title: Use of different subjective health indicators to assess health inequalities in an urban immigrant population in north-western Italy: a cross-sectional study.
abstract: BACKGROUND
  Despite the steady growth of the immigrant population in Italy, data on the health status of immigrants are scarce. Our main goals were to measure Health-Related Quality of Life (HRQoL), Self-Rated Health (SRH) and morbidity among immigrants in Genoa. We aimed to assess the relative contribution of some social, structural and behavioral determinants to "within-group" health disparities.
  
  
  METHODS
  We enrolled 502 subjects by means of snowball sampling. The SF-12 questionnaire, integrated with socio-demographic and health-related items, was used. Multivariate logistic and Poisson regression models were applied in order to identify characteristics associated with poor SRH, lower SF-12 scores and prevalence of self-reported morbidities.
  
  
  RESULTS
  Subjects showed relatively moderate levels of HRQoL (median physical and mental scores of 51.6 and 47.3, respectively) and about 15% of them rated their health as fair or poor. Lower scores in the physical dimension of HRQoL were associated with the presence of morbidities and immigration for work and religious reasons, while those who had migrated for religious and family reasons displayed a lower probability of lower scores in the mental dimension of HRQoL. Poor SRH was associated with female gender, overweight/obesity and presence of morbidities. Moreover, compared with immigrants from countries with a low human development index, immigrants from highly developed societies showed significantly lower odds of reporting poor SRH. About one-third of respondents reported at least one medical condition, while the prevalence of multi-morbidity was 10%. Females, over 45-year-olds, overweight and long-term immigrants had a higher prevalence of medical conditions.
  
  
  CONCLUSIONS
  Our study confirms the presence of health inequalities within a heterogeneous immigrant population. HRQoL, SRH and morbidity are valid, relatively rapid and cheap tools for measuring health inequalities, though they do so in different ways. These indicators should be used with caution and, if possible, simultaneously, as they could help to identify and to monitor more vulnerable subjects among immigrants.
authors.forename: Alexander
authors.initials: A
authors.lastname: Domnich
authors.forename: Daniela
authors.initials: D
authors.lastname: Amicizia
authors.forename: Donatella
authors.initials: D
authors.lastname: Panatto
authors.forename: Alessio
authors.initials: A
authors.lastname: Signori
authors.forename: Valentina
authors.initials: V
authors.lastname: Perelli
authors.forename: Sergio
authors.initials: S
authors.lastname: Adamoli
authors.forename: Edoardo Berti
authors.initials: EB
authors.lastname: Riboli
authors.affiliation: Department of Health Sciences, University of Genoa, via Pastore, 1-16132, Genoa, Italy. gasparini@unige.it.
authors.forename: Roberto
authors.initials: R
authors.lastname: Gasparini
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D054242:Emigrants and Immigrants; D004641:Emigration and Immigration; D005190:Family; D005260:Female; D006304:Health Status; D054624:Health Status Disparities; D006305:Health Status Indicators; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012067:Religion; D057566:Self Report; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014505:Urban Population; D014937:Work; D055815:Young Adult