El Contexto Escolar y la Salud Mental de Adolescentes Migrantes y no Migrantes en la Ciudad de Barcelona / School context and mental health of migrant and non-migrant adolescents in Barcelona

El constante flujo migratorio a nivel internacional invita a reinventarnos para crear sociedades inclusivas a nivel intercultural. La convivencia, como modelo basado en la integración mutua entre locales y migrantes, es todavía un desafío a enfrentar en Europa y España. Este estudio busca identificar qué variables de salud mental y resiliencia afectan a la integración escolar entendida como ejemplo del bienestar psicosocial, comparando una muestra de adolescentes migrantes con adolescentes locales. A través de una metodología cuantitativa, se estudiaron factores escolares, conductas problemáticas y factores de resiliencia en 132 estudiantes de entre 12 y 18 años. Los resultados revelan que los niveles de salud mental son semejantes en ambos grupos, pero la salud mental y la resiliencia contextual son más determinantes en la población adolescente migrante. Identificar con claridad las relaciones entre factores escolares y salud mental ofrece la posibilidad de diseñar intervenciones eficaces en el ámbito educativo. (AU)

The continuous international migration flow invites us to reinvent ourselves to create inclusive societies at intercultural level. Coexistence, as a model based on the mutual integration of locals and migrants, is still a challenge to face in Europe and Spain. This study aims to identify which mental health and resilience variables influence school integration used as a proxy for psychosocial well-being by comparing a sample of migrant and local adolescents. Through a quantitative methodology, school factors, disruptive behaviors, and resilience were measured in 132 students aged between 12 and 18 years old. The results reveal that although mental health scores are similar in both groups, mental health and contextual resilience are more critical for the migrant adolescent population than for the local one. Clearly identifying the relationships between school related factors and mental health offers the possibility of designing effective interventions within the educational context. (AU)

Editorial: Extreme Weather Resulting from Global Warming is an Emerging Threat to Farmworker Health and Safety.

A warming climate has been linked to an increase in the frequency and severity of extreme weather events, including heat and cold waves, extreme precipitation, and wildfires. This increase in extreme weather results in increased risks to the health and safety of farmworkers.

Metodología para el desarrollo de un resumen de evidencia para políticas en salud pública / Methodology for the development of policy brief in public health

El resumen de evidencia para políticas es un documento de referencia en la toma de decisiones políticas. De forma breve y directa, se define un problema, se realiza una síntesis de la evidencia disponible en torno al mismo, se identifican posibles líneas de actuación y se proponen recomendaciones. El objetivo de esta nota es describir su metodología, partiendo del modelo propuesto por Eugene Bardach y nuestra propia experiencia. Se describe la metodología en seis pasos: 1) identificación de la audiencia a la que se dirige el documento; 2) delimitación del problema; 3) recopilación de información y evidencias; 4) consideración de alternativas; 5) proyección de resultados y diseño de recomendaciones o mensajes clave; y 6) descripción de la historia. Se presenta también el resumen de evidencia para políticas como parte de una estrategia de comunicación más amplia que puede generar puntos de encuentro entre equipos de investigación y grupos de interés

A policy brief is a document that summarizes research to inform policy. In a brief and succinct way, it defines a policy problem, presents a synthesis of relevant evidence, identifies possible courses of action and makes recommendations or key points. The objective of this note is to describe the methodology used to produce a policy brief for communicating public health research. This note is based on the model presented by Eugene Bardach in addition to the authors’ own experiences. We describe six steps: 1) identifying the audience; 2) defining the problem; 3) gathering information and evidence; 4) consideration of policy alternatives; 5) projecting results and designing recommendations; and 6) telling the story. We make a case for the use of policy briefs as a part of an overall communications strategy for research that aims to bring together research teams and stakeholders

[Methodology for the development of policy brief in public health]. / Metodología para el desarrollo de un resumen de evidencia para políticas en salud pública.

A policy brief is a document that summarizes research to inform policy. In a brief and succinct way, it defines a policy problem, presents a synthesis of relevant evidence, identifies possible courses of action and makes recommendations or key points. The objective of this note is to describe the methodology used to produce a policy brief for communicating public health research. This note is based on the model presented by Eugene Bardach in addition to the authors' own experiences. We describe six steps: 1) identifying the audience; 2) defining the problem; 3) gathering information and evidence; 4) consideration of policy alternatives; 5) projecting results and designing recommendations; and 6) telling the story. We make a case for the use of policy briefs as a part of an overall communications strategy for research that aims to bring together research teams and stakeholders.

The Impact of Cultural Dissonance and Acculturation Orientations on Immigrant Students' academic performance / El impacto de la disonancia cultural y las orientaciones de aculturación en el rendimiento académico de estudiantes inmigrantes

Abstract Prior research has documented meaningful differences between school performance of immigrant and native students. Multicultural education has been associated with academic failure of foreign students. The aim of this study was to examine the impact of a set of psychosocial variables on the perceived academic achievement of first generation immigrant adolescents from public secondary schools in Northern Spain. Results showed that 46% of the variability in foreign students' perceived academic performance was explained by home-school cultural dissonance. We also explored the impact of acculturation orientation to separation, perception of discrimination from teachers, school adjustment, and psychological well-being in academic performance. Any multicultural education context should take into account psychosocial adjustment, given its influence on academic performance of all students.

Resumen Se han hallado diferencias significativas entre el rendimiento académico de los inmigrantes y el de los estudiantes nativos. Sin embargo, hay una escasa evidencia acerca de los aspectos psicosociales de este fenómeno. El objetivo de este estudio fue examinar el impacto de un conjunto de variables psicosociales: disonancia cultural y orientaciones de aculturación en el rendimiento académico percibido de adolescentes inmigrantes de primera generación de centros de Educación Secundaria en el Norte de España. Los resultados mostraron que alrededor del 46% de la variabilidad en el rendimiento era explicada por la disonancia cultural entre escuela y hogar. Cualquier contexto de educación multicultural ha de tomar en consideración el ajuste psicosocial, dada su influencia en el rendimiento académico de los estudiantes.

[PELFI Project: Recruitment and Sociodemographic Characteristics of Immigrant and Autochthonous Families from Alicante and Barcelona City Subcohorts]. / Proyecto PELFI: reclutamiento y características sociodemográficas de las familias inmigradas y autóctonas de las sub-cohortes de Alicante y Barcelona.

This study is a part of the multi-centre project "Platform of Longitudinal Studies of Immigrant Families (PELFI)" of the Immigration and Health Subprogram of the CIBER-ESP. It describes the field work and data collection of two sub-cohorts of immigrant and native families, and their main socio-demographic characteristics. Prospective observational cohort study in carried out in Barcelona and Alicante, Spain. The study population is a a non-probabilistic sample of 180 families of Colombian, Ecuadorian and Moroccan origin and 50 families of Spanish origin. We interviewed adults aged 18-65 years and adolescents aged 12-17 years in each family, through two questionnaires (adolescent/adult). The cooperation rate was 82.0% with an average recruitment rate of 1.3 families per day. In total, 250 families have been recruited, 82 from Ecuador, 82 from Colombia, 29 from Morocco and 57 from Spain. A total of 473 adults (59.8% women and 68.5% employed) were surveyed. Immigrant adults have an average of 13 years living in Spain. A total of 304 adolescents (53.9% female, 27.1% born in Spain but with immigrant parents) were surveyed. The combination of non-probabilistic techniques promoted access and improved recruitment speed. This study provides key information for the design and improvement of cohort studies with immigrant families.

Este artículo corresponde al "Proyecto de Estudios Longitudinales de Familias Inmigradas (PELFI)" del Subprograma de Inmigración y Salud del CIBERESP y describe el trabajo de campo basal y principales características socio-demográficas de dos sub-cohortes de familias inmigrantes y autóctonas. El diseño es observacional prospectivo. La población de estudio se definió como una muestra no probabilística de 180 familias de origen colombiano, ecuatoriano y marroquí y 50 españolas. Se entrevistó a a 473 personas adultas entre 18 y 65 años (59,8% mujeres, 68,5% ocupados/as) y a 304 adolescentes entre 12 y17 años (53,9% mujeres, 27,1% nacidos en España pero de padres inmigrados) de cada familia, mediante dos cuestionarios diseñados ad hoc. La tasa de cooperación fue del 82,0% con una velocidad media de reclutamiento de 1,3 familias diarias. En total, se reclutó a 250 familias, 82 procedentes de Ecuador, 82 de Colombia, 29 de Marruecos y 57 españolas. Los adultos inmigrados llevaban una media de 13 años en España. Las combinación de técnicas no probabilísticas permitió el acceso y velocidad de reclutamiento. Este estudio aporta información clave para el diseño y mejora de este tipo de cohortes en familias inmigradas.

Proyecto PELFI: reclutamiento y características sociodemográficas de las familias inmigradas y autóctonas de las subcohortes de Alicante y Barcelona / PELFI proyect: recruiment and sociodemographic characteristics of immigrant and autochthonous families from Alicante and Barcelona city subcohorts

Este artículo corresponde al 'Proyecto de Estudios Longitudinales de Familias Inmigradas (PELFI)' del Subprograma de Inmigración y Salud del CIBERESP y describe el trabajo de campo basal y principales características socio-demográficas de dos sub-cohortes de familias inmigrantes y autóctonas. El diseño es observacional prospectivo. La población de estudio se definió como una muestra no probabilística de 180 familias de origen colombiano, ecuatoriano y marroquí y 50 españolas. Se entrevistó a a 473 personas adultas entre 18 y 65 años (59,8% mujeres, 68,5% ocupados/ as) y a 304 adolescentes entre 12 y17 años (53,9% mujeres, 27,1% nacidos en España pero de padres inmigrados) de cada familia, mediante dos cuestionarios diseñados ad hoc. La tasa de cooperación fue del 82,0% con una velocidad media de reclutamiento de 1,3 familias diarias. En total, se reclutó a 250 familias, 82 procedentes de Ecuador, 82 de Colombia, 29 de Marruecos y 57 españolas. Los adultos inmigrados llevaban una media de 13 años en España. Las combinación de técnicas no probabilísticas permitió el acceso y velocidad de reclutamiento. Este estudio aporta información clave para el diseño y mejora de este tipo de cohortes en familias inmigradas (AU)

This study is a part of the multi-centre project 'Platform of Longitudinal Studies of Immigrant Families (PELFI)' of the Immigration and Health Subprogram of the CIBER-ESP. It describes the field work and data collection of two sub-cohorts of immigrant and native families, and their main socio-demographic characteristics. Prospective observational cohort study in carried out in Barcelona and Alicante, Spain. The study population is a a non-probabilistic sample of 180 families of Colombian, Ecuadorian and Moroccan origin and 50 families of Spanish origin. We interviewed adults aged 18-65 years and adolescents aged 12-17 years in each family, through two questionnaires (adolescent/ adult). The cooperation rate was 82.0% with an average recruitment rate of 1.3 families per day. In total, 250 families have been recruited, 82 from Ecuador, 82 from Colombia, 29 from Morocco and 57 from Spain. A total of 473 adults (59.8% women and 68.5% employed) were surveyed. Immigrant adults have an average of 13 years living in Spain. A total of 304 adolescents (53.9% female, 27.1% born in Spain but with immigrant parents) were surveyed. The combination of non-probabilistic techniques promoted access and improved recruitment speed. This study provides key information for the design and improvement of cohort studies with immigrant families (AU)

Understanding sickness presenteeism through the experience of immigrant workers in a context of economic crisis.

BACKGROUND: Previous economic recessions show that immigrant workers may experience longer periods of unemployment, a situation that may lead employees to presenteeism, the act of working in spite of a health problem. This study explored perceptions about the factors that lead to presenteeism in immigrant workers considering the context of economic crisis. METHODS: Six focus group discussions were held (February 2012), with men and women from Colombia, Ecuador, and Morocco (n=44) living in Spain and selected by theoretical sample. A qualitative content analysis was performed. RESULTS: Four categories were identified as factors that influence the occurrence of presenteeism in a context of economic crisis: poor employment conditions, fear of unemployment, employer/employee relationship, and difficulties in finding temporary replacement workers. Furthermore, musculoskeletal, respiratory, and mental problems were related to presenteeism. CONCLUSIONS: It is important to develop strategies to protect workers from negative working conditions that are associated with deterioration of health.

Preventing and addressing intimate partner violence against migrant and ethnic minority women: the role of the health sector: policy brief

Violence against women is an extreme manifestation of gender inequality in society and a serious violation of fundamental human rights. Intimate partner violence (IPV) is the most common type of such violence and takes place within couples. IPV can lead to death, physical injury, functional impairment, mental health problems, negative health behaviour, chronic conditions and reproductive health problems. Institutional discrimination, lack of access to or knowledge of services, and cultural differences can prevent women who are not only experiencing IPV but also migrants or members of ethnic minorities from seeking help. This policy brief aims to provide input into the role of the health sector in preventing and addressing IPV among migrant women and those of ethnic minorities. It describes the scope of the problem, presenting key evidence, and makes recommendations for health policy and health systems, health facilities and health service providers.

Preventing and addressing intimate partner violence against migrant and ethnic minority women: the role of the health sector

Violence against women is an extreme manifestation of gender inequality in society and a seriousviolation of fundamental human rights. Intimate partner violence (IPV) is the most common typeof such violence and takes place within couples. IPV can lead to death, physical injury, functionalimpairment, mental health problems, negative health behaviour, chronic conditions and reproductivehealth problems. Institutional discrimination, lack of access to or knowledge of services, and culturaldifferences can prevent women who are not only experiencing IPV but also migrants or members ofethnic minorities from seeking help. This policy brief aims to provide input into the role of the healthsector in preventing and addressing IPV among migrant women and those of ethnic minorities. Itdescribes the scope of the problem, presenting key evidence, and makes recommendations for healthpolicy and health systems, health facilities and health service providers.

The health status of latino immigrant women in the United States and future health policy implications of the affordable care act.

Immigrant women of Mexican birth face unique health challenges in the United States. They are at increased risk for developing many preventable health conditions due in part to limited access to healthcare and benefits, legal status, and inadequate income. Increased vulnerability of women has established a growing need to focus on their healthcare needs because of their role, position, and influence in the family. The purpose of this article is to review factors that impact the health status of Mexican-born women living in the United States and review policy implications of the Affordable Care Act for this population. Mexican-born women are the largest female immigrant group in the United States. Therefore, they comprise the group that will need health coverage in the greatest proportion. As a result, there will be a need for culturally and linguistically appropriate healthcare services and culturally sensitive providers.

Las mujeres inmigrantes originarias de México se enfrentan en los Estados Unidos a problemas sanitarios únicos. Corren un alto riesgo de desarrollar muchas patologías prevenibles, en parte debido a su acceso limitado a atención y prestaciones sanitarias, a su estatus legal y a sus ingresos insuficientes. La mayor vulnerabilidad de las mujeres ha hecho que cada vez resulte más apremiante que se centren en sus necesidades de atención sanitaria debido a su papel, posición e influencia en la familia.El objetivo de este artículo es revisar los factores que afectan al estado de salud de las mujeres originarias de México que viven en los Estados Unidos, y las implicaciones en el ámbito de las políticas de la Ley de Cuidado de la Salud Asequible (Affordable Care Act) para esa población.Las mujeres originarias de México constituyen en los Estados Unidos el colectivo inmigrante femenino más numeroso. Por esa razón, conforman el grupo que necesitará cobertura sanitaria en una proporción más alta. Como resultado, surgirá una necesidad de servicios de asistencia sanitaria que sean adecuados desde el punto de vista cultural y lingüístico, y de proveedores de atención culturalmente sensibles.

Differences in working conditions and employment arrangements among migrant and non-migrant workers in Europe.

OBJECTIVE: To determine migrant workers' exposure to select occupational risks and compare it with that of non-migrant workers in Europe. DESIGN: Based on the European Working Conditions Survey (EWCS-2005, n=29,654 workers, 31 countries) we examined differential prevalence amongst migrant and non-migrant workers' primary paid jobs in terms of employment arrangements (working >10 hours/day, working >5 days/week, on Sundays, without a contract, changes in the work schedule and not free to decide when to take holidays or days off) and working conditions (exposure to hazards including chemical, physical agents, physical load and psychological conditions). For the purpose of this study, a migrant is defined as a person without nationality of the country of residence (n=926). Adjusted prevalence ratios (aPRs) for age, economic sector and education were calculated. RESULTS: Differences in employment arrangements and working conditions were noted by migration status, gender and occupational status. Among non-manual workers, migrant males are more exposed than non-migrant males to negative psychosocial conditions--working at a very high speed (aPR 1.23; 95% CI 1.07-1.42) and shift work (aPR 1.66; 95% CI 1.27-2.17)--and adverse employment arrangements: working on Sundays (aPR 1.91; 95% CI 1.42-2.55), variable starting/finishing times (aPR 1.17; 95% CI 1.04-1.32) and changes in work schedule (aPR 1.56; 95% CI 1.30-1.88). Compared with non-migrant males, male migrant manual workers are the group with a greater number of disparities in terms of exposure to negative working conditions. Female migrant non-manual workers are more exposed to psychosocial conditions - working at very high speed (aPR 1.26; 95% CI 1.10-1.44) and shift work (aPR 1.61; 95% CI 1.29-2.01) while female manual migrant workers were more likely to report standing or walking (aPR 2.43; 95% CI 1.98-2.97), not having a contract (aPR 2.94; 95% CI 2.07-4.10) and not being free to decide days off and holidays (aPR 1.25; 95% CI 1.07-1.48) than non-migrants. CONCLUSION: Migrant workers across Europe are more likely to be exposed to certain working and employment arrangements that may place them at higher risk of future health problems.

The effect of perceived discrimination on the health of immigrant workers in Spain.

BACKGROUND: Discrimination is an important determinant of health inequalities, and immigrants may be more vulnerable to certain types of discrimination than the native-born. This study analyses the relationship between immigrants' perceived discrimination and various self-reported health indicators. METHODS: A cross-sectional survey was conducted (2008) amongst a non-random sample of 2434 immigrants from Ecuador, Morocco, Romania and Colombia in four Spanish cities: Barcelona, Huelva, Madrid and Valencia. A factorial analysis of variables revealed three dimensions of perceived discrimination (due to immigrant status, due to physical appearance, and workplace-related). The association of these dimensions with self-rated health, mental health (GHQ-12), change in self-rated health between origin and host country, and other self-reported health outcomes was analysed. Logistic regression was used adjusting for potential confounders (aOR-95%CI). Subjects with worsening self-reported health status potentially attributable to perceived discrimination was estimated (population attributable proportion, PAP %). RESULTS: 73.3% of men and 69.3% of women immigrants reported discrimination due to immigrant status. Moroccans showed the highest prevalence of perceived discrimination. Immigrants reporting discrimination were at significantly higher risk of reporting health problems than those not reporting discrimination. Workplace-related discrimination was associated with poor mental health (aOR 2.97 95%CI 2.45-3.60), and the worsening of self-rated health (aOR 2.20 95%CI 1.73- 2.80). 40% (95% CI 24-53) PAP of those reporting worse self-rated health could be attributable to discrimination due to immigrant status. CONCLUSIONS: Discrimination may constitute a risk factor for health in immigrant workers in Spain and could explain some health inequalities among immigrant populations in Spanish society.

Health of migrants: working towards a better future.

For international migrants, in particular for those who cross without the required documentation, there are a number of health threats and problems that may begin during transit and a number that occur as a result of migrants' socio-economic status in the receiving country. This article discusses the health status of Mexican immigrants in the United States including their access to health care, health disparities, and the social determinants of health among this population, with a focus on the health of women and children.

Sickness presenteeism in Spanish-born and immigrant workers in Spain.

BACKGROUND: Previous studies have shown that immigrant workers face relatively worse working and employment conditions, as well as lower rates of sickness absence than native-born workers. This study aims to assess rates of sickness presenteeism in a sample of Spanish-born and foreign-born workers according to different characteristics. METHODS: A cross-sectional survey was conducted amongst a convenience sample of workers (Spanish-born and foreign-born), living in four Spanish cities: Barcelona, Huelva, Madrid and Valencia (2008-2009). Sickness presenteeism information was collected through two items in the questionnaire ("Have you had health problems in the last year?" and "Have you ever had to miss work for any health problem?") and was defined as worker who had a health problem (answered yes, first item) and had not missed work (answered no, second item). For the analysis, the sample of 2,059 workers (1,617 foreign-born) who answered yes to health problems was included. After descriptives, logistic regressions were used to establish the association between origin country and sickness presenteeism (adjusted odds ratios aOR; 95% confidence interval 95%CI). Analyses were stratified per time spent in Spain among foreign-born workers. RESULTS: All of the results refer to the comparison between foreign-born and Spanish-born workers as a whole, and in some categories relating to personal and occupational conditions. Foreign-born workers were more likely to report sickness presenteeism compared with their Spanish-born counterparts, especially those living in Spain for under 2 years [Prevalence: 42% in Spanish-born and 56.3% in Foreign-born; aOR 1.77 95%CI 1.24-2.53]. In case of foreign-born workers (with time in Spain < 2 years), men [aOR 2.31 95%CI 1.40-3.80], those with university studies [aOR 3.01 95%CI 1.04-8.69], temporary contracts [aOR 2.26 95%CI 1.29-3.98] and salaries between 751-1,200€ per month [aOR 1.74 95% CI 1.04-2.92] were more likely to report sickness presenteeism. Also, recent immigrants with good self-perceived health and good mental health were more likely to report presenteeism than Spanish-born workers with the same good health indicators. CONCLUSIONS: Immigrant workers report more sickness presenteeism than their Spanish-born counterparts. These results could be related to precarious work and employment conditions of immigrants. Immigrant workers should benefit from the same standards of social security, and of health and safety in the workplace that are enjoyed by Spanish workers.