Perceived ethnic discrimination as a determinant of migrants’ health in Italy
| Published date | 01 April 2022 |
| Author | Valeria Quaglia,Marco Terraneo,Mara Tognetti |
| Date | 01 April 2022 |
| DOI | http://doi.org/10.1111/imig.12863 |
International Migration. 2022;60:107–125.
|
107
wileyonlinelibrary.com/journal/imig
ETHNIC DISCRIMINATION AND HEALTH
The proportion of foreign- born migrants has grown considerably in all European countries. By January 2018, a
total of 22.3 mill ion people (4.4% of the EU- 28 population) res ided in an EU Member State with citize nship of a
non- mem ber country (Eurostat , 2019). In absolute terms, the five EU Me mber States with the highes t number of
non- nationals residents were Germany (9.7 million persons), the United Kingdom (6.3 million), Italy (5.1 million),
France (4.7 million) and S pain (4.6 million) (Ibidem). Re cent data show that at 31 Dece mber 2019, in Italy 5.306.54 8
Received: 21 Oct ober 2020
|
Revised: 9 April 2 021
|
Accepted: 12 Apri l 2021
DOI: 10 .1111/imig .12863
ORIGINAL ARTICLE
Perceived ethnic discrimination as a determinant
of migrants’ health in Italy
Valeria Quaglia1| Marco Terraneo1| Mara Tognetti2
This is an open ac cess article und er the terms of the Crea tive Commons Attr ibution License, w hich permits use , distribution an d
reproduct ion in any medium, pro vided the origina l work is properly cit ed.
© 2021 The Author s. International Migration published by John Wil ey & Sons Ltd on behalf of In ternational Org anization for
Migration.
1Università degli Studi di Milano- Bicocca,
Milano, Italy
2Università d egli Studi di Napoli Fe derico II,
Napoli, Italy
Correspondence
Università degli Studi di Milano- Bicocca
Milano, Italy.
Email: valeria.quaglia@unimib.it
Abstract
Discrimination has a ne gative impact on immigrants’ he alth
and contributes to the (re)p roduction of health inequ alities.
The aim of this study was to investigate the effect of per-
ceived discrimination on physical and mental health out-
comes of migrants liv ing in Italy. Data were taken from the
Social Condition an d Integration of Foreign Citizens (SCIF)
survey, conducted in 2011– 2012 in Italy, namely the first
national survey that i nvestigates social co ndition and inte-
gration of foreign citizens. In order to assess the associa-
tion between perceived discrimination and both physical
and mental health of immigrants, two binomial logistic re-
gression models were f itted. The main finding of our stu dy
is that, also in Italy, perceived ethnic discrimination is as-
sociated with worse health outcomes, therefore, policy-
makers should develop and implement public interventions
aimed at reducing health inequalities with the rest of the
population and at pro moting migrants’ social integration .
108
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QUAGLIA etAL.
foreign citizens re sided in the country ; compared to 1 January 2019, they incre ased by 127 thousand unit s, repre-
senting the 8. 8 per cent of the total resident p opulation (ISTAT, 2020).
The overall health and well- being of migrants in Italy are of considerable interest for policymakers and re-
searchers. Re cently, attention has been drawn towa rds this issue from the recognitio n that the significant pres-
ence of migrants i n Italy places a stra in on the ability of the h ealthcare system to adequately respon d to the health
needs of those individuals who – because of their socio- economic conditions and culture – might present greater
health risk comp ared to non- migra nts (Tognetti Bordogna, 2 015).
As it has b een widely ackno wledged in the lite rature, with the exception of migrant s who flee a per secution,
climate change, env ironmental disasters or w ar, first- gene ration migrants usually have b etter overall health than
native- bor n population (Mackenbach et al., 2 005), this mainly because of t he so- called “healthy migr ant effect”:
namely, only indivi duals that are actuall y able both to undert ake the migratory jour ney and to work in the countr y
of destination usually migrate. Nevertheless, this initial health advantage is found to diminish significantly and
progressively with increasing length of reside nce, because over the years migra nts are exposed to several social
factors tha t impinge on their health st atus, such as povert y, substandard living condi tions, low- income s tatus and
ethnic discrimination. In this paper, we will focus on the latter.
Ethnic discrimin ation is based on prejudice, na mely the tendency to unjus tifiably consider in an unf avourable
way people that be long to a specific ethnic or nat ional group. When prejudice i nforms practices and be haviours,
discriminatio n occurs and causes unequal treatment to the disadvanta ge of marginalized groups (Allp ort, 1954).
Discrimi nation may take many d ifferent forms – this might include , for example, ins titutional, s tructural, interper-
sonal, overt an d covert, legal and illegal d iscrimination (Krieger, 1999) – and in a ll cases such processes conti nue
to drive and reinforce social relations of dominance and oppression, maintaining privileges of dominant groups at
the detriment of s ocially defined subord inate groups (Simon, 2013).
This paper focuses on the relationship between perceived ethnic discrimination – namely the perception
of being discriminated against because of one's geographical or ethnic origins – and migrants’ general health.
Underlying there is the assumption that health inequalities are not the mere result of intrinsic biological dif fer-
ences among individuals, they are rather a complex combination of social, psychological and biological processes1..
Studies have shown that ethnic discr imination negatively affec ts life expectancy (Wilk inson, 1996) and the overall
health of those who exp erience it (Clark et al., 1999; Krieger, 1999, 2000; Meyer, 2003; Pas coe & Smart Richman,
2009; William s et al., 2003) accelera ting cellular ageing (Epel et a l., 2006), increasing th e prevalence of cardiovas-
cular disease (Bro ndolo et al., 2008; Lewis et al ., 2010; Wyatt et al., 2003) and inc reasing the risk of hypertens ion
(Williams & Nei ghbors, 2001).
Exposure t o ethnic discrimin ation has also be en found to be a ssociated with po orer mental heal th outcomes
(Conklin, 2011; Ferdinand et al ., 2015; Goto et al., 2013; Llácer et al., 2009), higher leve ls of anxiety or depression
(Ikram et al. , 2015; Kelaher et al., 20 08), higher likeliho od of experiencing m ental disorders (C ardano et al., 2018),
depressive di sorder and/or anxiety disorder (Berger & Sarnyai, 2015; Chau e t al., 2018; Gee et al ., 2007; Karlsen
et al., 2005) lower levels of psychological functioning (Sellers et al., 2006) and lower self- esteem (Verkuyten,
1998). In a 2015 s tudy of 1.139 Australia ns, Ferdinand et a l., (2015) found that many Australians from racial and
ethnic minority backgrounds experience racial discrimination on a regular bases and that the odds of being above
the threshol d for high or very high psychol ogical distress were incr eased for people with med ium and high levels
of experiences of r acism compared to indivi duals who instead did not exp erience racism.
Analysing the intera ction of perceived ethni c discriminatio n with p hysical and mental hea lth allows to take
into account the pervasiveness of discriminator y behaviours in immigrants’ everyday life and its impact on the
well- bein g of this population. Furth ermore, immigrants’ he alth outcomes may thus be used a s an indicator of the
level of their inclu sion in the host society as wel l as of the vulnerability of thi s specific section of the po pulation
(Tognetti Bordogna, 2015).
Although the ethnic dis crimination varia ble has been operationalized in different w ays, several inte rnational
studies have found an associat ion between disc rimination and poo r overall health (Agudelo- Su árez, 2009, 2011;
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