Health, wellbeing and access to care of undocumented migrants in Geneva, Switzerland

Abstract

Abstract Background Switzerland hosts 50’000 to 100’000 undocumented migrants but hardly any evidence exist about their health and wellbeing. A pilot regularization policy took place in Geneva (2017-2018). Methods Parchemins is a mixed-methods prospective study assessing the impact of legal status regularization on undocumented migrants’ health and wellbeing. The quantitative data collection uses yearly face-to-face health questionnaire. Wellbeing is measured by self-reported satisfaction with life on a 10-point Likert scale. We present the results of the first wave of data collection conducted before regularization. Results Participants were mainly women (71.9%) from Latin America (63.2%), aged 44.2 (SD 10.4) years, with secondary or higher education (77.3%), living in Geneva with a partner (47.6%) and minor children (22.3%) for an average of 11.8 (SD 5.4) years. While 82.2% reported good to excellent health, 54% presented overweight or obesity and 21% suffered 3 or more chronic conditions. Self-reported prevalence of hypertension, hypercholesterolemia and diabetes were 17.6%, 7.6% and 4.9%, respectively. Screening for depression and anxiety using PHQ-9 and GAD-7 scales was positive in 45.2% and 35.9% of participants. Only 29.9% had a health insurance. In the previous year, 74.8% had at least one medical consultation and 30.4% consulted in emergency but 27% had renounced to seek care for economic reasons. Overall, 97.3% were exposed to health hazards at the workplace and 5.9% suffered an accident leading to work interruption in the last 6 months. Overall, life satisfaction level amounted to 7.4 (SD 2.2) out of 10. Conclusions The baseline results show a contrast between good self-reported health and fair wellbeing with frequent comorbid health conditions notably of mental origin, exposure to occupational hazards and economic limitations in the ability to respond to one’s health care needs. Next study waves will shade light on the public health and clinical impact of regularization. Key messages Legal status may act as a key determinant of health therefore regularization is likely to produce significant health effects. Undocumented migrants good wellbeing and self-reported health contrasts with high morbidity notably of mental origin.