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Moroccan Immigrants in Italy

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Moroccan Immigrants in Italy EUNAM FP7- HEALTH-2010 EU and North African Migrants: Health and Health Systems Moroccan immigrants in Italy Meriem Khyatti Institut Pasteur du Maroc and Emanuela Gualdi, StefaniaToselli Ferrara Meeting Sept. 8 – 9, 2011 Ferrara and Bologna Universities, Italy Moroccan immigration in Italy: a brief history First Moroccan immigrants worked in agriculture and as street vendors of carpets and handicrafts; the immigrants flow moved from southern Italy to northern Italy owing to better employment opportunities; first Moroccans (from Khouribga) arrived in Milan in the ’70s, in Turin in the '80s; about 60% of the Moroccan immigrants is located in three Italian regions: Lombardy, Piedmont, Emilia-Romagna; the phase of family reunification started since the ’90s; the presence of women in the Moroccan community is about 40%, on average, Moroccan immigrants in Italy: demographic trend Ferrara Meeting Sept. 8 – 9, 2011 Immigration in Italy +47.5% Overall in the same period, the increase was 14.4% in the European Union. Italy: a multicultural society ISTAT data updated to January 2010 Immigrants by geographical area and by sex ISTAT data updated to January 2010 Foreign population - first 16 countries- 2,148,457 •People from these 16 countries account for 75% of the foreign population resident in Italy. •Foreign people from the first five countries exceed 50% of the foreign population resident in Italy. Marocco, sett.09, RACINE -Mapping. Project financed by the European Return Fund Regular immigrants from Morocco to Italy +44% During the same period there was an increasing percentage of females in Moroccan community linked to . the increasing propensity of Moroccan immigrants to family reunification Distribution of Moroccans of both sexes in Italy • Prevalence of males (in blue) in the Moroccan community (about 60%). •The stabilization areas (in green) are still few. Marocco, sett.09, RACINE -Mapping. Project financed by the European Return Fund Age of Moroccans in Italy in comparison with Italians •The age pyramid for the Italians is very different from that of Moroccan immigrants, owing to the dramatic drop in births and the spread in life expectancy. • There is a prevalence of Moroccans in the working age-group “25-50 years”. • A balance between the sexes is present up to 30 years of age. • 55 % of Moroccan immigrants lives in Lombardy, Emilia- Romagna and Piedmont. Moroccan citizens resident per 1,000 Italians • High incidence of Moroccan immigrants in the industrialized area of Northern Italy. • Anomalous high incidence of Moroccans in some municipalities of Central -L’Aquila- and Southern Italy –Catanzaro-. Moroccan citizens resident per 1,000 Italians • Moroccans in Emilia-Romagna region Comune di Bologna data – Aprile 2010 Moroccan citizens resident in Bologna from Dec.31,1986 to Dec.31, 2009 • From a small group in 1986, Moroccans exceeded 1,000 units in 1994; • Moroccans are one of the largest foreign communities in Bologna; • Their number is currently about 7.5% of foreigner residents in Bologna. Moroccan males and females resident in Bologna •Males are prevalent in Moroccan community. Moroccan male and female citizens resident in Bologna ( from Dec.31,1986 to Dec.31, 2009) Males Females • The presence of Moroccan women increased over the time: from 15% in 1989 to 45% at the end of 2009. • Family reunification influenced this trend. Age of Moroccans resident in Bologna (Dec.31, 2009) 47.4 in Bolognese population •Moroccan community in Bologna is quite young. •78% of the community falls in age- group “0 - 44 years”. • The average age of the Moroccan citizens (31.9 years) resident in Bologna is significantly lower than the average age of the population of Bologna (47.4 years). Moroccan immigrants in Italy: health and nutritional status Ferrara Meeting Sept. 8 – 9, 2011 •There is a tendency of immigrants to acquire chronic diseases in the host country (Ngo et al., 2000). • The predisposition to chronic diseases may be amplified by environmental factors (diet, low physical activity, stress, low quality of life and health care) (Ngo et al., 2009; Gilbert and Khokhar, 2008). • The close association between changes in lifestyle and increased incidence of obesity was reported in immigrants ( Patel et al., 2006; Jorgensen et al., 2006; Toselli et al, 2008). • In Italy there are low hospitalization rates for foreigners not related to good health status, but to administrative, linguistic and cultural barriers (Cacciani et al, 2006). •Cardiovascular diseases cause 36.6% of the immigrants deaths (Gaudio et al., 2004).Therefore it is important to evaluate their health and CVD risk. •Some anthropometric traits and indices may be used as a measure of metabolic and cardiovascular risks. In addition to BMI, waist circumference is considered the best marker of central adiposity (Jansen et al, 2002). • Studies were carried out in Italy to analyze anthropometric characteristics, weight status, adiposity patterns, and hypertension in immigrants and to assess their susceptibility to disease with reference to obesity and cardiovascular response (Toselli et al, 2008; Gualdi-Russo et al., 2009). Toselli et al., 2008 Longitudinal study on North-African immigrants (90% of Moroccans, 10% of Tunisians) - anthropometric data from 1990 to 2000- 140 120,0 126,5 120 '90 2000 100 80,0 80,0 74,1 80 68,2 60 42,5 46,5 40 23,3 25,2 20 0 weight BMI syst. b. press. dias. b. press. dif. press. • Weight and BMI increased after 10 yrs of permanence in Italy. • The mean BMI value indicated an overweight condition (BMI>25) after a decade. • Blood pressure increased during the same period . Toselli et al., 2008 Longitudinal study on North-African immigrants (90% of Moroccans, 10% of Tunisians) - percentage of nutritional disorders from 1990 to 2000- • Trend in nutritional disorders after ten years: underweight subjects disappeared; there was an increase in overweight and a decrease in normal weight; obese subjects appeared. • Immigrants may develop the risk of obesity-related comorbidities. Gualdi-Russo et al., 2009 Percent distribution of immigrants in underweight, overweight and obese subjects and prevalence of central adiposity (WC: >102 in males;>88 cm in females) and of hypertension (SBP≥140 or DBP≥90 mm/Hg). ETHNIC Central Hypertensive GROUP BMI <18.5 25.0≤ BMI <29.9 BMI ≥30 adiposity subjects % % % % % SENEGALESE - Males 7.9 21.1 5.3 - 35.0 MOROCCANS - Males - 1.6 44.1 7.1 15.0 18.2 Fem. 15.4 46.2 23.1 54.5 0.0 TUNISIANS - Males 0 33.3 13.3 14.3 22.2 PAKISTANIS - Males 12.8 25.6 0 13.9 15.4 KOSOVARS - Males - 10.0 30.0 30.0 37.5 36.4 Fem. 0 33.3 40.0 83.3 5.3 ROMA - Males - 0 35.5 32.3 37.5 33.3 Fem. 15.4 33.3 12.8 32.1 23.5 • Moroccan immigrants (+Kosovars and Gypsies) had a particularly high prevalence (> 50%) of overweight/obesity (BMI>25 kg/m 2 ). •High percentage of subjects with central adiposity was found in female Moroccans (+Kosovars). Gualdi-Russo et al., 2009 Prevalence of immigrants at high CVD risk ( hypertension plus overweight/obesity and waist circumference (WC) > 102 in males or hypertension plus WC > 88 in females) •There was a significantly high variability in the prevalence of CVD risk among different ethnic groups. •The prevalence was low in Moroccan males. No subject with high CVD risk was observed among Moroccan women. In conclusion: Our previous studies confirm the general problem of obesity in Italian immigrants. The overall percentages of overweight/obesity are similar to those of native Italians for males, but they are higher in immigrant females, especially in Moroccans (Gualdi-Russo et al,09; ISTAT, 08). In Morocco and Tunisia overweight is on the rise in both sexes. However the prevalence of obesity (and central adiposity) is higher in Moroccans living in Italy (Gualdi-Russo et al,’09) than in Morocco (Mokhtar et al, ‘01; Rguibi and Belahsen, ‘07). Some major risk factors, such as diabetes, smoking and obesity, are more prevalent among Moroccan minorities than among the native European population (El Fakiri et al, ‘08) Since diabetes is one of the most prevalent cardiovascular risk factors among all ethnic minorities at risk of developing CVD, particularly Moroccans, (El Fakiri et al, ‘08) and the tendency to an health decline as the time since immigration increases was observed in Moroccans (Toselli et al,’08 ) the need for further research concerning the relationship between obesity and CVD risk and to tailor interventions for different ethnic groups in general practices is evident. EUNAM FP7- HEALTH-2010 EU and North African Migrants: Health and Health Systems Moroccan immigrants in Italy Meriem Khyatti Institut Pasteur du Maroc and Emanuela Gualdi, StefaniaToselli Ferrara Meeting Sept. 8 – 9, 2011 Ferrara and Bologna Universities, Italy.
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