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PubMed2002

Migration and mortality: a 20 year follow up of Finnish twin pairs with migrant co-twins in Sweden.

STUDY OBJECTIVE: Finland has a higher mortality overall and for major causes of death than Sweden, primarily in men. The objective of this study was to analyse mortality in migrants from Finland to Sweden. DESIGN: A longitudinal study based on the Finnish Twin Cohort Study. Information about migration from Finland to Sweden, duration of stay in Sweden for the migrants, and deaths 1976-1995 was obtained from national registers. Observed numbers of deaths in migrants were compared with expected numbers based on the age standardised mortality experience of the Finnish Twin Cohort. First deaths in migrants and non-migrants of migrant discordant pairs were compared controlling for genetic and early childhood factors. PARTICIPANTS: Twin pairs of the Finnish Twin Cohort Study where at least one twin had migrated to Sweden (1542 twin pairs). MAIN RESULTS: Among men, migrants from Finland to Sweden showed an overall similar mortality compared with all subjects of the Finnish Twin Cohort (SMR 1.1; 95% CI 0.9 to 1.4). Mortality from non-violent causes was increased for migrants with at most 20 years in Sweden (SMR 1.9; 95% CI 1.2 to 2.6) and decreased in those with a longer stay (SMR 0.7; 95% CI 0.4 to 0.9). Similar results were obtained concerning first deaths in twin pairs discordant for migration. Among women, migrants had an increased mortality overall (SMR 1.4; 95% CI 1.0 to 1.8), from cardiovascular disease (SMR 1.7; 95% CI 1.0 to 2.7), and from violent causes (SMR 2.5; 95% CI 1.2 to 4.6) compared with all women of the Finnish Twin Cohort. In analyses of migrant discordant pairs only first deaths from cardiovascular disease tended to be more common in the migrants than in non-migrant co-twins. CONCLUSIONS: Migrants from Finland to Sweden seem to have an overall mortality comparable to that prevailing in Finland suggesting no strong influence on mortality by the migration. Duration of stay seems to be associated with mortality in the migrants, at least in men, with a lower mortality after several years in Sweden.

Adult↗
PubMed2005

Risk factors for sexually transmitted disease among rural-to-urban migrants in China: implications for HIV/sexually transmitted disease prevention.

The objective of the study was to identify risk factors associated with sexually transmitted diseases (STDs) among rural-to-urban migrants in Beijing in 2002. Migrants with STDs consisted of 432 migrants who sought STD care in two public STD clinics. Migrants without STDs included 892 migrants recruited from 10 occupational clusters. Multiple logistic regression was used for data analysis. Compared to migrants without STDs, migrants with STDs were more likely to report having engaged in commercial sex (selling or buying sex) (odds ratio [OR] = 2.70, 95% confidence interval [CI]: 1.71-4.25), multiple sex partners in the previous month (OR = 6.50, 95% CI: 3.73-11.32) and higher perceived HIV-related stigma (OR = 1.89, 95% CI: 1.30-2.75). Being a migrant with an STD was also associated with female gender (OR = 4.10, 95% CI: 2.89-5.82), higher education (OR = 2.92, 95% CI: 1.40-6.06), and higher monthly salary (OR = 1.68. 95% CI: 1.23-2.29). Migrants with STDs visited their hometowns more frequently and had more stable jobs than migrants without STDs. Approximately 10% of the migrants with STDs and 7.7% of the migrants without STDs always used condoms. This study suggests that among migrants, acquisition of an STD is associated with higher participation in risk behaviors as would be expected, but also with higher perceived stigma, education, stable jobs, salary, and with female gender. Appropriate behavioral intervention programs are advocated to reduce the risk and stigma among the special population.

Adult↗
PubMedDate not supplied

Are temporary migrants escapees of the one-child-per-family population policy: a revisit to the detachment hypothesis.

Using Hubei province as a case study, this paper retests the detachment hypothesis against the three conventional hypotheses regarding migration-fertility linkage (i.e., selectivity, disruption, and adaptation hypotheses) in explaining migrant and non-migrant fertility differentials in China. The analysis of yearly order-specific birth probabilities suggests that temporary migrants exhibit a significantly higher probability of having a second or higher order birth than comparable permanent migrants and non-migrants. This higher fertility among temporary migrants occurs after migration; temporary migrants actually do not differ from non-migrants in fertility before migration. But permanent migrants experience no significant change in their fertility after migration. The results lend a strong support to the detachment hypothesis, which best explains the fertility differentials between migrant and non-migrant populations in contemporary China; the separation of temporary migrants' actual residence from their official one does lead to a greater likelihood among temporary migrants to have unplanned births.

Adult↗
PubMed1995

Cancer incidence in Asian migrants to New South Wales, Australia.

Cancer incidence during 1972-90 in Asian migrants to New South Wales, Australia, is described. Overall cancer incidence was lower than in the Australia born in most migrant groups, and this reached significance in migrants born in China/Taiwan, the Philippines, Vietnam and India/Sri Lanka, and in male migrants born in Indonesia. For the majority of cancers, rates were more similar to those in the Australia born than to those in the countries of birth. For cancers of the breast, colorectum and prostate, rates were relatively low in the countries of birth, but migrants generally exhibited rates nearer those of the Australia born. For cancers of the liver and cervix and, in India/Sri Lanka-born migrants, of the oral cavity, incidence was relatively high in the countries of birth but tended to be lower, nearer Australia-born rates, in the migrants. For these cancers, environmental factors related to the migrant's adopted country, and migrant selection, appeared to have a major effect on the risk of cancer. For certain other cancers, incidence was more similar to that in the countries of birth. Nasopharyngeal cancer, and lung cancer in females, had high rates in both the countries of birth and in migrants to Australia. Nasopharyngeal cancer rates were highest in China/Taiwan and Hong Kong-born migrants, and were also significantly high in migrants from Malaysia/Singapore, Vietnam and the Philippines. Rates of lung cancer were significantly high in women born in China/Taiwan, and the excess was greater for adenocarcinoma than for squamous cell carcinoma. Melanoma had low rates in both the migrants and in the countries of birth. For these cancers, it was probable that genetic factors, or environmental factors acting prior to migration, were important in causation.

Adolescent↗
PubMed2006

HIV and syphilis in migrant workers in eastern China.

OBJECTIVE: To measure the prevalence of HIV and syphilis in migrant and urban workers in eastern China, and to determine their knowledge and attitudes towards HIV. METHODS: A cross sectional survey involving dried blood spot testing and self completion questionnaires. Migrants and urban workers in 39 work units in two districts of Hangzhou, Zhejiang Province, were recruited. Respondents completed a questionnaire about knowledge and attitudes towards HIV. Testing for antibodies to HIV-1 and syphilis was carried out on dried blood spots using a gelatin particle agglutination technique. RESULTS: Data were obtained from 4148 migrants and 2197 urban workers. There were no HIV infections detected in either the migrant or urban populations. Syphilis was detected, but the prevalence was not significantly different between urban workers (0.68%, 95% CI: 0.35 to 1.02) and migrant workers (0.48%, 95% CI 0.26 to 0.66, p = 0.07). 36% of the migrants had migrated with a partner, and 7% had also migrated with children. Urban workers were consistently more knowledgeable than migrants about HIV, but knowledge of the major modes of transmission was good in both groups. Traditional attitudes to sexual behaviour were still pervasive in both groups and attitudes towards individuals with HIV were generally intolerant. The use of sex workers appears rare and no more common in migrants than urban workers. CONCLUSION: At present HIV is probably not spreading in the internal migrant population in eastern China. Syphilis is a problem in both the migrant and urban populations. The tendency to migrate with partners makes migrants relatively low risk for engaging in casual sex.

Adolescent↗
PubMed2005

Migrant status, age, gender and social isolation in very late-onset schizophrenia-like psychosis.

BACKGROUND: Data from two retrospective first contact studies suggest that the risk of developing very-late onset schizophrenia-like psychosis (SLP) may be raised in older migrant than British-born populations resident in the UK. OBJECTIVE: To investigate whether the relative excess of SLP observed amongst younger and male migrants in the above studies might have been explained by differences in the age-gender structures of migrant and British-born denominator populations. A secondary aim was to examine the associations of migrant group status and gender with markers of social isolation. METHOD: Eighty-six new referrals of SLP to the Mile End (1997-2003) and Maudsley (1995-2000) hospitals were identified from two retrospective case note studies. Local census data were used to estimate the denominator populations and to calculate rate ratios for migrant and British-born cases of SLP. Case notes were re-examined, to assess markers of social isolation in migrant and British-born patients. RESULTS: Migrant patients were more likely to be male (odds ratio = 4.8; CI(odds) = 1.8-13.2) than British-born patients. The ratio of first contact rates for migrant compared to British-born populations were highest amongst men. There was a lower mean age of onset of SLP in migrant than British-born patients (t = 4.30, 95% CI = 3.78-10.27), which was largely explained by a higher mean age of illness onset in British-born women. There were no differences between migrant and British-born patients with respect to markers of social isolation. Male patients were more likely to have never married than women (odds ratio = 0.28; 95% CI odds = 0.09-0.89). CONCLUSIONS: The age-gender structure of the background population is not sufficient to explain the socio-demographic differences between migrant and British-born patients with SLP. Male patients may be more socially isolated.

Age of Onset↗
PubMed1999

Cancer mortality in migrants from the British Isles and continental Europe to New South Wales, Australia, 1975-1995.

Routinely collected data for New South Wales were used to analyse cancer mortality in migrants from the British Isles, southern Europe and eastern Europe according to duration of residence in Australia. A case-control approach compared deaths from cancer at one site with deaths from all other cancers, adjusting for age, sex and calendar period. Compared with the Australia-born, migrants had a significantly lower risk of dying from cancers of the mouth/pharynx and prostate (migrants from each region), colon/rectum (from the British Isles and southern Europe) and lung (female southern European migrants), evident from the time of migration and maintained for 30 years after migration. Whereas a deficit of deaths from colorectal cancer remained in migrants from southern Europe, a clear gradient of increasing risk with duration of stay in Australia was apparent. A similar trend was seen with respect to kidney cancer in southern European migrants. Persistent excess risks of death from stomach cancer were seen in all migrant groups, from lung cancer in British migrants and from liver cancer in southern and eastern European migrants. Although the risk of death from breast cancer increased significantly with duration in Australia in southern European migrants, the increase was not monotonic, as the relative risk in the first 10 years after migration was almost the same as that after more than 30 years. The pattern of risk for cancers of the prostate and mouth/pharynx suggests some protective role for inheritance or maintained cultural factors.

Adolescent↗
PubMed2006

Cancer mortality rates among first and second generation migrants in the Netherlands: Convergence toward the rates of the native Dutch population.

This study investigates the difference in cancer mortality rates between migrant groups and the native Dutch population, and determines the extent of convergence of cancer mortality rates according to migrants' generation, age at migration and duration of residence. Data were obtained from the national cause of death and population registries in the period 1995-2000. We used Poisson regression to compare the cancer mortality rates of migrants originating from Turkey, Morocco, Surinam, Netherlands Antilles and Aruba to the rates for the native Dutch. All-cancer mortality among all migrant groups combined was significantly lower when compared to that of the native Dutch population (RR = 0.55, CI: 0.52-0.58). For a large number of cancers, migrants had more than 50% lower risk of death, while elevated risks were found for stomach and liver cancers. Mortality rates for all cancers combined were higher among second generation migrants, among those with younger age at migration, and those with longer duration of residence. This effect was particularly pronounced in lung cancer and colorectal cancer. For most cancers, mortality among second generation migrants remained lower compared to the native Dutch population. Surinamese migrants showed the most consistent pattern of convergence of cancer mortality. The generally low cancer mortality rates among migrants showed some degree of convergence but did not yet reach the levels of the native Dutch population. This convergence implies that current levels of cancer mortality among migrants will gradually increase in future years if no specific preventive measurements are taken.

Adolescent↗
PubMed2001

Nutrition and health among migrants in The Netherlands.

OBJECTIVE: this paper aims to give a broad overview of published data on nutrition and health among migrants in the Netherlands, as well as data on determinants of health. RESULTS AND CONCLUSIONS: Depending on the definition, 9 to 17% of the population belongs to the group 'migrants' and this proportion is expected to grow in the coming years. Roughly 2/3 of migrants are of the first generation and on average, they are younger than the Dutch population. Relatively few data concerning the health status of migrants are available. The diet of migrants showed both positive (macronutrients) and negative (micronutrients) differences with the general Dutch diet. The risk of overweight was high among both children and adult women, and the data suggest a higher risk for Turkish and Moroccan groups than for Dutch groups. The importance of health determinants, such as smoking, alcohol use and physical and social environment, was different for migrants than for the Dutch population; however, there were also differences between ethnic groups. The limited data on morbidity for migrants suggest higher risks than for the indigenous population. The same holds for mortality data, especially for the younger age groups. In general, the data that are available suggest that the health status of migrants was less favourable than that of the indigenous population. However, there were also differences between the various groups of migrants. The lower socio-economic position of migrant groups partly explained the differences in health status. Nevertheless, a study among Turkish people indicated that their health status was lower than that of Dutch people of comparable socioeconomic status.

Adult↗
PubMed2003

Emotional and behavioral problems in migrant children.

OBJECTIVES: To assess emotional (depression, anxiety and self-esteem) and behavioural problems in migrant children and to compare them with non-migrant children. METHODS: 526 students (60% boys, 40% girls) aged 11.23 +/- 1.05, at five schools in Adana, Turkey in areas with a high migrant population were included in this study. 182 children (35%) were migrants and 344 children (65%) were non-migrants. The Depression Inventory for Children (CDI), the State-Trait Anxiety Inventory for Children (STAI-C) and the Coopersmith Self-Esteem Inventory (CSEI) were administered to the pupils at their school and Rutter's Teachers Rating Scale (RTRS) was administered to their teachers. Sociodemographic variables were recorded on the basis of school records and the children's report. RESULTS: In the migrant group, fathers were less educated and had more employment problems, homes were rented and the children were unsuccessful at school. Migrant children had significantly lower self-esteem with higher depression and anxiety. Behavioural symptoms on RTRS were not significant with regard to migration. No significant correlation was found between psychometric tests and father's education, duration of residence after migration or room density. CONCLUSIONS: We found significant emotional but no behavioural problems in Turkish migrant children compared to Turkish non-migrant children. Further prospective studies are needed to clarify the long-term course of the various types of distress and the individual prognosis of migrant adjustment.

Anxiety↗
PubMed1991

Importance of migrants infected with Onchocerca volvulus in west African river valleys protected by 14 to 15 years of Simulium control.

A study was done to determine the importance of human migration from non-controlled endemic onchocerciasis foci to the river valleys that have been protected for the past 14 to 15 years by the vector control operations of the Onchocerciasis Control Programme in West Africa. The aim of the study was to assess the contribution of migrants to the prevalence and intensity of infection in villages from 5 major river valleys and their potential role in causing relapse of transmission once the vector is allowed to return. In Burkina Faso the migrant population varied from 0.0% to 18.1% of the village population, and averaged 4.9%. Migrants accounted only for 0.6% of the population in Ghanaian and Ivorian villages along the Black Volta river. The prevalence of infection was significantly higher in migrants (8.2%) than in non migrants (1.1%) in the surveyed villages in Burkina Faso, and 1.5% of migrants had infections with more than 16 microfilariae per snip as against 0.2% of non migrants. Nearly all infected migrants came from the south of the Côte d'Ivoire. The study shows that human migration has caused the importation of Onchocerca volvulus from non-controlled areas. However, the epidemiological importance of this phenomenon is limited because of the very small number of infected migrants per village while two-third of the infected migrants are believed to be infected with the less pathogenic forest strain of the parasite. Because migration patterns changes geographically and over time similar studies will be continued on a regular basis.

Animals↗
PubMed2005

[Methodological standards for migrant-sensitive epidemiological research].

Migrant-sensitive epidemiological research often encounters methodological problems: differences among studies with regard to the definition of the term "migrant", difficulties in identifying migrants among the study participants and low participation rates of migrants in epidemiological studies. Therefore, a project has been initiated at the Robert Koch Institute with the aim of developing standards which ensure migrant-sensitive epidemiological research, provide a uniform framework for data collection and analysis, and make different data sources comparable. Ideally, the following standards should be followed: a comprehensive definition of the study population which includes migrants, standardisation of the term "migrant" and of its operationalization, adequate participation rates of migrants in the study, inclusion of migrant-specific topics and questions, and migrant-specific non-responder analysis, data analysis, reporting of results and quality assurance. We give an overview of the status quo of the implementation of the these standards in ongoing studies of the Robert Koch Institute and propose minimum standards, which do not require considerable additional financial resources.

Adolescent↗