Obesity Inequalities According to Place of Birth: The Role of Education

This study examined obesity inequalities according to place of birth and educational attainment in men and in women in Spain. A cross-sectional study was conducted using data from the Spanish National Health Survey 2011–2012 and from the European Health Survey in Spain 2014. We used data for 27,720 adults aged 18–64 years of whom 2431 were immigrants. We used log-binomial regression to quantify the association of place of birth with obesity before and after adjusting for the selected characteristics in women and in men. We found a greater probability of obesity in immigrant women (PR: 1.42; 95% CI: 1.22–1.64) and a lower probability of obesity in immigrant men (PR: 0.73; 95% CI: 0.59–0.89) relative to natives after adjustment. Significant heterogeneity was observed for the association of place of birth and obesity according to education in men (p-interactions = 0.002): Men with lower educational levels (PR: 0.47; 95% CI: 0.26–0.83) have a protective effect against obesity compared with their native counterparts. This study suggests that place of birth may affect obesity in women and in men. However, this effect may be compounded with education differently for women and men

Immigrant Status and Ethnic Inequities in Dental Caries in Children: Bilbao, Spain

This study examined the migratory status/ethnic inequities in dental caries in school children aged 4–9 years (n = 1388) and the impact of the Children’s Oral Health Program in the Municipality of Bilbao in the Basque Country Region, Spain. Using the 2017 Children’s Oral Health Survey, log binomial regression was used to quantify the association of parental immigration status/ethnicity with tooth decay for (1) the primary and the permanent dentitions, separately, in children 4–9 years old; and (2) for the permanent dentition in children aged 7–9 years. Compared with Spanish children, Spanish Roma and immigrant children had a higher probability of tooth decay in primary and permanent teeth after adjustment. Similarly, Spanish Roma and immigrant children had a higher probability of caries experience in primary and permanent teeth. In children aged 7–9 years, Spanish Roma children had a greater probability of tooth decay and caries experience (DMFT index ≥ 1; PR: 6.20; 95% CI: 3.18, 12.12; and PR: 4.52; 95% CI: 2.46, 8.32; respectively) compared with Spanish Children. These associations were not observed in immigrant children. This study shows that parental immigration status and/or ethnicity affect caries outcomes in immigrant and Roma children in both primary and permanent dentition.This work was supported by the Bilbao City Council. Ref. 2015-061533

Perceived discrimination and self-rated health in the immigrant population of the Basque Country, Spain

Objective To examine the effect of perceived discrimination and self-rated health among the immigrant population in the Basque Country, Spain, and determine whether this effect varies according to region of origin, age, sex and education. Methods Descriptive cross-sectional study. The study population included immigrants aged 18 and older residing in the Basque Country. Data from the 2014 Foreign Immigrant Population Survey (n=3,456) were used. Log-binomial regression was used to quantify the association between perceived discrimination and self-rated health before and after checking for the selected characteristics. Results Almost 1 in 10 immigrant adults reports perceiving discrimination. In adjusted analyses, the immigrants perceiving discrimination were almost were 1.92 more likely to rate their health as poor (prevalence ratio: 1.92; 95% CI: 1.44–2.56) than those who did not report discrimination. This association did not vary according to region of origin, age, sex or educational level. Conclusions Perceived discrimination shows a consistent relationship with perceived health. Moreover, this association did not depend on the region of origin, age, sex or educational level of immigrants. These results show the need for implementing inclusive policies to eliminate individual and institutional discrimination and reduce health inequalities between the immigrant and native populations

Obesity Inequalities According to Place of Birth: The Role of Education

This study examined obesity inequalities according to place of birth and educational attainment in men and in women in Spain. A cross-sectional study was conducted using data from the Spanish National Health Survey 2011–2012 and from the European Health Survey in Spain 2014. We used data for 27,720 adults aged 18–64 years of whom 2431 were immigrants. We used log-binomial regression to quantify the association of place of birth with obesity before and after adjusting for the selected characteristics in women and in men. We found a greater probability of obesity in immigrant women (PR: 1.42; 95% CI: 1.22–1.64) and a lower probability of obesity in immigrant men (PR: 0.73; 95% CI: 0.59–0.89) relative to natives after adjustment. Significant heterogeneity was observed for the association of place of birth and obesity according to education in men (p-interactions = 0.002): Men with lower educational levels (PR: 0.47; 95% CI: 0.26–0.83) have a protective effect against obesity compared with their native counterparts. This study suggests that place of birth may affect obesity in women and in men. However, this effect may be compounded with education differently for women and men

Cardiovascular disease risk factors in Spain: A comparison of native and immigrant populations.

Cardiovascular disease (CDV) risk factors are highly prevalent among adults with low social class in Spain. However, little is known on how these factors are distributed in the immigrant population, a socio-economic disadvantaged population. Thus, this study aims to examine inequalities in CVD risk factors among immigrant and native populations. We conducted a cross-sectional study using data from the Spanish National Health Survey 2017 and used log-binomial regression to quantify the association of immigrant status on CVD risk factors among adults aged 25-64 years. The probabilities of having at least three CVD risk factors were higher for immigrants from Eastern Europe (PR: 1.25; 95% CI: 1.15-1.35) and lower for immigrants from Africa (PR: 0.79; 95% CI: 0.69-0.89) when compared with natives. The association of immigrant status and CVD risk factors varies with educational attainment (p-interaction = 0.001). Immigrants from Eastern Europe with low educational attainment have a higher probability of having at least three CVD risk factors compared with their native counterparts. In contrast, immigrants from Africa and Latin America with low educational attainment had a protective effect against having at least three CVD risk relative to natives. Health prevention and promotion strategies to reduce the burden of CVD taking should account for educational attainment given its differential effect among the immigrant population in Spain

Place of Birth Inequalities in Dental Care Use before and after the Economic Crisis in Spain

This study evaluates inequalities in the use of dental services according to place of birth before and after the economic crisis in Spain. A cross-sectional study was performed in adults aged 18 to 65 years in Spain. We used data from three Spanish National Health Surveys for the years 2006 (before the crisis), 2014, and 2017 (after the crisis). Log-binomial regression was used to quantify the association between place of birth and use of dental care services before and after controlling for the selected covariates. In 2006, we found a greater probability of not using dental care services in immigrants from Asia (PR: 1.36, 95% CI: 1.10–1.67) and Africa (PR: 1.16, 95% CI: 1.05–1.28) compared to the natives. For 2014, the probability of not using dental care services was greater for all immigrants relative to natives, with the greatest probability for those from Africa (PR: 1.71, 95% CI: 1.46–2.01) and Asia (PR: 1.3, 95% CI: 1.23–1.47). The associations for 2017 were weaker in magnitude than the ones observed for 2014, although stronger than for 2006. This study suggests that the economic recovery did not have the same impact for natives and immigrants regardless of regions of origin, given the observed inequalities in use of dental services

Variables sociodemográficas y estilos de vida como predictores de la autovaloración de la salud de los inmigrantes en el País Vasco Sociodemographic variables and lifestyle as predictors of self-perceived health in immigrants in the Basque Country (Spain)

Objetivo: Investigar la importancia de los factores sociodemográficos y de los estilos de vida en la autovaloración de la salud en los inmigrantes de origen magrebí, subsahariano, latinoamericano y europeo no comunitario del País Vasco. Métodos: Estudio descriptivo transversal con una muestra formada por 219 magrebíes (31,8%), 152 subsaharianos (22,1%), 167 latinoamericanos (24,2%) y 151 europeos no comunitarios (21,9%). La herramienta para la recopilación de datos fue la Encuesta de Salud de la Comunidad Autónoma del País Vasco (ESCAV'2002). El análisis multivariante se realizó con regresión logística dicotómica (soporte SPSS 13). Resultados: Para la autovaloración de la salud, el 64,2% de los magrebíes, el 78,7% de los subsaharianos, el 66,1% de los latinoamericanos y el 67,1% de los europeos declararon tener una salud muy buena o buena. Las variables asociadas significativamente (p < 0,05 y p < 0,01) a la autovaloración de la salud fueron la procedencia, el sexo y la edad. Ser subsahariano mostró mayor ventaja para una mejor valoración de la salud (odds ratio [OR] = 2,08; intervalo de confianza del 95% (IC95%): 1,29-3,36). La ventaja también se observó para los hombres (OR = 2,16; IC95%: 1,54-3,02) y la edad, especialmente en los de 33-38 años (OR = 3,13; IC95%: 1,71-5,73). En el análisis multivariante, dichas variables mantuvieron su significación. Conclusiones: Los resultados muestran la importancia de considerar el estado de salud percibida en los diferentes colectivos de inmigrantes e identificar las diferencias, así como las variables asociadas, para poder desarrollar actuaciones orientadas a mejorar la salud en estos grupos.<br>Objective: To explore the importance of socio-demographic factors as well as life-style and their influence in self-rated health of Maghribian, Sub-Saharian, Latin-American and non-Communitarian European immigrant groups living in the Basque Country (Spain). Methods: Descriptive cross-study with a convenience sample of 689 persons, consisting of 219 Maghribians (31.8%), 152 Sub-Saharians (22.1%), 167 Latino(a)s (24.2%) and 151 non-Communitarian Europeans (21.9%). Data base have been completed with data collected using the 2002 Regional Basque Health Interview Survey (ESCAV 2002). The multivariate analysis was performed by using the dicotomic logistic regression (software SPSS 13). Results: We found that 64.2% of Maghribian, 78.7% of Sub-Saharian, 66.1% of Latin-American and 67.1% of non-Communitarian European assessed their health as very good or good. The significantly associated variables (p < 0.05 and p < 0.01) with self-rated health were collective membership, sex and age. Persons belonging to the Sub-Saharian collective showed a stronger advantage of positively self-assessed health (OR = 2.08; 95%CI: 1.29-3.36). This advantage was also found among men of all four collectives (OR = 2.16, 95%CI: 1.54-3.02) and in persons in the age of 33-38 years (OR = 3.13, 95%CI: 1.71-5.73). Those variables remained significant in the multivariate analysis. Conclusions: Our results demonstrated the importance of considering differences in the health status and in self-rated health among immigrant groups, as well as the variables associated with those differences, when developing community-based health strategies

Inmigración y salud: desigualdades entre la población autóctona e inmigrante en el País Vasco

Objetivo: Analizar las desigualdades en el estado de salud percibido de la población autóctona e inmigrante residente en la comunidad autónoma del País Vasco y el papel de diferentes determinantes sociales en la explicación de tales desigualdades. Métodos: Estudio descriptivo transversal referido a la población de 18 a 64 años de edad residente en el País Vasco. Se utilizaron datos de la Encuesta de Salud de Euskadi 2007 (n = 4734) y de la Encuesta de Salud de la Población Inmigrante del País Vasco 2009 (n = 765). Se analizaron las desigualdades en la mala salud percibida entre personas autóctonas y cuatro grupos de inmigrantes (China, Latinoamérica, Magreb y Senegal). Para medir la asociación entre la mala salud y el lugar de nacimiento, y poder ajustarla por diferentes variables, se calcularon odds ratio (OR) mediante modelos de regresión logística. Resultados: La población inmigrante en el País Vasco mostró un peor estado de salud percibido que la autóctona, con independencia de la edad. El menor nivel de estudios, la peor situación laboral, el menor apoyo social y la discriminación percibida en la población inmigrante explicaron estas diferencias, en hombres y mujeres. En los hombres de China (OR: 0,18; intervalo de confianza del 95% [IC95%]: 0,04-0,91) y Magreb (OR: 0,26; IC95%: 0,08-0,91), y en las mujeres latinoamericanas (OR: 0,36; IC95%: 0,14-0,92), fue mejor que la de la población autóctona tras ajustar por todas las variables. Conclusiones: Los resultados muestran la necesidad de seguir monitorizando las desigualdades sociales y en salud entre la población autóctona e inmigrante en España, así como de apoyar aquellas políticas sociales que mejoren las condiciones de vida de la población inmigrante