Impact of economic crisis on mental health of migrant workers: what happened with migrants who came to Spain to work?

Objectives: To assess changes in mental health in a sample of migrant workers after the eruption of the economic crisis in Spain. Methods: 318 migrant workers were interviewed. Mental health, sociodemographic, and economic crisis related variables were obtained through face-to-face (2008) and phone (2011) interviews. Prevalence of poor mental health (PMH) was compared (2011–2008) and multivariate logistic regression models were fitted. Results: Change in prevalence of PMH was higher in men (aOR 4.63; 95 % CI 2.11–10.16). Subgroups of men showing the largest detrimental mental health effects were: unemployed, with low salaries (≤1,200 euros) and those reporting family burden. An increase of PMH was found in women, without significant associations. Conclusions: Mental health of migrant workers in Spain has worsened during the economic crisis.

Invisible work, unseen hazards: the health of women immigrant household service workers in Spain

BACKGROUND: Household service work has been largely absent from occupational health studies. We examine the occupational hazards and health effects identified by immigrant women household service workers. METHODS: Exploratory, descriptive study of 46 documented and undocumented immigrant women in household services in Spain, using a phenomenological approach. Data were collected between September 2006 and May 2007 through focus groups and semi-structured individual interviews. Data were separated for analysis by documentation status and sorted using a mixed-generation process. In a second phase of analysis, data on psychosocial hazards were organized using the Copenhagen Psychosocial Questionnaire as a guide. RESULTS: Informants reported a number of environmental, ergonomic and psychosocial hazards and corresponding health effects. Psychosocial hazards were especially strongly present in data. Data on reported hazards were similar by documentation status and varied by several emerging categories: whether participants were primarily cleaners or carers and whether they lived in or outside of the homes of their employers. Documentation status was relevant in terms of empowerment and bargaining, but did not appear to influence work tasks or exposure to hazards directly. CONCLUSIONS: Female immigrant household service workers are exposed to a variety of health hazards that could be acted upon by improved legislation, enforcement, and preventive workplace measures, which are discussed.

Relación en España de la duración de la gestación y del peso al nacer con la nacionalidad de la madre durante el período 2001-2005

Fundamento: La asociación de la inmigración con el bajo peso al nacimiento (BP) y el parto pretérmino (PP) es un importante indicador de inequidades en salud. El objetivo de este estudio es analizar las diferencias entre BP y el PP según la nacionalidad de la madre. Métodos: Los datos proceden del Boletín Estadístico de Nacimientos. Durante el período de estudio hubo 1.878.718 recién nacidos. La nacionalidad fue considerada como variable de exposición (española-inmigrante). Las variables de efecto son BP (nacimientos de 37 o más semanas de gestación con un peso inferior a 2.500 gramos) y PP (recién nacidos con menos de 37 semanas de gestación). Se calcularon odds ratios simples y ajustadas por posibles variables de confusión mediante regresión logística. Resultados: La prevalencia de BP y PP entre las mujeres españolas fue de 7,9% y 3,2% respectivamente, mientras que en las extranjeras fue de 7,3% y 2,4% respectivamente. En comparación con las españolas, el riesgo más bajo de PP lo presentaron las mujeres procedentes de África del Norte (ORa= 0,77 IC95%0,74-0,80). Con respecto al BP el riesgo más bajo se observó en madres de Sudamérica (ORa=0,62 IC95%0,59-0,65) y Europa del Este (ORa=0,65 IC95%0,60-0,71). Conclusión: Los recién nacidos de madre extranjera presentan menos riesgo de BP y PP que los autóctonos, posiblemente como consecuencia del sesgo por la condición de ser inmigrante sano y por la menor frecuencia de prácticas de riesgo durante la gestación de las mujeres inmigrantes.

Differences in exposure to occupational health risks in Spanish and foreign-born workers in Spain (Itsal Project)

Migrant workers usually show higher rates of work-related health problems than natives. However, little information is available about their exposure to occupational risks. We describe self-reported working exposure in Spanish and foreign-born workers. A cross-sectional survey was conducted as part of the ITSAL Project. Data on sociodemographic and self-reported occupational exposure in 1,841 foreign-born and 509 Spanish workers were collected through face-to-face interviews. Prevalence and adjusted odds ratios-aOR- (by age, education, type of contract) were calculated. Foreign-born men in non-services sectors and those in manual occupations perceived exposure to occupational risks with lower prevalence than Spanish workers. Foreign-born women reported higher prevalence of exposure than Spanish female workers. By occupation, foreign-born female workers were more likely than Spanish workers to report working many hours/day (aOR2.68; 95 % CI 1.06–6.78) and exposure to extreme temperatures (aOR2.19; 95 % CI 1.10–4.38). Some groups of migrant workers may need increased protection regarding some occupational exposures.

Work-related health problems among resident immigrant workers in Italy and Spain

Background: in both Spain and Italy the number of immigrants has strongly increased in the last 20 years, currently representing more than the 10% of workforce in each country. The segregation of immigrants into unskilled or risky jobs brings negative consequences for their health. The objective of this study is to compare prevalence of work-related health problems between immigrants and native workers in Italy and Spain. Methods: data come from the Italian Labour Force Survey (n=65 779) and Spanish Working Conditions Survey (n=11 019), both conducted in 2007. We analyzed merged datasets to evaluate whether interviewees, both natives and migrants, judge their health being affected by their work conditions and, if so, which specific diseases. For migrants, we considered those coming from countries with a value of the Human Development Index lower than 0.85. Logistic regression models were used, including gender, age, and education as adjusting factors. Results: migrants reported skin diseases (Mantel-Haenszel pooled OR=1.49; 95%CI: 0.59-3.74) and musculoskeletal problems among those employed in agricultural sector (Mantel-Haenszel pooled OR=1.16; 95%CI: 0.69-1.96) more frequently than natives; country-specific analysis showed higher risks of musculoskeletal problems among migrants compared to the non-migrant population in Italy (OR=1.17; 95% CI: 0.48-1.59) and of respiratory problems in Spain (OR=2.02; 95%CI: 1.02-4.0). In both countries the risk of psychological stress was predominant among national workers. Conclusions: this collaborative study allows to strength the evidence concerning the health of migrant workers in Southern European countries.

A metasynthesis of qualitative studies regarding opinions and perceptions about barriers and determinants of health services’ accessibility in economic migrants

Background: Access to health services is an important health determinant. New research in health equity is required, especially amongst economic migrants from developing countries. Studies conducted on the use of health services by migrant populations highlight existing gaps in understanding which factors affect access to these services from a qualitative perspective. We aim to describe the views of the migrants regarding barriers and determinants of access to health services in the international literature (1997–2011). Methods: A systematic review was conducted for Qualitative research papers (English/Spanish) published in 13 electronic databases. A selection of articles that accomplished the inclusion criteria and a quality evaluation of the studies were carried out. The findings of the selected studies were synthesised by means of metasynthesis using different analysis categories according to Andersen’s conceptual framework of access and use of health services and by incorporating other emergent categories. Results: We located 3,025 titles, 36 studies achieved the inclusion criteria. After quality evaluation, 28 articles were definitively synthesised. 12 studies (46.2%) were carried out in the U.S and 11 studies (42.3%) dealt with primary care services. The participating population varied depending mainly on type of host country. Barriers were described, such as the lack of communication between health services providers and migrants, due to idiomatic difficulties and cultural differences. Other barriers were linked to the economic system, the health service characteristics and the legislation in each country. This situation has consequences for the lack of health control by migrants and their social vulnerability. Conclusions: Economic migrants faced individual and structural barriers to the health services in host countries, especially those with undocumented situation and those experimented idiomatic difficulties. Strategies to improve the structures of health systems and social policies are needed.

Late life second move housing choices of international retiree migrants

Purpose – Many international retirement migrants are amenity movers undertaking the first move in the late life course model of migration. The purpose of this paper is to examine second moves within the retirement destination community to test whether the model of late life course migration accurately portrays the motivations and housing choices local movers make after retiring to another country. Design/methodology/approach – The paper combines secondary data and survey results to examine the composition of the retiree migrant population in the Alicante province of Spain. The socioeconomic characteristics and housing choices of those who have made a second move since retiring to Spain are compared with those who have not moved through a series of t-tests and chi-square tests. Findings – The paper finds that those who have made a second move within Spain are somewhat typical of second movers in the late life course. They are likely to cite mobility or health problems as a reason for moving and appear to recognize the need for a home that provides living area on one floor. Yet, they are choosing to move within an area that does not provide them with access to informal family care givers. Research limitations/implications – The data are restricted to retirees of two nationalities in one province of Spain. Further research is suggested in other locations and with retirees of other nationalities for comparison. Practical implications – Because many international retirees do not plan to return to their countries of origin, they will create demand for formal in-home care services and supportive retiree housing in the near future in their retirement destination countries. Originality/value – This paper provides understanding of a growing consumer housing segment in retirement destinations.

La integración cultural y social en las migraciones intraeuropeas

Cuando un migrante llega a una sociedad distinta, debe elegir cómo vivir en ella. En esta elección cuentan su pasado, su presente y especialmente su futuro en términos de expectativas de movilidad. Comprender cómo viven los residentes extranjeros en su país de destino implica considerar conceptos clave como procesos de socialización, shock cultural, competencia intercultural o procesos de aculturación que implican aprender nuevas competencias culturales. A partir de los datos de la Encuesta Social de Migraciones Internas Europeas (EIMSS) este trabajo se centra en el análisis de dos dimensiones, la integración cultural y la integración social, que van a caracterizar el modo en que los migrantes europeos viven en su nuevo entorno social, y su relación con la percepción de la discriminación que tiene el migrante o su adaptación psicológica, en términos de nostalgia y satisfacción con la vida.

Los inmigrantes como amenaza: procesos migratorios en la televisión española

La mayor parte de las investigaciones desarrolladas en torno a la imagen mediática de los procesos migratorios destacan la tendencia hacia su problematización, de forma que se asocia a la población inmigrante con amenazas sociales, económicas, culturales, con la desviación, delincuencia, ilegalidad, etc. Tomando como referencia el caso de España, en este artículo se analiza la manera en que los noticiarios televisivos construyen aquellas noticias relacionadas con la población inmigrante. Con este fin, se han recogido un total de 145 noticias emitidas en 105 programas informativos de cuatro cadenas de televisión (tres de ámbito nacional y una regional), a cuyos contenidos se han aplicado, fundamentalmente, técnicas cualitativas de análisis.

La nueva Estadística de Migraciones: una buena elección por parte del INE

El Instituto Nacional de Estadística ha decidido elaborar una nueva Estadística de Migraciones utilizando como base la Estadística de Variaciones Residenciales. En este artículo se aportan algunos argumentos que apoyan esta decisión, ante la persistente falta de coherencia entre las fuentes del sistema estadístico español para captar la movilidad. En particular, se profundiza en los problemas de subestimación e inconsistencia interna de la Encuesta de Población Activa para medir la inmigración, a la vista de las diferencias entre las tres series de flujos de inmigración internacional que es posible estimar a partir de la misma.

Condiciones de trabajo y salud de los trabajadores inmigrantes en España. Revisión bibliográfica

Fundamentos: La relación entre inmigración, trabajo y salud constituye uno de los retos más importantes en salud laboral y más concretamente en España por el importante incremento de proporción inmigrante acontecido en el mercado laboral. El objetivo de esta investigación es conocer la relación entre las condiciones de trabajo y sus efectos en la salud de trabajadores inmigrantes en España. Métodos: Revisión bibliográfica de artículos científicos originales en español e inglés Medline y Medes (1998-2012). Se revisaron los textos completos de los artículos incluidos. Resultados: Se incluyeron 20 estudios, 13 con metodología de investigación cuantitativa y 7 cualitativa. Los temas tratados abordaban problemas específicos de salud relacionados con el trabajo (principalmente lesiones por accidente de trabajo), incapacidad laboral y diferencias en condiciones de trabajo y empleo. Los hallazgos de los estudios mostraron mayor incidencia de lesiones por accidentes de trabajo, menores tasas de incapacidad laboral, mayor prevalencia de presentismo laboral, exposición a factores psicosociales y precariedad laboral en la población inmigrante. Conclusiones: A pesar de la singularidad del proceso demográfico migratorio, los problemas de salud y determinantes identificados no difieren de los referenciados en otros países, en otros contextos y en otros momentos.

Prácticas de autocuidado sexual y reproductivo en mujeres “parejas de” migrantes internacionales de San Luis Potosí, México

Los migrantes y sus parejas han sido incorporados en los discursos institucionales de salud como “sujetos en riesgo” frente a las Infecciones de Trasmisión Sexual (ITS), sin embargo la incorporación de esta población específica en la comunicación y gestión del riesgo de ITS ha sido ambigua en el contexto mexicano. El objetivo del presente acercamiento fue conocer las prácticas de autocuidado sexual y reproductivo que adoptan en su cotidianeidad mujeres parejas de migrantes y la relación de dichas medidas con la comunicación y gestión del riesgo que los Servicios de Salud realizan. Se trató de una aproximación de tipo cualitativo con 20 mujeres “de migrantes” localizadas mediante los servicios de salud, la información se recabó a través de entrevistas a profundidad que focalizaron en las esferas de “percepción del riesgo” y “Autocuidado sexual y reproductivo”. Se encontró que la mayoría de las mujeres no se reconoce vulnerable frente a las ITS y que la percepción del riesgo no es determinante en la confrontación que respecto a la amenaza puedan desarrollar, dado que los imaginarios patriarcales que prevalecen en ellas, sus parejas y el personal de salud desestiman la utilización de medidas de prevención y detección oportuna.

From the boom to the crisis: changes in employment conditions of immigrants in Spain and their effects on mental health

Background: Migrant workers have been one of the groups most affected by the economic crisis. This study evaluates the influence of changes in employment conditions on the incidence of poor mental health of immigrant workers in Spain, after a period of 3 years, in context of economic crisis. Methods: Follow-up survey was conducted at two time points, 2008 and 2011, with a reference population of 318 workers from Colombia, Ecuador, Morocco and Romania residing in Spain. Individuals from this population who reported good mental health in the 2008 survey (n = 214) were interviewed again in 2011 to evaluate their mental health status and the effects of their different employment situations since 2008 by calculating crude and adjusted odds ratios (aORs) for sociodemographic and employment characteristics. Findings: There was an increased risk of poor mental health in workers who lost their jobs (aOR = 3.62, 95%CI: 1.64–7.96), whose number of working hours increased (aOR = 2.35, 95%CI: 1.02–5.44), whose monthly income decreased (aOR = 2.75, 95%CI: 1.08–7.00) or who remained within the low-income bracket. This was also the case for people whose legal status (permission for working and residing in Spain) was temporary or permanent compared with those with Spanish nationality (aOR = 3.32, 95%CI: 1.15–9.58) or illegal (aOR = 17.34, 95%CI: 1.96–153.23). In contrast, a decreased risk was observed among those who attained their registration under Spanish Social Security system (aOR = 0.10, 95%CI: 0.02–0.48). Conclusion: There was an increase in poor mental health among immigrant workers who experienced deterioration in their employment conditions, probably influenced by the economic crisis.

A qualitative exploration of the impact of the economic recession in Spain on working, living and health conditions: reflections based on immigrant workers' experiences

Background: This study aimed to analyse how immigrant workers in Spain experienced changes in their working and employment conditions brought about Spain's economic recession and the impact of these changes on their living conditions and health status. Method: We conducted a grounded theory study. Data were obtained through six focus group discussions with immigrant workers (n = 44) from Colombia, Ecuador and Morocco, and two individual interviews with key informants from Romania living in Spain, selected by theoretical sample. Results: Three categories related to the crisis emerged – previous labour experiences, employment consequences and individual consequences – that show how immigrant workers in Spain (i) understand the change in employment and working conditions conditioned by their experiences in the period prior to the crisis, and (ii) experienced the deterioration in their quality of life and health as consequences of the worsening of employment and working conditions during times of economic recession. Conclusion: The negative impact of the financial crisis on immigrant workers may increase their social vulnerability, potentially leading to the failure of their migratory project and a return to their home countries. Policy makers should take measures to minimize the negative impact of economic crisis on the occupational health of migrant workers in order to strengthen social protection and promote health and well-being.

Limitaciones y recomendaciones metodológicas en las publicaciones sobre salud de la población inmigrante en España

El objetivo es describir las limitaciones y las recomendaciones metodológicas identificadas por los autores de artículos originales sobre inmigración y salud en España. Se realizó una revisión bibliográfica de artículos originales publicados en español e inglés entre 1998 y 2012, combinando descriptores de inmigración y salud. Se incluyeron 311 artículos; de ellos, 176 (56,6%) mencionaban limitaciones y 15 (4,8%) emitían recomendaciones. Entre las limitaciones más mencionadas destacan el reducido tamaño de las muestras, problemas de validez interna y representatividad de la muestra con infrarrepresentación o sobrerrepresentación de determinados grupos, problemas de validez de la información recogida y datos faltantes relacionados sobre todo con los instrumentos de medición, y ausencia de variables clave de ajuste o estratificación. En función de los resultados obtenidos, se proponen una serie de recomendaciones para minimizar las limitaciones habituales y avanzar en la calidad de los trabajos científicos sobre inmigración y salud en nuestro ámbito.