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Selected social determinants of health in immigrants in some regions of the Czech Republic
BRABCOVÁ, Iva
The main aim of the research was to map the influence of selected social determinants on health of target immigrant groups. The method was based on the concept of ten social determinants of health as introduced by Wilkinson and Marmot (2003). The quantitative method used were interviews. The survey was carried out in the period from January 2010 to December 2012. Data collection was carried out in two stages. In the first stage, the influence of two social determinants of health (nutrition and addiction) on the respondents' state of health was investigated. The second stage of the survey focused on working conditions and on how respondents can use health care. 246 immigrants were interviewed in the first stage of the survey. They were from the following regions: South Bohemian Region, the capital Prague and Vysočina Region. 236 immigrants from two regions (South Bohemian Region and the capital Prague) were addressed in the second stage of the survey. They were legally settled immigrants in the age group 18 65, of Vietnamese, Mongolian and Ukrainian nationality. The results of the survey clearly show that the target immigrant groups are more exposed to unfavorable working conditions than majority population. Compared to the Czech population the target immigrant groups show statistically significant differences especially in the area of excessive workload and discrimination in the workplace. Increasing incidence of unfavorable working conditions resulted in significant increase in occupational diseases. The factors influencing use of healthcare by immigrants are the type of health insurance, length of residence, sex and knowledge of Czech language. Immigrants who had entered the system of public health insurance used healthcare much more frequently than immigrants with commercial health insurance. Male immigrants smoke and drink alcohol much more heavily than female immigrants. The young generation of immigrants (aged 18 to 29) smoke statistically more significantly than the middle-aged and older generation of immigrants. Middle-aged immigrants (aged 30 to 50) consume more wine and spirits. Their health was perceived subjectively as "worse" by those respondents who at the same time mentioned chronic pain and psychic stress in the workplace. The following measures could lead to elimination of social inequality and to improvement of immigrants' situation in the Czech Republic: equal working conditions for immigrants and Czech employees, improvement of immigrants' knowledge of Czech, shortening of the overall time for obtaining permanent residence, simplification of the terms for gaining citizenship, guarantee of access to public healthcare to all legally settled immigrants.
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