High prevalence of comorbidities at diagnosis in immigrants with multiple sclerosis

Background: Multiple sclerosis (MS) has been associated with certain comorbidities in general population studies, but it is unknown how comorbidity may affect immigrants with MS. Objective: To compare prevalence of comorbidities in immigrants and long-term residents at MS diagnosis, and in matched control populations without MS. Methods: We identified incident MS cases using a validated definition applied to health administrative data in Ontario, Canada, from 1994 to 2017, and categorized them as immigrants or long-term residents. Immigrants and long-term residents without MS (controls) were matched to MS cases 3:1 on sex, age, and geography. Results: There were 1534 immigrants and 23,731 long-term residents with MS matched with 4585 and 71,193 controls, respectively. Chronic obstructive pulmonary disease (COPD), diabetes, hypertension, ischemic heart disease, migraine, epilepsy, mood/anxiety disorders, schizophrenia, inflammatory bowel disease (IBD), and rheumatoid arthritis were significantly more prevalent among immigrants with MS compared to their controls. Prevalence of these conditions was generally similar comparing immigrants to long-term residents with MS, although COPD, epilepsy, IBD, and mood/anxiety disorders were less prevalent in immigrants. Conclusion: Immigrants have a high prevalence of multiple comorbidities at MS diagnosis despite the “healthy immigrant effect.” Clinicians should pay close attention to identification and management of comorbidity in immigrants with MS.

Effect of Health Comorbidities on Death from COVID-19 in Immigrants in Mexico

BackgroundComorbidities increase the risk of death for patients with COVID-19, however, little is known about how comorbidities affect immigrants, as well as their prognosis in the case of contracting the virus. Therefore, this article aims to determine which comorbidities are associated with the probability of death among immigrants in Mexico. Methods We use a sample of migrants (N = 3,567) registered in the public database published in the National Epidemiological Surveillance System of the Mexican Ministry of Health; the technique used was a Probit regression. Results The results show that comorbidities commonly associated with death from COVID-19, are not significant when present in immigrants, also, migrants have fewer comorbidities than the native born. These findings could be explained by the Healthy Immigrant Effect, which states that migration is a self-selection process, in which those who migrate are the healthiest. However, the cases of migrants who have died from COVID-19 are related to the time they have taken to go to hospitals and to problems of access to health care.ConclusionsThe immigrant populations (especially those in transit and refugees) do pose certain challenges to public policies in the countries of destination, so specific measures need to be taken in order to protect immigrant communities from the spread of the virus. It is important to improve the conditions during the migratory journey, avoiding overcrowding, as well as testing in various places (shelters, immigration controls, among others) in order to determine the levels of positivity in this group. ​However, the detection of more cases of COVID-19 among immigrants, should not equal to the denial for entry. Formal mechanisms should be put into place to guarantee the right to asylum and non-refoulement, even for migrants who test positive for the virus.

Do Not Disturb/Please Clean Room: The Invisible Work and Real Pain of Hotel Housekeepers in the GTA

The hotel industry in the GTA is dependent on cheap, racialized and gendered work; the result has been significant poor health outcomes for immigrant women of colour who are over represented in this industry. This paper explores the larger structural processes intensified by neoliberal globalism that leads to the racialized segregated labour of immigrant women of colour working as hotel housekeepers. This will begin by critically analyzing the organization of the economy and the "global city" through a feminist political economy approach and by linking the downward trajectory in immigrant health to the Health Immigrant Effect and gaps in the Population Health Approach. This will be highlighted by personal narratives from immigrant women of colour currently working as housekeepers in the GTA, who have shared their stories and how they are actively contesting and negotiating with their spaces of precarious employment to promote and increase health and well being at work, in their homes and within their communities.

Do Not Disturb/Please Clean Room: The Invisible Work and Real Pain of Hotel Housekeepers in the GTA

The hotel industry in the GTA is dependent on cheap, racialized and gendered work; the result has been significant poor health outcomes for immigrant women of colour who are over represented in this industry. This paper explores the larger structural processes intensified by neoliberal globalism that leads to the racialized segregated labour of immigrant women of colour working as hotel housekeepers. This will begin by critically analyzing the organization of the economy and the "global city" through a feminist political economy approach and by linking the downward trajectory in immigrant health to the Health Immigrant Effect and gaps in the Population Health Approach. This will be highlighted by personal narratives from immigrant women of colour currently working as housekeepers in the GTA, who have shared their stories and how they are actively contesting and negotiating with their spaces of precarious employment to promote and increase health and well being at work, in their homes and within their communities.

A Global Meta-analysis of the Immigrant Mortality Advantage

A large body of research on the “Healthy Immigrant Effect” (or “Paradox”) has reported an immigrant mortality advantage. However, other studies do not find such significant effects, and some even present contradictory evidence. This article is the first systematic meta-analysis that investigates the immigration-mortality relationship from a global perspective, examining 1,933 all-cause and cardiovascular mortality risk estimates from 103 publications. Our comprehensive analysis allows us to assess interactions between origin and destination regions and to reexamine, on a global scale, some of the most notable explanations for the immigrant mortality advantage, including suggestions that this paradox may be primarily the result of selection effects. We find evidence for the existence of a mild immigrant mortality advantage for working-age individuals. However, the relationship holds only for immigrants who moved between certain world regions, particularly those who immigrated from Northern Africa, Asia, and Southern Europe to richer countries. The results highlight the need in the broader migration literature for an increased focus on selection effects and on outcomes for people who chose not to migrate or who were denied entry into their planned destination country.