Moroccan immigrants in Italy

Meriem Khyatti, PhD

Nadia Laantri

Khalid Moumad

Institut Pasteur du Maroc

EUNAMFP7- HEALTH-2010

EU and North African Migrants: Health and Health Systems

Ferrara Meeting

Sept. 8 – 9, 2011

• Morocco has evolved into one of the prime sourcecountries of labour migrants to Europe.1960s

• low-skilled Moroccan emigrants have increasingly headed toItaly and Spain, while the higher-skilled increasingly migrateto the US and Canada

1990

• Morocco was the largest remittance receiver in Africa.2006

Pre-colonialmigration

• Nomadic or semi-nomadic

• Arab-Islamic conquests

• Moroccan Jews have been highly mobile both within Morocco and internationally

Migration in the colonial

era

• Flourishing of the French economy in 1920

Moroccanmigration

boom

• Rapid post-war economic growth in northwest Europe created increasing unskilled labour shortages in sectors such as industry, mining, housing construction and agriculture from the 1950s.

Historical and Recent Trends in Immigration and Emigration

Moroccans are the largest and most dispersed Africanimmigrant population living in Europe, where theyalone outnumber all West African migrants living inEurope. Moroccans form the second most sizeable non-EU immigrant population living in Europe after Turks.While the Turkish migration to the EU is stagnating,Morocco has been among the top source countries ofimmigrants to the EU and is expected to overtakeTurkey as the main source of non-EU immigrants in thecoming decade.

Moroccan population abroad

The Moroccan population living abroad as follows on the main destinations:

Continents Number of people %

Europe 2.837.654 86.18

Arab World 281.631 8.55

America 161.216 4.90

South of Africa 8.061 0.25

Asia 4.037 0.12

TOTAL 3.292.599 100.00

Source: Hassan II foundation, « Les Marocains de l’extérieur », 2007

Between 1965 and 1972, the estimated number of registered Moroccans living in Europe increased tenfold, from 30,000 to 300,000, to around 400,000 by 1975 (see Table 1).

Evolution of population with Moroccan citizenship in main European destination,

1972-2005

The Moroccan Emigrant Population

Distribution of Moroccan population living abroad, 2004

Source: Moroccan Consular

services

Moroccan Community living in Europe as of 2007

39.86

19.28

13.36

10.04

9.8

4.58 3.09

France

Spain

Italy

Belgium

Netherlands

Germany

Other countries

Figure made out of data from DACS

Moroccan population abroad

Year Number of people Annual growth rate

(%)

% of total foreign

residants

1993 78596 - 12.5

1994 86128 9,6 12,6

1995 92905 7,9 12,6

1996 117487 26,5 13,3

1997 132653 12,9 13,4

1998 147783 11,4 13,2

1999 170905 15,6 13,5

2000 194617 13,9 13,3

2001 180103 -7,5 13,5

2002 215430 19,6 13,9

2003 253362 18,6 12,7

2004 294945 16,4 12,3

2005 319537 8,3 12,0

2006 34228 7,4 11,7

2007 365908 6,6 10,7

TOTAL - 11,6 --

Growth of the moroccan community living in Italy (1993-2007)

Imigration Morocco-Italy

Growth of the moroccan community living in Italy (1993-2007)

Moroccan population abroad

Growth of the moroccan community living in Italy (1993-2007)

Spatial distribution of the Moroccan community in Italy

Region Number of people Percentage (%)

Lombardia 42172 23,4

Emilia-Romagna 28543 15,8

Piemonte 27701 14,8

Veneto 25406 14,2

Toscana 10196 5,7

Marche 6751 3,7

Calabria 5358 3,0

Sicilia 4833 2,7

Campiana 4532 2,5

Lazio 4521 2,5

Liguria 4019 2,2

Umbria 3803 2,1

Trentino Alto Adige 3632 2,0

Puglia 3189 1,8

Sadegna 1741 1,0

Abruzzo 1602 0,9

Friuli Venezia Giulia 1237 0,7

Valle d’Aosta 816 0,5

Basilicata 582 0,3

Molise 469 0,3

TOTAL 180103 100,0

Distribution of Moroccan resident in the main Italian regions by Region of origin

and sex in Morocco.

Sex Structure

Origins from

Morocco

Italy Region Total

Piemonte Lombardia Veneto Emilia Romagna Other

Man

Chaouia-Ouardigha 40,7 12,7 15,7 25,0 34,2 25,9

Grand Casablanca 25,1 13,4 22,2 30,1 19,5 20,8

Rabat-Salé 10,0 9,5 9,3 5,8 10,7 9,3

Tadla-Azilal 5,7 39,0 11,6 13,1 10,8 17,5

Other 18,5 25,5 41,3 26,0 24,9 26,4

Total (%) 100,0 100,0 100,0 100,0 100,0 100,0

Number of people 32980 54190 28802 33093 66962 216027

Women

Chaouia-Ouardigha 36,7 13,7 14,5 25,4 27,8 23,7

Grand Casablanca 26,2 17,5 26,0 32,1 25,4 25,0

Rabat-Salé 11,4 11,9 11,5 7,5 13,6 11,5

Tadla-Azilal 5,4 27,5 9,3 11,7 9,4 13,1

Other 20,3 29,5 38,7 24,2 23,7 26,6

Total (%) 100,0 100,0 100,0 100,0 100,0 100,0

Number of people 15950 21408 13502 16480 29671 97011

Age Structure

Age

Groups

Imigrant Sex Total

Man Women

Less than 15 years 5,1 9,1 6,3

15 – 29 years 24,6 31,5 26,7

30 – 44 years 48,7 42,1 46,6

45 – 59 years 18,9 13,5 17,2

60 years ans over 2,7 3,8 3,1

Total(%) 100,0 100,0 100,0

Average Age 35,6 32,9 34,7

Number of people 232436 104425 336861

• The current average age of moroccan living in Italy is

34,7.

• 90.5% for the age group 15-59 years functional

• 6.3% are under15

• only 3.1% for 60 years and over.

• age pyramid reflects mainly distributed

between 25 and 55.

• beyond the age of 50 migrants are also

present, but their proportion is becoming

progressively weaker as we advance in age.

Geographical and

sociodemographic of

Morocco

• Morocco covers an area of 710 850 km2

and consists of 16 regions and 73 provinces and

prefectures.

Population:

• 31,224,000 according to 2007 census

• 44 persons per km2 (density 2007)

Climate:

• Morocco is a country of the subtropical

western

• It suffers in the summer conditions of hot

arid zone, while in winter the area is

temperate and humid.

Age groups 1960 1971 1982 1994 1999 2004 2009 2014 2019

0-14 years 44,4 45,9 42,2 37,0 33,1 29,6 26,9 25,1 23,6

15-59 years 51,6 49,4 53,9 55,9 59,7 62,7 65,1 65,6 69,2

Over 60 years 4,0 4,7 3,9 7,1 7,2 7,7 8,0 9,3 7,3

Total 100,0 100,0 100,0 100,0 100,0 100,0 100,0 100,0 100,0

012345678

75-8

0

81-8

1

84-8

7

89-9

1

89-9

1

90-9

4

93-9

4

96-9

7

2004

2009

2014

2019

Urban

Rural

Total

Evolution and trends in the structure of the Moroccan population by age group (1960-2019)

Evolution of fertility:

Over the past two decades:

• rising age of marriage

• social changes

• increasing the coverage of family

planning services

significant decline in fertility

Contributed

Morocco Health Profile

Mortality

Despite health indicators have improved significantly in recent years, infant mortality

is still high and maternal mortality remains a major public health problem.

Mortality in Morocco

Crude death rate 4,74%

Infant Mortality rate 29,75%

Men 43,77%

Women 24,49%

0

50

100

150

200

250

Série 1

Série 2

Série 3

Graphique : Evolution and

trends in mortality (‰) in

childhood during the period

1962 to 2016.

Mort

alit

yfo

r 1000 b

irth

53%40%

3%2% 1% 1%

infectious diseases

perinatal causes

malformation

malnutrition

Other M.N.T

Accidents

13

20

25

27.8

27.8

28

30

31

32

36.6

37

41

43

43

45

54

58

0 10 20 30 40 50 60 70

Grand casablanca

Rabat-Salé

Doukkala-Abda

Oued-Eddahab-Lagouira

Laayoune-Boujdour

El Gharb-Chrada

Chaouia-Ouardigha

Guelmim-Es-Semara

Orientale

National

Fès-Boulmane

Marrakech-Tensift

Tadla-Azilal

Tanger-Tétouan

Sous-Massa-draâ

Taza-Al Hoceima-Taounate

Meknès-Tafilalet

Distribution of infant mortality

rates by region - 1997

Main causes of child mortality

in Morocco, ECCD 1998

Groups Man & Women Man Women

Number % Number % Number %

Groupe 1 1576030 33,4 764357 30,1 811673 37,2

Groupe 2 2630273 55,8 1412266 55,7 1218007 55,9

Groupe 3 4716654 10,8 359479 14,2 150870 6,9

Total 4716654 100 2536103 100 2180551 100

Weight of the global burden of disease

The global burden of disease (CMG) is an indicator developed to express the full amount of

life lost as the disease is measured in years of disability-adjusted life (DALYs).

Perinatal condition15.64%

Infectious andparasitic diseases

14.57ù

neuropsychiatricDiseases13.47%

diseases of the circulatory system

11.3%

Table 2: Percentage Distribution of DALYs by disease group and sex, 1992.

NCD remains the main cause of

mortality in country

Analysis of the results

by sub group of diseases

54.9% of the

Global Burden Disease (CMG)

revealed

284

362

332

125

307

228

0

50

100

150

200

250

300

350

400

Urban Rural Both

ENPS II 1992 PAPCHILD 1997

Level of maternal mortality

Maternal mortality by place of residence (per 100 000 live births) - Comparison between 1987 and 1992

Analysis of data obtained from surveys shows that the rate of

decline between 1987 and 1992 is recorded especially in urban

areas where the maternal mortality rate decreased by 2.3 times

in the space of eight years. While in rural areas, the decline

was only 1.2 times.

• The level of infant and child mortality, though improving, remains relatively high,

with respective rates of 40% and 47%.

• With 359 to 227 deaths per 100.000 live births, the level of maternal mortality

remains alarmingly high compared to countries at the same level.

• Significant disparities are still observed in the distribution of maternal and

children mortalityby place of residence, standard of living and region.

• Measures should be taken to reduce maternal and child health and reduce

disparitiesby the standard of living on a first hand and by region on an other hand.

Infectious diseases

• Infectious diseases are diseases that are defined by vector, virus, bacterium,

parasite, fungus, or prion.

• They are likely to affect any living organism (animal or plant).

• Their mode of transmission is variable and depends on the tank (human, animal,

environmental).

• They are more or less contagious.

• From the nineties, Morocco has experienced a decline in infectious diseases who

has had an impact on the lengthening of life expectancy at birth.

• This action on infectious diseases has highlighted the general population the

emergence of chronic and degenerative diseases(diabetes, hypertension, ...)

Infectious diseases

• Infectious diseases are responsible for 17 million deaths annually, representing

one third of mortality.

• They represent 43% of deaths in developing countries, against 1% in industrialized

countries.

• The following six diseases account for 90% of deaths from infectious

diseases worldwide:

World wide

Disease number of deaths per year worldwide:

Respiratory diseases: 3000000

Aids: 3million (2001);

Diarrheal diseases: 2.5 million;

Tuberculosis: nearly 2 million ;

Malaria: more than 1million deaths

and

Measles: 900 000

Parasitic diseases

• Since 2002, four cases were detected in

2003 and one case in 2004, all remaining.

And since 2005, no indigenous cases have

been detected at the national level.

• WHO has decided to put Morocco

on the list of countries that have

eradicated the scourge.

Paludisme:

Leishmaniasis

Leishmaniasis continues to pose a public

health problem in Morocco. The review of

reported cases in 2006, according to the

Department of Epidemiology and Disease

Control (DELM) of the Department of Public

Health is: 78 Semara new cases, 857 in

Souss-Massa-Deraa, 71-El-Gharb Chaouia,

441 in Marrakech El Haouz and 793 in the

eastern region. Leishmaniasis is expected to

increase due to global and ruralization of

suburban space.

Parasitic diseases

Tuberculosis

Nationally, during 2007, from 500 to 1,000 deaths from tuberculosis,

and 25,562 new cases were identified, a stagnation of the incidence of

the disease. In 50% of cases, this pathology is detected in large urban

and suburban, and 70% of patients are between 15 and 45. The

treatment of tuberculosis, which can last from 6 to 18 months, is done

in specialized centers for diagnosis of tuberculosis of the Ministry of

Health. Consultations late and non adherences to treatment are the

cause of resistance to tuberculosis in Morocco.

Nutritional problems and micronutrient deficiencies

Diet Moroccan Mediterranean type:

large consumption of cereals ; fruits and

vegetables. to a lesser extent, dairy

products.

In 2005-2007

• the index of food diversification

was 36% / 32% since 1965-67

• Cereals, sweeteners and vegetable

oils account for more than 80% of the

DEA, which is a sign of nutritional

transition

• The index of food diversification of

Morocco is well below that of Algeria and

Tunisia (41% and 48%) (FAO,

FAOSTAT).

Levels of malnutrition

• Malnutrition among children under five years affects between 10 and 25% of

Moroccan children

• The disparity between environments is obvious, since stunting affects 29.3%

of children in rural areas and 14.6% in urban areas, twice, when the percentage

of underweight ranged from 11.8 % in rural areas and 4.7% in urban areas,

nearly three times more.

Main deficiencies in micronutrientsVitamin D deficiency:The policy for several years in the fight against rickets (VD deficiency) has

reduced the acuteness of this problem.

Vitamin A deficiency: in children aged 6 to 71 months is 40.9% (retinol levels less than or equal

to 200 mg / l)

Hemoglobin or anemia: in children aged six months to five years is estimated at the national

level (rate hemoglobin <11 g / dl) to 31.6%.

iodine deficiency: the average prevalence of goiter in children aged 6 to 12 years is estimated at

22% with a confidence interval of 20 to 24.14. Morocco is among the countries with the severity

of disorders due to iodine deficiency is moderate.

fluorine deficiency: The prevalence of dental caries in children 12 years increased from 67.3%

in 1991 to 72% in 1999.

• Perinatal conditions constitute 15.64% of the Global Burden of Disease against

14.57% for infectious and parasitic diseases.

• The weight of numbers DALYs by age reveals that the edges of the age of five

and 15 to 44 are the most important representing respectively 37.9% and 32.4%.

The duration of life lived with disability is estimated at 14.5 years in Morocco.

• Children under 5 years are still a population at risk of death will require the

strengthening of health programs: immunization, vitamin supplementation, weight

monitoring, detection and treatment of anemia, treatment of morbid quality of the

episodes so acute.

• Adolescence (11-16 years) who is a vulnerable segment should also be

considered in future strategies.

• Morbidity due to communicable, maternal and perinatal continues to

represent a relatively large weight in the global burden of disease with the

avdp 46.4 and 33.4% of DALYs. It affects more disadvantaged population

groups.

• Non-communicable diseases dominate the structure of the global burden of disease

with 55.8% and 41.2% of DALYs avdp and trauma are the emerging phenomenon of

global morbidity with 10.8% and 9.6% of DALYs of avdp.

Acknowledging that changes in sociocultural

environment influence health status, we purpose to

study health problems in Moroccan immigrants in Italy.

Migrant health problems categories

Psychosocial health

problems

Physical problems

Disease-specifc

problemsAccidents

Problems specific to

women