Social determinants of health and multidimensional health screening findings among immigrants participating in a community-based programme in Portugal: a cross-sectional study
Abstract
Background: Migrant health is influenced by social and structural determinants of health that may affect both health outcomes and access to healthcare. Existing evidence has often focused on specific populations, health conditions, or areas of care, while less is known about multidisciplinary community-based approaches that assess social determinants alongside health findings across multiple domains within the same migrant population.
Objective: To describe social determinants of health and health screening findings across multiple domains among immigrants participating in the ACOLHER community-based programme in Almada, Portugal, using the PROGRESS framework—Place of residence, Race/ethnicity/culture/language, Occupation, Gender/sex, Religion, Education, Socioeconomic status, and Social capital—to structure an equity-oriented descriptive analysis.
Methods: A cross-sectional descriptive study was conducted using data from 152 adult immigrants who participated in two editions of the ACOLHER Programme. ACOLHER 1.0 was held on 25 October 2025 and ACOLHER 2.0 on 22 November 2025. Participants were recruited through convenience sampling during community-based activities. Data were collected using a registration questionnaire and multidisciplinary health screening covering mental health, oral health, pelvic health, cardiometabolic risk, and functional capacity. Social determinants were organised according to the PROGRESS framework. Analyses were descriptive, categorical results were reported using valid denominators, and no confirmatory determinant–outcome modelling was undertaken because the study was neither designed nor powered for such analyses, and screening-station denominators were self-selected and variable.
Results: Participants presented several indicators of social and material vulnerability, including having no income of their own, limited social support, and lack of reported access to healthcare. Among participants with valid healthcare-access data, 56/148 (37.8%) reported having no access to healthcare services. Seventeen of 147 participants with valid data (11.6%) reported receiving food assistance, such as food baskets. Health screening findings varied across domains and should be interpreted considering voluntary attendance at individual screening stations and the resulting differences in denominators. Among those who underwent oral health assessment, dental caries and visible plaque were common. Mental health screening identified psychological symptom scores above the reference threshold among many participants who reported mental or emotional concerns.
Conclusions: The ACOLHER Programme provided a community-based setting in which social vulnerabilities and health screening findings could be described among participating immigrants in Almada. The finding that 56/148 (37.8%) of participants with valid data reported having no access to healthcare services warrants further investigation. Larger, population-based studies are needed to determine whether the patterns observed in this convenience sample are also present in the wider migrant population and to evaluate the impact of community-based programmes on healthcare utilisation and health outcomes.
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BibTeX
@article{braganca2026social,
title = {{Social determinants of health and multidimensional health screening findings among immigrants participating in a community-based programme in Portugal: a cross-sectional study}},
author = {Hélio Bragança and Célia Belim and Iris Almeida and Renata Benavente and Ana Brantes and Rita Cerqueira and Sofia Jordão and Tiago Marques and Ana Romão and Cecília Rozan and Sónia Vicente and José João Mendes and Cristina Vaz de Almeida},
journal = {BMC Public Health},
year = {2026},
month = nov,
doi = {10.1186/s12889-026-30033-4},
url = {https://link.springer.com/article/10.1186/s12889-026-30033-4},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Social determinants of health and multidimensional health screening findings among immigrants participating in a community-based programme in Portugal: a cross-sectional study
AU - Hélio Bragança
AU - Célia Belim
AU - Iris Almeida
AU - Renata Benavente
AU - Ana Brantes
AU - Rita Cerqueira
AU - Sofia Jordão
AU - Tiago Marques
AU - Ana Romão
AU - Cecília Rozan
AU - Sónia Vicente
AU - José João Mendes
AU - Cristina Vaz de Almeida
PY - 2026
DA - 2026/11/03
JO - BMC Public Health
DO - 10.1186/s12889-026-30033-4
UR - https://link.springer.com/article/10.1186/s12889-026-30033-4
AB - Background: Migrant health is influenced by social and structural determinants of health that may affect both health outcomes and access to healthcare. Existing evidence has often focused on specific populations, health conditions, or areas of care, while less is known about multidisciplinary community-based approaches that assess social determinants alongside health findings across multiple domains within the same migrant population. Objective: To describe social determinants of health and health screening findings across multiple domains among immigrants participating in the ACOLHER community-based programme in Almada, Portugal, using the PROGRESS framework—Place of residence, Race/ethnicity/culture/language, Occupation, Gender/sex, Religion, Education, Socioeconomic status, and Social capital—to structure an equity-oriented descriptive analysis. Methods: A cross-sectional descriptive study was conducted using data from 152 adult immigrants who participated in two editions of the ACOLHER Programme. ACOLHER 1.0 was held on 25 October 2025 and ACOLHER 2.0 on 22 November 2025. Participants were recruited through convenience sampling during community-based activities. Data were collected using a registration questionnaire and multidisciplinary health screening covering mental health, oral health, pelvic health, cardiometabolic risk, and functional capacity. Social determinants were organised according to the PROGRESS framework. Analyses were descriptive, categorical results were reported using valid denominators, and no confirmatory determinant–outcome modelling was undertaken because the study was neither designed nor powered for such analyses, and screening-station denominators were self-selected and variable. Results: Participants presented several indicators of social and material vulnerability, including having no income of their own, limited social support, and lack of reported access to healthcare. Among participants with valid healthcare-access data, 56/148 (37.8%) reported having no access to healthcare services. Seventeen of 147 participants with valid data (11.6%) reported receiving food assistance, such as food baskets. Health screening findings varied across domains and should be interpreted considering voluntary attendance at individual screening stations and the resulting differences in denominators. Among those who underwent oral health assessment, dental caries and visible plaque were common. Mental health screening identified psychological symptom scores above the reference threshold among many participants who reported mental or emotional concerns. Conclusions: The ACOLHER Programme provided a community-based setting in which social vulnerabilities and health screening findings could be described among participating immigrants in Almada. The finding that 56/148 (37.8%) of participants with valid data reported having no access to healthcare services warrants further investigation. Larger, population-based studies are needed to determine whether the patterns observed in this convenience sample are also present in the wider migrant population and to evaluate the impact of community-based programmes on healthcare utilisation and health outcomes.
SN - 1471-2458
ER -