Core health indicators in countries with high proportion of expatriates: Case study of Qatar.

Autor:	Moradi-Lakeh M; Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran.; Optimax Access LLC, Mission Viejo, CA, United States., Toumi A; Public Health Department, Ministry of Public Health, Doha, Qatar., Khalifa SE; Public Health Department, Ministry of Public Health, Doha, Qatar., Doctor HV; Department of Science, Information and Dissemination, Regional Office for the Eastern Mediterranean, World Health Organization, Cairo, Egypt., Alyafei S; Public Health Department, Ministry of Public Health, Doha, Qatar., Al Hamad SK; Mortuary, Hamad Medical Center, Doha, Qatar., Al-Thani M; Public Health Department, Ministry of Public Health, Doha, Qatar., Rashidian A; Department of Science, Information and Dissemination, Regional Office for the Eastern Mediterranean, World Health Organization, Cairo, Egypt.
Jazyk:	angličtina
Zdroj:	Frontiers in public health [Front Public Health] 2023 Feb 07; Vol. 11, pp. 1035686. Date of Electronic Publication: 2023 Feb 07 (Print Publication: 2023).
DOI:	10.3389/fpubh.2023.1035686
Abstrakt:	Background: Population size and structure have a huge impact on health indicators. In countries with a high proportion of expatriates, there are some limitations in estimating, aggregating and reporting of the health indicators, and corrections may be required in the established estimation methodologies. We review the case of Qatar to see how its specific population characteristics affect its health indicators. Methods: We used routinely collected data and reviewed and calculated a selected list of health indicators for Qatari and non-Qatari populations residing in Qatar. Mortality and cancer incidence rates, stratified by nationality, were used for this purpose. Also, a direct method was used to estimate completeness of the death registry, compared to the mortuary data. Results: Age and sex distribution of Qatari and non-Qatari populations are completely different. Compared to the mortuary data, completeness of death registration for the total population was estimated at 98.9 and 94.3%, with and without considering overseas deaths, respectively. Both estimates were considerably higher than estimates from the indirect methods. Mortality patterns were different even after standardization of age and stratification of sex groups; male age-standardized mortality rates were 502.7 and 242.3 per 100,000 individuals, respectively for Qataris and non-Qataris. The rates were closer in female populations (315.6 and 291.5, respectively). The leading types of cancer incidents were different in Qataris and non-Qataris. Conclusions: Expatriates are a dynamic population with high-turnover, different from Qatari population in their age-sex structure and health status. They are more likely to be young or middle-aged and are less affected by age related diseases and cancers. Also, they might be at higher risks for specific diseases or injuries. Aggregating indicators of Qatari and non-Qatari populations might be mis-leading for policy making purposes, and common estimation correction approaches cannot alleviate the limitations. High-proportion of expatriate population also imposes significant errors to some of the key demographic estimates (such as completeness of death registry). We recommend a standardized approach to consider nationality in addition to age and sex distributions for analysis of health data in countries with a high proportion of expatriates. Competing Interests: MM-L was employed by Optimax Access LLC. AT, SK, SA, and MA-T work for the Ministry of Public Health in Qatar. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2023 Moradi-Lakeh, Toumi, Khalifa, Doctor, Alyafei, Al Hamad, Al-Thani and Rashidian.)
Databáze:	MEDLINE
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