In Western Europe, the number of excluded and especially that of illegal aliens continues to grow, along with the globalization of socio-economic and migratory movements. Difficult access to health care for excluded are multi-factorial, they depend on the care system and the patient himself but also the lack of information and training for health professionals. Increase accessibility of the excluded in the system of care involves the development work in multidisciplinary network in which the doctor but the nurse, the social and community network have a key role. If awareness of the problem of insecurity can gradually improve the coverage of the poorest in the country, those living in illegality can move quickly in an emergency, in case of illness. There is an urgent need to better document these cases to alert public opinion and politics.It is well established that social determinants are of major importance for health, both individually and collectively. Regardless of the degree of development of the country of residence, the more one is poor, the more one is sick and it was likely to die prematurely. Corollary: the more one is high in the social hierarchy, the lower mortality, longer life expectancy and in particular the longest life expectancy in good health.
[...] Hassin State of health and care of homeless people in Paris. In: Lebas Chauvin eds. Insecurity and health. Paris: Flammarion 107- Wilkinson RG. Socioeconomic determinants of health. Health inequalities: Relative or absolute material standards? BMJ 1997; 314: 591- Mizrahi Mizrahi Ar Inequality of access to care: cumulative risk and consumption of social care. In: Lebas Chauvin eds. Insecurity and health. Paris: Flammarion 45- Office of [...]
[...] The policy response to this phenomenon, often only repressive, promotes further illegal immigration: humanitarian medical outreach has yet to live beautiful days and it becomes urgent to train "pauvrologues" in our schools. Bibliography 1 Mac Keown T. The role of medicine: Dream, Mirage or Nemesis? 2.ed. Oxford: Basil Blackwell Whitehead M. The Health Divide. London: Penguin Books Marmot MG. Health inequalities among British civil servants: The Whitehall study. Lancet 1991; 337: 1387- S Durieux-Paillard, Figueras Aeschlimann Tuosto-R, et al. Insecurity and access to care: the hospital in Geneva fate of its walls. Med Hyg 1999, 57: 1825- Scott J. Homeless and mental illness. Br J Psychiatry 1993; 162: 314- J. [...]
[...] With his savings, he was able to build cons a small house in Colombia and planned to return permanently to the country in the near future, but he recently learned that it had been destroyed during the last earthquake. Everything is to start and the family remained in the country asked for financial help to survive this natural disaster. In April 1999 he was hospitalized in emergency for a transmutable infarction resulting from stenosis of the anterior descending artery and was treated by dilatation, he released after ten days. [...]
[...] However, in this situation of chronic diseases, the action of the UMSCO is essentially palliative: as illegal, the patient is not entitled to any benefits of public assistance and it will never be insurable, unless the law changes. Discussion This case illustrates the difficulties of life that a patient may encounter precarious and their possible repercussions on his health. In this case, and although it is partly the result of a deliberate choice, the status of aliens illegally in a "host" country is a delicate balance that relies mainly on its capital health. [...]
[...] The difficulties of access to care for people in precarious situations are multi-casual: the care of these patients requires a better collaboration between health and social worlds and daily practice of networking. In Geneva, the creation in 1997 of UMSCO helped meet the demand for outpatient care of a significant fraction of the population of the canton: migrants and 300 to 2,000 people homeless, according to sources. 10) same in the private system, many doctors are adapting to socioeconomic status of their patients by modulating their rate of economic opportunities to them. [...]
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