Objective: Cardio-metabolic diseases are highly prevalent among ethnic minority groups in Europe. However, information on health needs of undocumented immigrants, especially regarding risk factors, are lacking. The aim of this study was to examine prevalence, awareness and treatment of hypertension, diabetes mellitus, and hypercholesterolemia in a large cohort of undocumented and documented (registered with National Health Service, NHS) Chinese immigrants living in Italy. Design and method: Population-based, cross-sectional study. Chinese first-generation immigrants living in Prato, underwent blood pressure (BP) measurement, blood tests (fasting glucose, FG, and total cholesterol, TC), and anthropometric measurements. Hypertension was diagnosed for BP>140/90 mmHg at two visits, and/or BP-lowering medication use; type 2 diabetes for FG>126 mg/dL at two visits, and/or glucose lowering drugs use; hypercholesterolemia for TC>240 mg/dL and/or statins use. Undocumented and documented migrants were compared via logistic regression analysis adjusted for age, gender, central obesity, and educational level. Results: A large proportion of investigated Chinese immigrants (3435) were undocumented (1766, 51% with 1669, 49% registered with NHS). At logistic regression analysis, prevalence of hypertension was similar between the two groups, while prevalence of diabetes and hypercholesterolemia was higher among undocumented migrants, despite having a younger age and a lower prevalence of central obesity. Registration to NHS was associated with a higher awareness and prevalence of treated subjects for hypertension and diabetes. More precisely, registered migrants were 6 times more treated for type 2 diabetes than undocumented migrants. A small minority of subjects were treated with statins independently from NHS registration. Conclusions: Undocumented migrants seem to represent a large proportion of the Chinese migrant population living in Italy; undocumented migrants had lower levels of awareness and rate of treatment for hypertension and type 2 diabetes than migrants registered in the NHS. Acute treatment for stroke and myocardial infarction is guaranteed to all subjects regardless of NHS registration in Italy as in the majority of European countries. Health policies targeting this hard-to-reach population must be improved.
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