The European Journal of Public Health
Volume 25, Issue 2, 01 April 2015
http://eurpub.oxfordjournals.org/content/25/suppl_1

Commentaries
The Ebola crisis: perspectives from European Public Health
Aura Timen , Marc Sprenger , Michael Edelstein , Jose Martin-Moreno , Martin McKee
DOI: http://dx.doi.org/10.1093/eurpub/cku236 187-188 First published online: 12 January 2015
Extract
As of 26 November 2014, 15 935 cases of Ebola had been reported to the World Health Organization (WHO), of whom 5689 have died.1 It is widely believed that these figures are underreported and the actual number of cases and deaths is higher.2 Six cases and one death were reported outside West Africa.3 This unprecedented outbreak took professionals and policy makers by surprise as it occurred where it was not expected and developed on a scale that could not have been predicted. Or at least, that has been the accepted view. A consideration of the population affected and the weak health infrastructure of the countries most affected should have led to a recognition that, once a contagious disease such as Ebola developed in this setting, the scope for rapid spread was great, given the high population density and degree of connectivity among the people of the region.4 Unlike previous outbreaks that occurred in remote rural areas of central Africa,5 this developed in a densely populated area and, very quickly, outbreaks occurred in the capitals of the main affected countries (Guinea, Sierra Leone and Liberia). Rapid initial spread was facilitated by lack …

Ebola’s media outbreak: lessons for the future
José Joaquín Mira , Susana Lorenzo , María Teresa Gea , Jesús Aranaz , Carlos Aibar
DOI: http://dx.doi.org/10.1093/eurpub/cku237 188-189 First published online: 12 January 2015
Extract
On 8 August 2014, the World Health Organization (WHO’s) Emergency Committee declared the Ebola virus disease (EVD or ‘Ebola’) outbreak a Public Health Emergency of International Concern. On 6 October 2014, the first case of EVD contracted in Europe was diagnosed.1 A healthcare worker was infected, after providing treatment to an Ebola patient in Spain. This secondary case, like those that occurred in Dallas, tested both the responsiveness of the healthcare system, and the attitudes and skills of the population, the health professionals and the media.
Virulence and infectivity are epidemiological characteristics that define the magnitude and significance of an infectious disease. EVD virulence is evident as shown by its lethality. The number of cases this time exceeded past outbreaks suggesting people that infectivity was greater.2 These factors coalesced to generate social alarm.
Unlike EVD, transmitted by direct contact with an infected patient or contaminated material, virus fear can spread in…

Immigrants’ health and health inequality by type of integration policies in European countries
Davide Malmusi
DOI: http://dx.doi.org/10.1093/eurpub/cku156 293-299 First published online: 18 September 2014
Abstract
Background: Recent efforts to characterize integration policy towards immigrants and to compare immigrants’ health across countries have rarely been combined so far. This study explores the relationship of country-level integration policy with immigrants’ health status in Europe.
Methods: Cross-sectional study with data from the 2011 European Union Survey on Income and Living Conditions. Fourteen countries were grouped according to a typology of integration policies based on the Migrant Integration Policy Index: ‘multicultural’ (highest scores: UK, Italy, Spain, Netherlands, Sweden, Belgium, Portugal, Norway, Finland), ‘exclusionist’ (lowest scores: Austria, Denmark) and ‘assimilationist’ (high or low depending on the dimension: France, Switzerland, Luxembourg). People born in the country (natives, n = 177 300) or outside the European Union with >10 years of residence (immigrants, n = 7088) were included. Prevalence ratios (PR) of fair/poor self-rated health between immigrants in each country cluster, and for immigrants versus natives within each, were computed adjusting by age, education, occupation and socio-economic conditions.
Results: Compared with multicultural countries, immigrants report worse health in exclusionist countries (age-adjusted PR, 95% CI: men 1.78, 1.49–2.12; women 1.58, 1.37–1.82; fully adjusted, men 1.78, 1.50–2.11; women 1.47, 1.26–1.70) and assimilationist countries (age-adjusted, men 1.21, 1.03–1.41; women 1.21, 1.06–1.39; fully adjusted, men 1.19, 1.02–1.40; women 1.22, 1.07–1.40). Health inequalities between immigrants and natives were also highest in exclusionist countries, where they persisted even after adjusting for differences in socio-economic situation.
Conclusion: Immigrants in ‘exclusionist’ countries experience poorer socio-economic and health outcomes. Future studies should confirm whether and how integration policy models could make a difference on migrants’ health.