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Methods: A participatory action research study in Bologna (2021, with AUSL Bologna) combined retrospective observational analyses of local health databases with qualitative cross-sectional work using participant observation and semi-structured interviews. Results: 2021–2023 findings identified equity challenges and three action priorities, including over 20,000 undocumented migrants seeking care (2018–2022), data identification methods, and fragmented integration linked to exclusion from monitoring systems, lack of integrated protection, and governance gaps. Conclusion: Mechanisms intersect with structural racism, discrimination, and healthcare privatization, driving ethical conflicts and informing policy.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/adressing-structural-inequety-for-undocumented-migrants-in-primary-healthcare-a-multi-methodological-study-in-bologna/448783/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/adressing-structural-inequety-for-undocumented-migrants-in-primary-healthcare-a-multi-methodological-study-in-bologna/448783.png","ImageObject",300,407,{"name":92,"@type":93},"Jordan Avery","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-01","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",13,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What question does the study aim to answer?","Question",{"text":113,"@type":114},"It examines how healthcare services either mitigate or perpetuate health disparities experienced by undocumented migrants and socially marginalized individuals in Italy, and the related impacts on workers and patients.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"What methods were used in Bologna?",{"text":118,"@type":114},"A participatory action research design combined a retrospective observational study using local health databases with a qualitative cross-sectional study based on participant observation and semi-structured interviews with key healthcare professionals.",{"name":120,"@type":111,"acceptedAnswer":121},"What equity-related challenges were identified?",{"text":122,"@type":114},"The study reported exclusion from health data systems and monitoring, lack of integrated social protection and health promotion initiatives, and absence of structured equity-oriented governance mechanisms.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},448783,1790766475,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":8,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":81,"preview_page_count":4},1099523882367,"https://ap-avatar.wpscdn.com/davatar_9964176cb1d06d4a9deccf72a44ae3dc","2nd World Congress on Migration, Ethnicity, Race & Health Abstract Book vi35  \nOP 10: Determinants of Health Disease and Interventions 2, B207  \n(FCSH), September 3, 2025, 15:45-16:45  \nAim: Decades of research have highlighted persistent health inequalities in Italy, particularly affecting undocumented migrants and socially marginalized individuals. However, little is known about how healthcare services either mitigate or perpetuate these disparities, as well as their impact on healthcare workers and patients. To investigate these dynamics, a participatory action research study was launched in Bologna in 2021 in collaboration with the local health authority (AUSL Bologna) .  \nMethods: The research adopted a multi-methodological approach, combining:  \na. A retrospective observational study, analyzing local health databases to examine disparities in healthcare access among undocumented migrants, regular migrants, and Italian citizens.  \nb. A qualitative cross-sectional study, using participant observation and semi-structured interviews with key healthcare professionals to explore service organization, challenges, and best practices.  \nResults: Between 2021 and 2023, observations of multidisciplinary teams and governance groups focused on migrant health enabled the identification of key equity-related challenges and three researchaction priorities. Preliminary statistical analysis revealed that over  \n20,000 undocumented migrants sought care in Bologna between 2018 and 2022, influenced by factors like COVID-19 vaccination and the Ukrainian refugee crisis. The study also developed a methodology to identify undocumented migrants in health databases. The qualitative research mapped over 20 healthcare and social services, highlighting fragmented integration and organizational mechanisms contributing to inequality:  \n• Exclusion from health data systems and monitoring  \n• Lack of integrated social protection and health promotion initiatives  \n• Absence of structured, equity-oriented governance Conclusion: These mechanisms intersect with structural racism, discrimination, and healthcare privatization, affecting both patients and healthcare workers, generating frustration and ethical conflicts. Despite being preliminary, the findings underscore the importance of participatory, action-oriented research in addressing inequalities and informing health policy.  \nAbstract citation ID: ckaf180.097  \n440 Adressing structural inequety for undocumented migrants in primary healthcare a multi-methodological study in Bologna  \nLeonardo Mammana1  \n1Center for International and Intercultural Health, University of Bologna, Bologna, Italy","cbCaiseN9KGihwGT","https://ap.wps.com/l/cbCaiseN9KGihwGT","pdf",57454,"English","# OP 10: Determinants of Health Disease and Interventions 2\n## Aim\n## Methods\n## Results\n## Conclusion\n## Abstract citation","[{\"question\":\"What question does the study aim to answer?\",\"answer\":\"It examines how healthcare services either mitigate or perpetuate health disparities experienced by undocumented migrants and socially marginalized individuals in Italy, and the related impacts on workers and patients.\"},{\"question\":\"What methods were used in Bologna?\",\"answer\":\"A participatory action research design combined a retrospective observational study using local health databases with a qualitative cross-sectional study based on participant observation and semi-structured interviews with key healthcare professionals.\"},{\"question\":\"What equity-related challenges were identified?\",\"answer\":\"The study reported exclusion from health data systems and monitoring, lack of integrated social protection and health promotion initiatives, and absence of structured equity-oriented governance mechanisms.\"}]","Adressing structural inequety for undocumented migrants in primary healthcare - a multi-methodological study in Bologna | PDF",1790728738]