Browsing by Author "Uphoff, Eleonora"
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Item A systematic review of socioeconomic position in relation to asthma and allergic diseases(European Respiratory Society, 2015) Uphoff, Eleonora; Cabieses, Báltica; Pinart, Mariona; Valdés, Macarena; Antó, Josep Maria; Wright, JohnThe role of socioeconomic position (SEP) in the development of asthma and allergies is unclear, with some pointing to the risks of low SEP and other research pointing in the direction of higher SEP being associated with higher prevalence rates. The aim of this systematic review is to clarify associations between SEP and the prevalence of asthma and allergies. Out of 4407 records identified, 183 were included in the analysis. Low SEP was associated with a higher prevalence of asthma in 63% of the studies. Research on allergies, however, showed a positive association between higher SEP and illness in 66% of studies. Pooled estimates for the odds ratio of disease for the highest compared with the lowest SEP confirmed these results for asthma (unadjusted OR 1.38, 95% CI 1.37-1.39), allergies in general (OR 0.67, 95% CI 0.62-0.72), atopic dermatitis (unadjusted OR 0.72, 95% CI 0.61-0.83) and allergic rhinoconjunctivitis (unadjusted OR 0.52, 95% CI 0.46-0.59). Sensitivity analyses with a subsample of high-quality studies led to the same conclusion. Evidence from this systematic review suggests that asthma is associated with lower SEP, whereas the prevalence of allergies is associated with higher SEP.Item A Systematic Review on the Development of Asthma and Allergic Diseases in Relation to International Immigration: The Leading Role of the Environment Confirmed(PLoS, 2014) Cabieses, Báltica; Uphoff, Eleonora; Pinart, Mariona; Antó, Josep Maria; Wright, JohnBACKGROUND: The prevalence of asthma and allergic diseases is rising worldwide. Evidence on potential causal pathways of asthma and allergies is growing, but findings have been contradictory, particularly on the interplay between allergic diseases and understudied social determinants of health like migration status. This review aimed at providing evidence for the association between migration status and asthma and allergies, and to explore the mechanisms between migration status and the development of asthma and allergies. METHODS AND FINDINGS: Systematic review on asthma and allergies and immigration status in accordance with the guidelines set by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The pooled odds ratio (OR) of the prevalence of asthma in immigrants compared to the host population was 0.60 (95% CI 0.45-0.84), and the pooled OR for allergies was 1.01 (95% CI 0.62-1.69). The pooled OR for the prevalence of asthma in first generation versus second generation immigrants was 0.37 (95% CI 0.25-0.58). Comparisons between populations in their countries of origin and those that emigrated vary depending on their level of development; more developed countries show higher rates of asthma and allergies. CONCLUSIONS: Our findings suggest a strong influence of the environment on the development of asthma and allergic diseases throughout the life course. The prevalence of asthma is generally higher in second generation than first generation immigrants. With length of residence in the host country the prevalence of asthma and allergic diseases increases steadily. These findings are consistent across study populations, host countries, and children as well as adults. Differences have been found to be significant when tested in a linear model, as well as when comparing between early and later age of migration, and between shorter and longer time of residence.Item Household Typology and Family Social Capital Among White British and Pakistani Women in Bradford, England(2014) Cabieses, Báltica; Fairley, Lesley; Uphoff, Eleonora; Santorelli, Gillian; Petherick, Emily; Prady, Stephanie; Croudace, Tim; West, JaneAbstract: Objectives: International evidence suggests positive close relationships with household members (family social capital) can improve wellbeing; however, mixed effects for associations between the number of household members and generational status (household typology) have been found. Further, it is unclear how family social capital and household typology might vary between families of different ethnic origins. Design: Cross-sectional study. Setting: The Born in Bradford cohort study. Participants: We used data from that including Pakistani (n=1772) and White British (n=1859) women. Main Outcome Measures: Household typologies and four measures of family social capital (I wish there was more warmth/affection; I feel closely attached to my family; My family takes notice of me; I feel excluded in my family; all binary variables). Results: We found that household typology was largely not significantly associated with family social capital measures, with some exceptions (women living with child only, women living with child and parents only, p<0.05). Pakistani women were more likely to report low family social capital (OR between 1.72 and 3.32, p<0.05) and this was significantly associated with financial insecurity and living in extended families. Conclusion: This study suggests the relationship between household typology and family social capital is complex and varies across ethnic and socioeconomic groups. Pakistani women were more likely to report low family social capital while living in the UK compared to the White British.Item Use of health services among international migrant children – a systematic review(2018) Markkula, Niina; Cabieses, Báltica; Lehti, Venla; Uphoff, Eleonora; Astorga-Pinto, Sofia; Stutzin Donoso, FranciscaBackground: Migrant children have specific health needs, and may face difficulties in accessing health care, but not enough is known about their health service use. This study aims to describe patterns of use of health services of international migrant children and differences to respective native populations. Methods: Electronic databases PubMed and Web of Science, references of identified publications, and websites of relevant international agencies were searched. We included observational studies published between 2006 and 2016 that reported use of formal health services by migrant children (0–18 years), including first and second generation migrants. Data on study characteristics, study theme, main outcome and study quality were extracted. Results: One hundred seven full texts were included in the review. Of the studies that reported comparable outcomes, half (50%) indicated less use of healthcare by migrants compared with non-migrants; 25% reported no difference, 18% reported greater use, and 7% did not report this outcome. There was variation by theme, so that the proportion of conclusions “less use” was most common in the categories “general access to care”, “primary care” and “oral health”, whereas in the use of emergency rooms or hospitalisations, the most common conclusion was “greater use”. Conclusions: Migrant children appear to use different types of healthcare services less than native populations, with the exception of emergency and hospital services.