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Open Access Research article

What are the living conditions and health status of those who don’t report their migration status? a population-based study in Chile

Baltica Cabieses12*, Kate E Pickett3 and Helena Tunstall4

Author Affiliations

1 Lecturer at the Faculty of Medicine, Universidad del Desarrollo, Av. Las Condes 12.438, Lo Barnechea, Santiago, Chile

2 Visiting scholar at the Department of Health Sciences, University of York, Second Floor ARRC Building, Heslington, York, YO10 5DD, UK

3 Professor at the Department of Health Sciences, University of York, Seebohm Rowntree Building, Area 3 Heslington, York, YO10 5DD, UK

4 Research Fellow at the School of GeoSciences, University of Edinburgh, Geography Building, Drummond Street, Edinburgh, EH8 9XP, UK

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BMC Public Health 2012, 12:1013  doi:10.1186/1471-2458-12-1013

Published: 21 November 2012

Abstract

Background

Undocumented immigrants are likely to be missing from population databases, making it impossible to identify an accurate sampling frame in migration research. No population-based data has been collected in Chile regarding the living conditions and health status of undocumented immigrants. However, the CASEN survey (Caracterizacion Socio- Economica Nacional) asked about migration status in Chile for the first time in 2006 and provides an opportunity to set the base for future analysis of available migration data. We explored the living conditions and health of self-reported immigrants and respondents who preferred not to report their migration status in this survey.

Methods

Cross-sectional secondary analysis of CASEN survey in Chile in 2006. Outcomes: any disability, illness/accident, hospitalization/surgery, cancer/chronic condition (all binary variables); and the number of medical/emergency attentions received (count variables). Covariates: Demographics (age, sex, marital status, urban/rural, ethnicity), socioeconomic status (education level, employment status and household income), and material standard of living (overcrowding, sanitation, housing quality). Weighted regression models were estimated for each health outcome, crude and adjusted by sets of covariates, in STATA 10.0.

Results

About 1% of the total sample reported being immigrants and 0.7% preferred not to report their migration status (Migration Status - Missing Values; MS-MV). The MS-MV lived in more deprived conditions and reported a higher rate of health problems than immigrants. Some gender differences were observed by health status among immigrants and the MS-MV but they were not statistically significant. Regressions indicated that age, sex, SES and material factors consistently affected MS-MVs’ chance of presenting poor health and these patterns were different to those found among immigrants. Great heterogeneity in both the MS-MV and the immigrants, as indicated by wide confidence intervals, prevented the identification of other significantly associated covariates.

Conclusion

This is the first study to look at the living conditions and health of those that preferred not to respond their migration status in Chile. Respondents that do not report their migration status are vulnerable to poor health and may represent undocumented immigrants. Surveys that fail to identify these people are likely to misrepresent the experiences of immigrants and further quantitative and qualitative research is urgently required.

Keywords:
Self-reported health; Population-based study; Missing data; Immigrants; Undocumented immigration; Socioeconomic status