@article{fdi:010079131,
  title = {{T}he negative self-perceived health of migrants with precarious status in {M}ontreal, {C}anada : a cross-sectional study},
  author = {{C}loos, {P}. and {N}dao, {E}. {M}. and {A}ho, {J}. and {B}enoit, {M}. and {F}illol, {A}mandine and {M}unoz-{B}ertrand, {M}. and {O}uimet, {M}. {J}. and {H}anley, {J}. and {R}idde, {V}al{\'e}ry},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground {K}nowledge about the health impacts of the absence of health insurance for migrants with precarious status ({MPS}) in {C}anada is scarce. {MPS} refer to immigrants with authorized but temporary legal status (i.e. temporary foreign workers, visitors, international students) and/or unauthorized status (out of legal status, i.e. undocumented). {T}his is the first large empirical study that examines the social determinants of self-perceived health of {MPS} who are uninsured and residing in {M}ontreal. {M}ethods and findings {B}etween {J}une 2016 and {S}eptember 2017, we performed a cross-sectional survey of uninsured migrants in {M}ontreal, {Q}uebec. {M}igrants without health insurance (18+) were sampled through venue-based recruitment, snowball strategy and media announcements. {A} questionnaire focusing on sociodemographic, socioeconomic and psychosocial characteristics, social determinants, health needs and access to health care, and health self-perception was administered to 806 individuals: 54.1% were recruited in urban spaces and 45.9% in a health clinic. 53.9% were categorized as having temporary legal status in {C}anada and 46% were without authorized status. {R}egions of birth were: {A}sia (5.2%), {C}aribbean (13.8%), {E}urope (7.3%), {L}atin {A}merica (35.8%), {M}iddle {E}ast (21%), {S}ub-{S}aharan {A}frica (15.8%) and the {U}nited {S}tates (1.1%). {T}he median age was 37 years (range:18-87). {T}he proportion of respondents reporting negative (bad/fair) self-perception of health was 44.8%: 36.1% among migrants with authorized legal status and 54.4% among those with unauthorized status (statistically significant difference; p<0.001). {F}actors associated with negative self-perceived health were assessed using logistic regression. {T}hose who were more likely to perceive their health as negative were those: with no diploma/primary/secondary education (age-adjusted odds ratio [{AOR}]: 2.49 [95% {CI} 1.53-4.07, p<0.001] or with a college diploma ({AOR}: 2.41 [95% {CI} 1.38-4.20, p = 0.002); whose family income met their needs not at all/a little ({AOR}: 6.22 [95% {CI} 1.62-23.85], p = 0.008) or met their needs fairly ({AOR}: 4.70 [95% {CI} 1.21-18.27], p = 0.025); with no one whom they could ask for money ({AOR}: 1.60 [95% {CI} 1.05-2.46], p = 0.03); with perception of racism ({AOR}: 1.58 [95% {CI} 1.01-2.48], p = 0.045); with a feeling of psychological distress ({AOR}: 2.17 [95% {CI} 1.36-3.45], p = 0.001); with unmet health care needs ({AOR}: 3.45 [95% {CI} 2.05-5.82], p<0.001); or with a health issue in the past 12 months ({AOR}: 3.44 [95% {CI} 1.79-6.61], p<0.001). {S}ome variables that are associated with negative self-perceived health varied according to gender: region of birth, lower formal education, having a family income that does not meet needs perfectly/very well, insalubrious housing, not knowing someone who could be asked for money, and having ever received a medical diagnosis. {C}onclusions {I}n our study, almost half of immigrants without health insurance perceived their health as negative, much higher than reports of negative self-perceived health in previous {C}anadian studies (8.5% among recent immigrants, 19.8% among long-term immigrants, and 10.6% among {C}anadian-born). {O}ur study also suggests a high rate of unmet health care needs among migrants with precarious status, a situation that is correlated with poor self-perceived health. {T}here is a need to put social policies in place to secure access to resources, health care and social services for all migrants, with or without authorized status.},
  keywords = {{CANADA} ; {MONTREAL}},
  booktitle = {},
  journal = {{PL}o{S} {O}ne},
  volume = {15},
  numero = {4},
  pages = {e0231327 [22p.]},
  ISSN = {1932-6203},
  year = {2020},
  DOI = {10.1371/journal.pone.0231327},
  URL = {https://www.documentation.ird.fr/hor/fdi:010079131},
}