Yolanda González-Rábago

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

OBJECTIVE To analyze health inequalities between native and immigrant populations in the Basque Country (Spain) and the role of several mediating determinants in explaining these differences. METHODS A cross-sectional study was performed in the population aged 18 to 64 years in the Basque Country. We used data from the Basque Health Survey 2007 (n=4,270) and the Basque Health Survey for Immigrants 2009 (n=745). We calculated differences in health inequalities in poor perceived health between the native population and immigrant populations from distinct regions (China, Latin America, the Maghreb and Senegal). To measure the association between poor perceived health and place of origin, and to adjust this association by several mediating variables, odds ratios (OR) were calculated through logistic regression models. RESULTS Immigrants had poorer perceived health than natives in the Basque Country, regardless of age. These differences could be explained by the lower educational level, worse employment status, lower social support, and perceived discrimination among immigrants, both in men and women. After adjustment was performed for all the variables, health status was better among men from China (OR: 0.18; 95% confidence interval [CI95%]: 0.04-0.91) and Maghreb (OR: 0.26; 95% CI: 0.08-0.91) and among Latin American women (OR: 0.36; 95% CI: 0.14-0.92) than in the native population. CONCLUSIONS These results show the need to continue to monitor social and health inequalities between the native and immigrant populations, as well as to support the policies that improve the socioeconomic conditions of immigrants.

The Impact of Fiscal Policies on the Socioeconomic Determinants of Health: A Structured Review

There has been considerable recent debate around the alleged impact of discretionary fiscal policies – especially austerity policies – on health and health inequalities. Assuming that most of the impact will have to run via the effect of fiscal policies on socioeconomic determinants of health (SDH), it is of interest to gain a further understanding of the relationship between fiscal policies and SDH. Therefore, the aim of this article is to review the recent evidence on the impact of discretionary fiscal policies on key SDH, i.e. income, poverty, education, and employment, in high income OECD countries. We find that there are no simple answers as to how fiscal policy affects those determinants of health. The effects of contractionary and expansionary fiscal policies on the analyzed SDH vary considerably across countries and will largely depend on the pre-crisis situation. Contractionary fiscal policies seem to have increased poverty, while their impact on income inequality will be influenced by the composition of the implemented measures. More empirical research trying to directly link fiscal policies to health outcomes, while taking into account of some of the mechanisms encountered here, would be worthwhile.

Original articlePerceived discrimination and self-rated health in the immigrant population of the Basque Country, SpainDiscriminación y salud percibida en la población inmigrante del País Vasco (España)

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.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.

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.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.

Modes of engagement of immigrants with their home societies: types and measurements of engagement

ABSTRACT The objective of this article is to review how transnational engagement has been traditionally measured and then offer a proposal for measurements corresponding to how immigrants perceive their transnational practices. Based on the traditional conceptual model of immigrant transnationalism, a system of indicators was developed in accordance with a broad and integral view of the connection with their home societies. This system of indicators was applied to an Andean sample population residing in the Basque Country, Spain, and analysed using factor analysis to produce an empirical model of engagement from the traditional conceptual one. Results show the importance of the private aspect of the relationships with origin and the existence of a continuum in the immigrant connection with their home countries that ranges from the personal to the community. Moreover, two types of intensity of this connection stand out: the first suggests a mere interest in the place of origin while the second implies an active connection with their home countries, both personal and community based.

The Active Ageing Index in a Southern European Region (Biscay): Main Results and Potentials for Policymaking

This chapter presents the experience of the calculation of the Active Ageing Index (AAI) at the subnational level in Southern Europe and discusses its role as a useful tool to support political decision-making. The index for Biscay was calculated for the period 2012–2014, following the internationally agreed methodology, but at the same time it took into account the specificities of the region and the availability of data sources. It was based on secondary data, as well as on primary data as a result of a specific survey among people 55 years and older. The Biscay’s experience shows that the AAI can be a good tool for monitoring active ageing and it could be well used as an advisory tool for policymaking at the regional level in the EU.

Salud y determinantes sociales de la salud en hijos e hijas de personas inmigrantes internacionales: ¿desigualdades sociales en salud desde la infancia?

OBJECTIVE To analyse the social inequalities in health between children and youth population of an immigrant origin from low-income countries and those of native origin in the Basque Country. METHOD Cross-sectional descriptive study using data from the Basque Country Health Survey 2013. Variables of health, behaviours and life conditions were used as the outcome variables. Prevalence ratios were calculated using robust Poisson models. RESULTS The children with immigrant parents had poorer self-rated health, a higher prevalence of obesity, spent more hours in sedentary activities and lived in households with greater economic difficulties. The differences persisted even after adjusting for social class and educational level of parents. CONCLUSIONS A migrant background is a highly relevant axis of health inequalities and has an influence beyond a generation. Given this reality, it is necessary to implement effective and suitable measures to ensure life with good health conditions and to reduce social inequalities in health, not only in childhood but through the entire life cycle.

The role of birthplace and educational attainment on induced abortion inequalities

BackgroundInduced abortion (IA) has shown social inequality related to birthplace and education with higher rates of IAs in immigrant and in less educated women relative to their native and highly educated counterparts. This study examined the independent and joint effects of birthplace and education on IA, repeated and IA performed during the 2nd trimester of pregnancy among women residing in the Basque Country, Spain.MethodsWe conducted a cross-sectional population-based study of IA among women aged 25–49 years residing in the Basque Country, Spain, between 2011 and 2013. Log-binomial regression was used to quantify the independent and joint effects of birthplace and education attainment on all outcomes.ResultsImmigrant women exhibited higher probability of having an IAs (PR: 5.31), a repeated (PR: 7.23) or a 2nd trimester IAs (PR: 4.07) than women born in Spain. We observed higher probabilities for all outcomes among women with a primary or less education relative to those with a graduate education (All IAs PR: 2.51; repeated PR: 6.00; 2nd trimester PR: 3.08). However, no significant heterogeneity was observed for the effect of education on the association of birthplace with IAs, repeated or 2nd trimester IAs.ConclusionsBirthplace and education are key factors to explain not only an IA decision but also having a repeated or a 2nd trimester IA. However, the effects of birthplace and education may be independent from each other on these outcomes. A better understanding of these factors on IAs is needed when designing programs for sexual and reproductive health aimed to reduce inequalities among women.

Engagement Policies in Favour of Transnationalism: the expansion of transnational citizenship within Colombian emigrants

Communities of nationals living abroad are attracting the interest of sending countries, which are paying increasing attention to the way in which emigrants connect with their origin and the potential benefits of it. Focusing on the case of Colombia and analysing the initiatives under the Colombia Nos Une Program, this article examines the role that the proactive attitude of institutional actors is playing in the potential engagement of migrants with their country of origin and the creation of a transnational citizenship. Colombia, as a sending country, is looking at their emigrants in an attempt to take advantage of their economic and human capital in order to improve its development through networks of knowledge, entrepreneurship and socio-cultural initiative. An increasing knowledge of the way policies of origin are implemented and the impact they have on the migrants’ lives will give a more comprehensive framework to understand the effects of a transnational life and to conceptualize a transnational citizenship.