Self-rated health among undocumented and newly regularized migrants in Geneva: a cross-sectional study

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Abstract

Background

In Europe, knowledge about the social determinants of health among undocumented migrants is scarce. The canton of Geneva, Switzerland, implemented in 2017–2018 a pilot public policy aiming at regularizing undocumented migrants. We sought to test for associations between self-rated health, proven eligibility for residence status regularization and social and economic integration.

Methods

This paper reports data from the first wave of the Parchemins Study, a prospective study whose aim is to investigate the effect of residence status regularization on undocumented migrants’ living conditions and health. The convenience sample included undocumented migrants living in Geneva for at least 3 years. We categorized them into those who were in the process of receiving or had just been granted a residence permit (eligible or newly regularized) and those who had not applied or were ineligible for regularization (undocumented). We conducted multivariate regression analyses to determine factors associated with better self-rated health, i.e., with excellent/very good vs. good/fair/poor self-rated health. Among these factors, measures of integration, social support and economic resources were included.

Results

Of the 437 participants, 202 (46%) belonged to the eligible or newly regularized group. This group reported better health more frequently than the undocumented group (44.6% versus 28.9%, p-value < .001), but the association was no longer significant after adjustment for social support and economic factors (odds ratio (OR): 1.12; 95% confidence interval (CI): 0.67–1.87). Overall, better health was associated with larger social networks (OR: 1.66; 95% CI: 1.04–2.64). This association remained significant even after adjusting for health-related variables.

Conclusion

At the onset of the regularization program, access to regularization was not associated with better self-rated health. Policies aiming at favouring undocumented migrants’ inclusion and engagement in social networks may promote better health. Future research should investigate long-term effects of residence status regularization on self-rated health.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-11239-0.

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Most cited references 44

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Generalized anxiety disorder (GAD) is one of the most common mental disorders; however, there is no brief clinical measure for assessing GAD. The objective of this study was to develop a brief self-report scale to identify probable cases of GAD and evaluate its reliability and validity. A criterion-standard study was performed in 15 primary care clinics in the United States from November 2004 through June 2005. Of a total of 2740 adult patients completing a study questionnaire, 965 patients had a telephone interview with a mental health professional within 1 week. For criterion and construct validity, GAD self-report scale diagnoses were compared with independent diagnoses made by mental health professionals; functional status measures; disability days; and health care use. A 7-item anxiety scale (GAD-7) had good reliability, as well as criterion, construct, factorial, and procedural validity. A cut point was identified that optimized sensitivity (89%) and specificity (82%). Increasing scores on the scale were strongly associated with multiple domains of functional impairment (all 6 Medical Outcomes Study Short-Form General Health Survey scales and disability days). Although GAD and depression symptoms frequently co-occurred, factor analysis confirmed them as distinct dimensions. Moreover, GAD and depression symptoms had differing but independent effects on functional impairment and disability. There was good agreement between self-report and interviewer-administered versions of the scale. The GAD-7 is a valid and efficient tool for screening for GAD and assessing its severity in clinical practice and research.

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Self-Rated Health and Mortality: A Review of Twenty-Seven Community Studies

Ellen L Idler, Yael Benyamini (1997)

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Author and article information

Contributors

Julien Fakhoury:

ORCID: http://orcid.org/0000-0002-5465-5307

julien.fakhoury@unige.ch

Journal

Journal ID (nlm-ta): BMC Public Health

Journal ID (iso-abbrev): BMC Public Health

Title: BMC Public Health

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-2458

Publication date (Electronic): 23 June 2021

Publication date PMC-release: 23 June 2021

Publication date Collection: 2021

Volume: 21

Electronic Location Identifier: 1198

Affiliations

[1 ]GRID grid.8591.5, ISNI 0000 0001 2322 4988, Swiss NCCR Lives, , University of Geneva, ; Geneva, Switzerland

[2 ]GRID grid.8591.5, ISNI 0000 0001 2322 4988, Centre interfacultaire de gerontologie et d’etudes des vulnerabilites (CIGEV), , University of Geneva, ; Geneva, Switzerland

[3 ]GRID grid.8591.5, ISNI 0000 0001 2322 4988, Institute of sociological research, , University of Geneva, ; Geneva, Switzerland

[4 ]GRID grid.150338.c, ISNI 0000 0001 0721 9812, Division of Primary Care Medicine, , Geneva University Hospital and University of Geneva, ; Geneva, Switzerland

Author information

Julien Fakhoury http://orcid.org/0000-0002-5465-5307

Article

Publisher ID: 11239

DOI: 10.1186/s12889-021-11239-0

PMC ID: 8220781

PubMed ID: 34162363

SO-VID: 8951b918-a389-4615-a9fd-a36113abb4fd

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 19 May 2020

Date accepted : 8 June 2021

Funding

Funded by: FundRef http://dx.doi.org/10.13039/501100001711, Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung;

Award ID: Grant 100017_182208

Award Recipient : Yves Jackson

Custom metadata

ScienceOpen disciplines: Public health

Keywords: undocumented migrants,self-rated health,legal status regularization,geneva,switzerland

Data availability:

ScienceOpen disciplines: Public health

Keywords: undocumented migrants, self-rated health, legal status regularization, geneva, switzerland

Self-rated health among undocumented and newly regularized migrants in Geneva: a cross-sectional study

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Supplementary Information

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Most cited references 44

A brief measure for assessing generalized anxiety disorder: the GAD-7.

A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity.

Self-Rated Health and Mortality: A Review of Twenty-Seven Community Studies

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