A new wave of Spanish emigration to France and the United Kingdom: who are the emigrants and why are they moving?

The number of Spanish nationals emigrating towards the United Kingdom, France, and Germany has risen to consistently high levels. Two main profiles emerge: naturalized immigrants who were particularly hard-hit by the 2008 economic crisis and who emigrate to find work in another European country, and young, often highly qualified, native-born Spaniards for whom freedom of movement in Europe provides opportunities for career advancement

La première vague de Covid-19 a été plus meurtrière pour les populations nées à l’étranger

Habituellement, la mortalité (toutes causes confondues) des populations immigrées est plus basse que celle de la population du pays d’accueil. Une étude a montré qu’en France, la première vague de la pandémie avait conduit à un retournement de cette situation, du fait d’un excès de mortalité beaucoup plus important pour les immigrés d’Afrique subsaharienne, du Maghreb, d’Asie et d’Océanie. Ces résultats invitent à porter une attention particulière aux conditions de vie et d’accès aux soins de ces populations

Évolution des remboursements de dépenses de santé pour les patients atteints de pathologies cardiovasculaires aiguës pendant la pandémie de COVID-19 en France : une étude dans le Système National des Données de Santé

Introduction En 2020, pour faire face à la pandémie de COVID-19, une réorganisation majeure du système de santé a été mise en place, entraînant la déprogrammation des soins non essentiels. En dépit de leur caractère urgent, une baisse des hospitalisations pour évènements cardiovasculaires aigus (ECA) (infarctus du myocarde, accident vasculaire cérébral, embolie pulmonaire et insuffisance cardiaque) a été constatée. Nous avons étudié l’évolution des consommations de soins des patients ECA en période pandémique et les coûts associés. Méthodes Cette étude nationale observationnelle française dans le Système National des Données de Santé a identifié 3 481 127 patients-années ECA sur la période 2015–2022 en utilisant la Cartographie des pathologies et des dépenses de l'Assurance Maladie (version G11). Les dépenses totales attendues entre 2020 et 2022 en l'absence de pandémie ont été estimées avec un modèle de Poisson, en prenant comme référence la tendance des années 2015−2019. La différence entre les dépenses observées et attendues en période pandémique constituait l'indicateur de perturbation de l’évolution des dépenses. Résultats L'augmentation estimée des remboursements de l'ensemble des dépenses de santé des patients ECA s'élevait à 45,9 M€ [18,2–73,5 M€] (+0,5%) ([intervalle de confiance à 95%] (pourcentage d'augmentation observé relatif à l'attendu)) pour l'année 2020, 454,6 M€ [424,1–485,3 M€] (+4,6%) pour 2021, et 507,2 M€ [475,6–539,5 M€] (+5,1%) pour 2022. L'augmentation cumulée de 2020 à 2022 était de 1007,7 M€ [955,9–1059,0 M€] (+3,6%) pour les 1 298 896 patients-années ECA concernés. Une hospitalisation pour COVID-19 concernait 53 099 (4,1%) d'entre eux, et l'augmentation de l'ensemble de leurs dépenses de soins cumulée entre 2020 et 2022 s’élevait à 728,9 M€ [726,2–731,7 M€]. Discussion/Conclusion Pendant la pandémie, les remboursements des dépenses de santé des patients ECA ont augmenté de 3,6%, 72,3% de ce surcoût étant porté par ceux hospitalisés pour COVID-19 alors qu'ils représentaient 4,1% de l'effectif. Des analyses détaillées par poste de dépense permettront d'explorer les modifications des parcours de soins en période pandémique

Patterns of perinatal exposure to PUFAs and child neurodevelopment: evidence from Mendelian randomization using FADS cluster variants

Background: The potential causal effects of perinatal exposure to polyunsaturated fatty acids (PUFAs) on child neurodevelopment remains controversial. Objective: To infer causation, we assessed the association of perinatal PUFA patterns and child neurodevelopment by using conventional regression analyses and 1-sample Mendelian randomization (MR). Methods: Among 1096 mother–child pairs from the French Etude des Déterminants Pré- et Postnatals du Développement de la Santé de L’enfant cohort, patterns of perinatal exposure to PUFAs were previously identified combining PUFA levels from maternal and cord erythrocytes, and colostrum. Child verbal, performance, and full-scale intelligence quotients (IQs) were assessed at ages 5–6 y. Among maternal fatty acid desaturase (FADS) variants genotyped, 2 candidates, rs174546 (FADS1) and rs174634 (FADS3), were selected, as instrumental variables, for the MR analysis. The association of PUFA patterns with child IQ was examined by conventional multivariable linear regression and 2-stage least-squares MR regression. Results: In the conventional approach, the first pattern “high omega-3 long-chain PUFAs (LC-PUFAs), low omega-6 LC-PUFAs” was positively associated with verbal IQ [β (95% confidence interval) = 1.24 (0.27, 2.21) points per 1 standard deviation (SD) increase in pattern] and full-scale IQ [1.11 (0.18, 2.05)]. This pattern was independent of FADS variants, rendering MR analysis inapplicable. The third pattern, “colostrum LC-PUFAs,” was positively associated with verbal [1.11 (0.19, 2.02)], performance [1.01 (0.09, 1.93)], and full-scale IQ [1.13 (0.25, 2.01)]. The MR approach, based on genetic instruments strongly associated with the third pattern, supported the beneficial effect on performance IQ [2.93 (0.05, 5.81) points per 1 SD increase in genetically predicted pattern]. The MR also suggested a deleterious effect of the fourth pattern “linoleic acid (LA) and dihomo-gamma-linolenic acid (DGLA)” on performance IQ [–1.66 (–3.22, –0.09)]. Conclusions: These findings supported the potential beneficial effects of perinatal exposure to LC-PUFAs on child neurodevelopment while highlighting possible adverse effects associated with exposure to LA and DGLA

Social patterns of miscarriage reporting and risk: insights from survey data in France

Miscarriages, which are spontaneous pregnancy losses before 20–28 weeks of gestation, affect approximately 15% of recognized pregnancies. Existing population-based evidence of social inequalities in miscarriage risk is inconsistent, partly due to a lack of data. Surveys can be representative of a national population but are subject to underreporting of miscarriages. We examine whether miscarriages are underreported in a French nationally representative survey, FECOND (2010–11), and analyse socioeconomic risk factors for miscarriage. First, we apply a model that estimates miscarriage underreporting. Second, we use multilevel multinomial logistic regressions to examine socio-demographic and epidemiological factors associated with miscarriage. We estimate that 92% of miscarriages were reported, and underreporting was slightly more pronounced among lower-educated women. The estimated prevalence of miscarriages (14% of all pregnancies) is unaffected by underreporting rates and only with small educational differences. Thus, investigating social disparities in miscarriage risk can be done without correcting for reporting bias. Advanced reproductive ages are associated with higher miscarriage risk. Unobserved time-consistent individual characteristics explain the association between miscarriage risk and prior reproductive history. Conversely, education and self-assessed financial conditions are not associated with miscarriage risk. Younger cohorts exhibit a higher miscarriage risk, suggesting an age effect on recall, a cohort effect on pregnancy recognition, or reduced stigma resulting in more reliable reporting of miscarriage. In sum, the miscarriage reporting rate in FECOND survey is relatively high and with only slight social disparities. No large socioeconomic differences were found in miscarriage risk

Spatial Trends in Mortality Convergence: The Cases of France, Italy, and Spain, 1975–2019

Spatial differences in mortality are a significant source of inequality in low-mortality countries and are important for public health, regional planning, and subnational population forecasts. Long-term trends in geographic mortality inequalities remain poorly understood, especially from a comparative perspective. In this study, we examine trends in subnational mortality differences in France, Italy, and Spain from 1975 to 2019. We study whether life expectancy has converged or diverged between geographic areas, assess how the geographic mortality gradient has changed, and document age-specific differences. We find convergence in life expectancy in all three countries, although the path of convergence varies between countries and sexes. We find concerning evidence of diverging mortality at younger ages in all three countries. Our results show that even in similar national contexts, very different subnational trajectories in mortality inequalities can occur

Bringing back gender and agency into the study of state-organised emigration from the French Caribbean

Article figurant dans un numéro spécial de la revue Modern and Contemporary France consacré à l'histoire du BUMIDOM et des migrations dans le cadre de la politique d'émigration des Antilles et de La Réunion. Numéro coordonné par Antonia Wimbush et Malika Danican