Citizenship and Immigration stated that CIC is indeed considering implementing mandatory HIV testing for all prospective immigrants to Canada, and excluding all those testing positive (with the exception of refugees and family-class sponsored immigrants) from immigrating to Canada on both public health and "excessive cost" grounds. This proposal was met with vehement opposition from a broad range of organizations and individuals. In particular, they pointed out that, as stated in the International Guidelines on HIV/AIDS and Human Rights (UNHCHR/UNAIDS, 1998: para 105), "[t]here is no public health rationale for restricting liberty of movement or choice of residence on the ground of HIV status." At the time of going to print, no final decision had been made about whether mandatory HIV testing for all immigrants would be implemented. There are sound ethical, legal, and public policy arguments against imposing mandatory testing and excluding those who test HIV-positive.

AIDS Serodiagnosis↗

PubMed1989

Sponsors, sponsorship rates and the immigration multiplier.

"This article reviews the evidence pertaining to the extent to which U.S. immigrants actually make use of the family reunification entitlements of United States immigration laws, examining the two available studies which are based on probability samples of immigrant entry cohorts. It then provides new estimates of the characteristics of the U.S. citizen sponsors of immigrant spouses and parents.... With respect to the characteristics of sponsors, analysis of the information in the GAO [General Accounting Office] report indicates that 80 percent of the persons who immigrated in FY 1985 as the spouses of U.S. citizens were sponsored by native born U.S. citizens. In contrast, native born U.S. citizens sponsored only five percent of the parent immigrants. Additional findings on the country of origin and sex of the sponsored immigrants are presented."

Americas↗