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Abstract
BackgroundUndocumented migrants endure adverse living conditions while facing barriers to access healthcare. Evidence is lacking regarding their healthcare needs, notably in regards to chronic diseases. Our goal was to investigate health conditions in undocumented migrants attended in primary care setting.MethodsThis study was conducted at the primary care outpatient clinic, Geneva University Hospitals, Switzerland. We retrospectively recorded and coded all medical conditions of a random sample of 731 undocumented migrants using the International Classification of Primary Care, 2nd version (ICPC-2). We dichotomized conditions as chronic or non-chronic and considered multimorbidity in the presence of three or more chronic conditions.ResultsParticipants originated from 72 countries and were mainly female (65.5%) with a mean age of 42.4 (standard deviation [SD]: 11.4) years. They presented a mean of 2.9 (SD: 2.1; range: 1–17) health conditions. In multivariable analysis, the number of conditions was associated with female gender (p = 0.011) and older age (p <0.001), but not with origin (p = 0.373). The body systems most frequently affected were endocrine, metabolic and nutritional (n = 386; 18.4%), musculoskeletal (n = 308, 14.7%) and digestive (n = 266, 12.8%). Hypertension (17.9%; 95% CI: 15.2%, 29.9%), obesity or overweight (16%; 95% CI: 13.4%, 18.9%) and gastric problems (14.1%; 95% CI: 11.6%, 16.8%) were most prevalent. Overall, 71.8% (95% CI: 68.5%, 75%) participants had at least one chronic condition while 20% (95% CI: 17.2%, 23.1%) had three or more. In multivariable analysis, age (p <0.001) was the only predictor of presenting at least one or three or more chronic conditions.ConclusionsUndocumented migrants present multiple health problems in primary care settings and bear an important burden of chronic diseases. The extent of multimorbidity highlights the need to provide and facilitate the access to comprehensive and long-term primary healthcare services.
Highlights
Migration caused by political instability, socioeconomic disparities and environmental events has become a global issue entailing major health challenges, notably access to health services in destination countries
Participants originated from 72 countries and were mainly female (65.5%) with a mean age of 42.4 years
Hypertension (17.9%; 95% confidence intervals (95% CI): 15.2%, 29.9%), obesity or overweight (16%; 95% CI: 13.4%, 18.9%) and gastric problems (14.1%; 95% CI: 11.6%, 16.8%) were most prevalent
Summary
Migration caused by political instability, socioeconomic disparities and environmental events has become a global issue entailing major health challenges, notably access to health services in destination countries. In 2008, it was estimated that there were 1.9–3.8 million undocumented migrants in the 27 European Union countries [3] They commonly lack access to basic social services and policies regulating their access to the healthcare system differ between and within countries [4, 5]. Out-of-pocket payment, administrative barriers and fear of denunciation are key factors that impede undocumented migrants to adequately engage with health services. These barriers are associated with potentially severe health consequences for migrants and result in insufficient medical attention to chronic diseases [5,6,7]. Our goal was to investigate health conditions in undocumented migrants attended in primary care setting
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