787 Mortality among migrant children and young people (CYP): results from a systematic review
Notice bibliographique
Résumé
Objectives Migration status is a key determinant of health, but health outcomes among migrant children and young people (CYP) are poorly understood. A ‘healthy migrant’ effect has been demonstrated among adults,1 but evidence for the same effect in CYP is lacking. Our objectives are to summarise evidence on mortality among migrant CYP (aged < 18 and living elsewhere than their country of birth), including cause-specific mortality. These results are part of a systematic review addressing a range of health outcomes among migrant CYP.2 Methods PubMed/Medline, Embase and Cochrane databases were searched between 01/01/2000 and 01/06/2021 for English-language studies presenting mortality data for migrant CYP, with or without a control group.2 PROSPERO number CRD42020166305. Results The search strategy yielded 903 studies: 23 were included and 2 further studies were identified via reference searching. Meta-analysis was not possible due to inconsistent methodologies and outcomes measures. Table 1. shows the characteristics of included studies. Four studies address all-cause mortality, of which two show a mortality advantage among migrant children, specifically refugee children (US3 and Canada4). Conversely, a German study showed similar mortality rates among migrant CYP and the general population,5 and a case-control study in Sweden showed increased mortality among migrant CYP.6 Intercountry adoptees in Sweden increased ‘avoidable mortality’ (preventable or treatable deaths) compared with the host population.7 Nine studies presented data on cause-specific mortality and two on mortality in intensive care. Of these, a large study on children with leukaemia in Canada showed superior adjusted event-free survival among migrant CYP. The remaining studies all showed higher crude death rates in migrant CYP compared with the host population, including tuberculosis, burns, road-traffic accidents, suicide, heat-related causes and work-injuries. A study without control group described 3 deaths among ‘illegal immigrant’ CYP in the US. Eight studies presented under-5 mortality rates for refugee camps ranging from 0.21 to 10.3/10,000 person-days, but none provided control groups. In three studies this exceeded the United Nations Human Rights Commissioner for Refugees emergency threshold (2/10,000 person days). Conclusion Results are inconclusive but show some evidence of the ‘healthy migrant’ effect in CYP, including refugees, living in high income countries. However, crude mortality from some preventable causes is higher among migrant CYP, consistent with findings in the adult population.1 These results demonstrate a paucity of studies on migrant CYP, particularly in low and middle-income countries and studies with control groups, limiting the conclusions that can be drawn. References Aldridge RW, Nellums LB, Bartlett S, Barr AL, Patel P, et al. Global patterns of mortality in international migrants: a systematic review and meta-analysis. The Lancet 2018. Armitage AJ, Heys M, Lut I, Hardelid P. Health outcomes in international migrant children: protocol for a systematic review. BMJ Open 2021;11(5):e041173. Linton NM, DeBolt C, Newman LP, et al. Mortality rate and causes of death among refugees resettled in Washington State, 2006–2016. Journal of Immigrant and Minority Health 2020 DesMeules M, Gold J, McDermott S, Cao Z, Payne J, Lafrance B, et al. Disparities in mortality patterns among Canadian immigrants and refugees, 1980–1998: results of a national cohort study. Journal of Immigrant and Minority Health 2005. Makarova N, Brand T, Brünings-Kuppe C, Pohlabeln H, Luttmann S. Comparative analysis of premature mortality among urban immigrants in Bremen, Germany: a retrospective register-based linkage study. BMJ Open 2016. Albin B, Hjelm K, Ekberg J, Elmståhl S. Mortality among 723 948 foreign-and native-born Swedes 1970–1999. The European Journal of Public Health 2005. Hjern A, Vinnerljung B, Lindblad F. Avoidable mortality among child welfare recipients and intercountry adoptees: a national cohort study. Journal of Epidemiology & Community Health 2004.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,011 | 0,047 |
| Méta-épidémiologie (sens strict) | 0,002 | 0,001 |
| Méta-épidémiologie (sens large) | 0,009 | 0,013 |
| Bibliométrie | 0,011 | 0,014 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,003 | 0,002 |
| Science ouverte | 0,002 | 0,002 |
| Intégrité de la recherche | 0,002 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,007 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».