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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Children's Health".

Deadline for manuscript submissions: closed (31 March 2023) | Viewed by 42892

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Special Issue Editors

Dr. Bukola Salami

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Guest Editor

Faculty of Nursing, University of Alberta, Edmonton, AB T6G 1C9, Canada
Interests: immigrant health; migration and health; african migration

Dr. Christa Fouche

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Guest Editor

Faculty of Education and Social Work, University of Auckland, Auckland 1023, New Zealand
Interests: immigrant health; social work practice; community based research

Dr. Saida Abdi

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Guest Editor

School of Social Work, University of Minnesota, St. Paul, MN 55108, USA
Interests: refugee youth and families; refugee and immigrant mental health; trauma systems therapy; building culturally responsive interventions

Dr. Andre Renzaho

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Guest Editor

Translational Health Research Institute, Western Sydney University, Campbelltown NSW 2560, Australia
Interests: migration; global health; cultural competence; health service delivery

Special Issue Information

Dear Colleagues,

International and internal migration is a growing phenomenon. According to the 2020 World Migration Report, there are over 272 million international migrants. However, there is a larger number of individuals, including internally displaced persons, who move within borders. Approximately 31 million international migrants are children. While most children who migrate internationally do so through safe migration routes, many children are exposed to health risks, human rights violations, and violence during the migration progress. Particularly unaccompanied children, refugee children, internally displaced children, and separated children may face heightened health risks.

Conditions before, during, and after the migration process are important considerations in addressing the health of migrant children. For instance, research in the area of immigrant child health identify that post migration factors, including access to health services and the diverse influences of social determinants of health, may further complicate the health of immigrant children. Increasingly, research has shed light on the mental health of refugee children, the reproductive and sexual health of migrant children, access to health services for immigrant children, nutritional status of refugee children, and the importance of infectious disease prevention and control for all migrant children. However, there remain several gaps in research, including a dearth of longitudinal and comparative studies. Intervention research in this field is also limited.

This Special Issue focuses on research related to the health of migrant children. We are particularly interested in shedding light on the health needs of the most vulnerable migrant children, including internally displaced persons, refugees, unaccompanied minors, and trafficked children. We are also interested in data from both the Global South and the Global North. Diverse methodological and theoretical approaches are welcome, including systematic reviews, quantitative research, qualitative research, and intervention research. We welcome research on all health conditions as well as research on first- and second-generation immigrant children. Our goal is to improve access to findings that will help address several Sustainable Development Goals as they relate to migrant children.

Dr. Bukola Salami
Dr. Christa Fouche
Dr. Saida Abdi
Dr. Andre Renzaho
Guest Editors

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Keywords

adolescent
child
immigrant
internally displaced
migrant
migration
refugee
youths

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Published Papers (12 papers)

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Research

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14 pages, 512 KiB

Open AccessArticle

Assessing Quality of Life in First- and Second-Generation Immigrant Children and Adolescents; Highlights from the DIATROFI Food Aid and Healthy Nutrition Promotion Program

by Dimitrios V. Diamantis, Iliana Stavropoulou, Konstantinos Katsas, Lyndsey Mugford, Athena Linos and Matina Kouvari

Int. J. Environ. Res. Public Health 2023, 20(3), 2471; https://doi.org/10.3390/ijerph20032471 - 30 Jan 2023

Cited by 4 | Viewed by 2111

Abstract

To compare first- and second-immigrant pediatric populations with a non-immigrant pediatric population in terms of quality-of-life metrics, a cross-sectional analysis using data from the DIATROFI Program was implemented. In total, n = 2277 students (mean age: 9(4) years) from public schools in Greece participating in the 2020–2021 school year were analyzed. The students’ immigration status (first-generation/second-generation) was defined as per the standard definition. The students’ health related-quality of life (HRQoL) was assessed using a parental-perceived quality of life questionnaire. The sample included 4.8% first-generation and 21.2% second-generation immigrant students. Compared with non-immigrants, the first-generation immigrant students were more likely to have poor HRQoL (odds ratio (OR) = 2.82; 95% confidence interval (95%CI) = 11.75, 4.53), physical (OR = 1.91; 95%CI = 1.18, 3.10), social (OR = 1.94; 95%CI = 1.16, 3.22) and school function (OR = 2.52; 95%CI = 1.54, 4.13). Similar results were observed for second-generation immigrant students regarding HRQoL (OR = 1.68; 95%CI = 1.28, 2.21), physical (OR = 1.60; 95%CI = 1.23, 2.10) and school function (OR = 2.09; 95%CI = 1.58, 2.77). Children with one parent having a country of origin different that the country of residence had elevated odds of having poor emotional health (OR = 1.19; 95%CI = 0.87, 1.64). The family’s affluency level was interrelated with the connection of poor HRQoL and immigration status. The immigrant students have a poorer quality of life depending on their immigration generation and irrespective of their socioeconomic background. Full article

(This article belongs to the Special Issue Health of Migrant Children)

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11 pages, 538 KiB

Open AccessArticle

Social Identity, Core Self-Evaluation, School Adaptation, and Mental Health Problems in Migrant Children in China: A Chain Mediation Model

by Ye Chen, Xinxin Yu, Aini Azeqa Ma’rof, Zeinab Zaremohzzabieh, Haslinda Abdullah, Hanina Halimatusaadiah Hamsan and Lyuci Zhang

Int. J. Environ. Res. Public Health 2022, 19(24), 16645; https://doi.org/10.3390/ijerph192416645 - 11 Dec 2022

Cited by 6 | Viewed by 3008

Abstract

(1) Background: The present study investigated the relationships between social identity, core self-evaluation, school adaptation, and mental health problems in migrant children, and the mechanism underlying these relationships; (2) Methods: The participants were migrant middle school students in China. Data analysis was conducted using SPSS version 26. A survey comprising the social identity scale, core self-evaluation scale, school adaptation scale, and mental health scale MMHI-60 was deployed; (3) Results: Findings indicated a significant and negative association between social identity and mental health problems, and such an association was sequentially mediated by core self-evaluation and school adaptation. Furthermore, core self-evaluation and school adaptation played a chain mediation role between social identity and migrant children’s mental health problems; (4) Conclusions: It is crucial to improve social identity, core self-evaluation, and school adaptation to reduce mental health problems among this population. Therefore, the research results provide a new direction for promoting the development of mental health education for migrant workers and their children in China. Full article

(This article belongs to the Special Issue Health of Migrant Children)

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15 pages, 767 KiB

Open AccessArticle

Social Support and Loneliness among Chinese Rural-to-Urban Migrant Children: A Moderated Mediation Analysis of the Roles of Social Competence and Stress Mindset

by Luxi Chen and Fang Yang

Int. J. Environ. Res. Public Health 2022, 19(23), 15933; https://doi.org/10.3390/ijerph192315933 - 29 Nov 2022

Cited by 7 | Viewed by 2335

Abstract

Social support has been an important social-contextual protective factor against loneliness. However, how individual-level protective factors, such as social competence and a positive stress mindset, may jointly influence the relationship between social support and loneliness is less known. This study examined to what extent the link between social support and loneliness would be mediated by social competence and moderated by stress mindset among migrant children. In total, 198 rural-to-urban migrant children aged 10–14 years (56.1% girls) in Beijing, China, completed a set of self-reported questionnaires. A moderated mediation analysis was performed. We found that perceived social support was associated with a lower level of loneliness, and this association was significant only for migrant children holding a positive stress mindset (indicated by a high ratio of the stress-is-a-challenge mindset to the stress-is-a-threat mindset). Notably, across children with different stress mindsets, perceived social support was indirectly related to a lower level of loneliness through greater social competence. Our findings suggest that social competence and a stress-is-a-challenge mindset are important individual-level protective factors for migrant children to overcome loneliness. Social competence can carry the effect of social support, and a stress-is-a-challenge mindset can optimize the effect of environmental resources on mental health. Full article

(This article belongs to the Special Issue Health of Migrant Children)

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14 pages, 334 KiB

Open AccessArticle

The Health Experiences of Young Internal Migrants in Ghana—Identifying Priorities for Sustainable Health Promotion

by Grace Spencer, Ernestina Dankyi, Jill Thompson, Faye Acton and Stephen Owusu Kwankye

Int. J. Environ. Res. Public Health 2022, 19(22), 15229; https://doi.org/10.3390/ijerph192215229 - 18 Nov 2022

Cited by 1 | Viewed by 1759

Abstract

The Sustainable Development Goals underscore the importance of migration to the achievement of health, and global migration presents both opportunities and challenges for the development of health promotion. Despite such recognition, very little work has focused on health promotion with young migrants, including how migration shapes opportunities for positive health. This paper reports findings from a qualitative study that sought to advance knowledge of the health experiences of young internal migrants in Ghana (n = 14) and considers ways to harness these perspectives in the development of sustainable health promotion solutions. Methods included community consultations, participatory workshops and interviews with young migrants aged 14–21 years. Findings highlighted how the social determinants of health affected young migrants’ opportunities to support their health. Our analysis highlights how a lack of access to adequate food, shelter and health services often resulted in the adoption of alternative health practices, including the use of herbal remedies. Supporting positive livelihoods as part of tackling the social determinants of health is crucial to mitigate the impacts of poverty and inequalities on young migrants’ health practices and outcomes. We conclude by considering how to advance relevant health promotion with young migrants living in contexts of vulnerability. Full article

(This article belongs to the Special Issue Health of Migrant Children)

20 pages, 729 KiB

Open AccessArticle

Investigating Outcomes of a Family Strengthening Intervention for Resettled Somali Bantu and Bhutanese Refugees: An Explanatory Sequential Mixed Methods Study

by Sarah Elizabeth Neville, Kira DiClemente-Bosco, Lila K. Chamlagai, Mary Bunn, Jordan Freeman, Jenna M. Berent, Bhuwan Gautam, Abdirahman Abdi and Theresa S. Betancourt

Int. J. Environ. Res. Public Health 2022, 19(19), 12415; https://doi.org/10.3390/ijerph191912415 - 29 Sep 2022

Cited by 6 | Viewed by 3048

Abstract

Pre- and post-migration stressors can put resettled refugee children at risk of poor mental health outcomes. The Family Strengthening Intervention for Refugees (FSI-R) is a peer-delivered preventative home visiting program for resettled refugees that aims to draw upon families’ strengths to foster improved family communication, positive parenting, and caregiver-child relationships, with the ultimate goal of reducing children’s risk of mental health problems. Using an explanatory sequential mixed methods design, this study draws upon qualitative interviews with caregivers (n = 19) and children (n = 17) who participated in a pilot study of the FSI-R intervention in New England, as well as interventionists (n = 4), to unpack quantitative findings on mental health and family functioning from a randomized pilot study (n = 80 families). Most patterns observed in the quantitative data as published in the pilot trial were triangulated by qualitative data. Bhutanese caregivers and children noted that children were less shy or scared to speak up after participating in the FSI-R. Somali Bantu families spoke less about child mental health and underscored feasibility challenges like language barriers between caregivers and children. Interventionists suggested that families with higher levels of education were more open to implementing behavior change. In both groups, families appreciated the intervention and found it to be feasible and acceptable, but also desired additional help in addressing broader family and community needs such as jobs and literacy programs. Full article

(This article belongs to the Special Issue Health of Migrant Children)

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16 pages, 378 KiB

Open AccessArticle

Navigating Stigma and Discrimination: Experiences of Migrant Children with Special Needs and Their Families in Accessing Education and Healthcare in Hong Kong

by Kim Kwok and Sylvia Kwok Lai Yuk Ching

Int. J. Environ. Res. Public Health 2022, 19(10), 5929; https://doi.org/10.3390/ijerph19105929 - 13 May 2022

Cited by 6 | Viewed by 3909

Abstract

This paper explores the barriers to supporting South Asian (Pakistani, Nepalese and Indian) migrant children with special needs and their families encountered navigating Hong Kong’s special needs system and accessing education and healthcare services. It adopts concepts of stigma and disability rights. It draws on semi-structured interviews with fifteen South Asian children and young people with special needs (age 5–21; M = 10; F = 5) and their families, and seven professional practitioners based on the qualitative descriptive method. Informants experienced intersecting stigmatization that included (1) institutional exclusion, (2) daily life microaggressions, and (3) misunderstandings and a lack of awareness education. Simultaneously, some were empowered through (4) support and accommodation, and (5) spiritual support from religion. This paper reveals a paradox embodied by Hong Kong; it is an Asian multicultural city committed to embracing the vision of disability inclusion while failing to ensure necessary support to reduce the stigma experienced by culturally diverse children with a disability. It makes recommendations based on a socioecological framework and concludes that concerted efforts by relevant authorities and organizations should be made to reduce stigma by taking into consideration the intersecting stigmas, specific resources unique to migrant communities, disability rights and cultural sensitivity. Full article

(This article belongs to the Special Issue Health of Migrant Children)

24 pages, 1389 KiB

Open AccessFeature PaperArticle

Assessing the Impact of Integrated Community-Based Management of Severe Wasting Programs in Conflict-Stricken South Sudan: A Multi-Dimensional Approach to Scalability of Nutrition Emergency Response Programs

by Andre M. N. Renzaho, Gilbert Dachi, Kibrom Tesfaselassie, Kiross Tefera Abebe, Ismail Kassim, Qutab Alam, Nawal Sadick Shaban, Tesfatsion Shiweredo, Hari Vinathan, Chandrakala Jaiswal, Hellen Martin Abraham, Khamisa Ayoub Miluwa, Rashidul Alam Mahumud, Eric Ategbo, Biram Ndiaye and Mohamed Ag Ayoya

Int. J. Environ. Res. Public Health 2021, 18(17), 9113; https://doi.org/10.3390/ijerph18179113 - 29 Aug 2021

Cited by 2 | Viewed by 3253

Abstract

Community-based management of severe wasting (CMSW) programs have solely focused on exit outcome indicators, often omitting data on nutrition emergency preparedness and scalability. This study aimed to document good practices and generate evidence on the effectiveness and scalability of CMSW programs to guide future nutrition interventions in South Sudan. A total of 69 CMSW program implementation documents and policies were authenticated and retained for analysis, complemented with the analyses of aggregated secondary data obtained over five (2016–2020 for CMSW program performance) to six (wasting prevention) years (2014–2019). Findings suggest a strong and harmonised coordination of CMSW program implementation, facilitated timely and with quality care through an integrated and harmonised multi-agency and multidisciplinary approach. There were challenges to the institutionalisation and ownership of CMSW programs: a weak health system, fragile health budget that relied on external assistance, and limited opportunities for competency-based learning and knowledge transfer. Between 2014 and 2019, the prevalence of wasting fluctuated according to the agricultural cycle and remained above the emergency threshold of 15% during the July to August lean season. However, during the same period, under-five and crude mortality rates (10,000/day) declined respectively from 1.17 (95% confidence interval (CI): 0.91, 1.43) and 1.00 (95% CI: 0.75, 1.25) to 0.57 (95% CI: 0.38, 0.76) and 0.55 (95% CI: 0.39, 0.70). Both indicators remained below the emergency thresholds, hence suggesting that the emergency response was under control. Over a five-year period (2016–2020), a total of 1,105,546 children (52% girls, 48% boys) were admitted to CMSW programs. The five-year pooled performance indicators (mean [standard deviations]) was 86.4 (18.9%) for recovery, 2.1 (7.8%) for deaths, 5.2 (10.3%) for defaulting, 1.7 (5.7%) for non-recovery, 4.6 (13.5%) for medical transfers, 2.2 (4.7%) for relapse, 3.3 (15.0) g/kg/day for weight gain velocity, and 6.7 (3.7) weeks for the length of stay in the program. In conclusion, all key performance indicators, except the weight gain velocity, met or exceeded the Humanitarian Charter and Minimum Standards in Humanitarian Response. Our findings demonstrate the possibility of implementing robust and resilient CMSAM programs in protracted conflict environments, informed by global guidelines and protocols. They also depict challenges to institutionalisation and ownership. Full article

(This article belongs to the Special Issue Health of Migrant Children)

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21 pages, 2101 KiB

Open AccessArticle

Integration of Newly Arrived Refugee Children into the German School System

by Pia Jäger, Notburga Ott, Angela Brand and Karim Fereidooni

Int. J. Environ. Res. Public Health 2021, 18(15), 7854; https://doi.org/10.3390/ijerph18157854 - 25 Jul 2021

Cited by 3 | Viewed by 3198

Abstract

Background: The assignment of newly arrived refugee children to the differentiated German school system represents a major challenge for the responsible municipalities. In this explorative research approach, the current assignment procedure, in addition to the necessary assessment of performance and the detection of learning, mental, or social disabilities of newly arrived refugee children in North Rhine-Westphalia (NRW), Germany, were investigated. Methods: Eight staff members of six relevant Communal Integration Centers (CICs) in NRW were interviewed and a qualitative content analysis was conducted. Results: The current assignment practices varied widely. The binding to guidelines differed; additionally, the school assignment or recommendation largely depended on personal engagement, connections, and attitudes of the relevant CIC staff. None of the CICs used standardized instruments. Instead, the staff assessed the performance with self-developed strategies such as free and playful approaches or self-developed worksheets, and counted on their ‘gut feeling’ and professional experience. Conclusion: The school career and education of newly arrived refugee children in NRW is largely inconsistent and dependent on the responsible CIC (e.g., the allocation of the family) and on the counseling staff member. Additionally, it must be assumed that relevant disabilities remain largely undetected. Full article

(This article belongs to the Special Issue Health of Migrant Children)

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16 pages, 382 KiB

Open AccessArticle

Differences between Chinese Adolescent Immigrants and Adolescent Non-Immigrants in Hong Kong: Perceived Psychosocial Attributes, School Environment and Characteristics of Hong Kong Adolescents

by Hechao Jiang, Daniel T. L. Shek and Moon Y. M. Law

Int. J. Environ. Res. Public Health 2021, 18(7), 3739; https://doi.org/10.3390/ijerph18073739 - 2 Apr 2021

Cited by 7 | Viewed by 3370

Abstract

Although the impact of immigration on adolescent developmental outcomes has received extensive scholarly attention, the impact of internal migration, particularly in the Chinese context, on adolescents’ psychosocial development has not been scientifically investigated. This study examined whether mainland Chinese adolescent immigrants (N = 590) and adolescent non-immigrants (n = 1798) differed on: (a) psychosocial attributes indexed by character traits, well-being, social behavior, and views on child development, (b) perceived school environment, and (c) perceptions of characteristics of Hong Kong adolescents. Consistent with the healthy migration hypothesis, Hong Kong adolescents and mainland Chinese adolescent immigrants did not differ on most of the outcomes; Chinese adolescent immigrants showed higher perceived moral character, empathy, and social trust than did Hong Kong adolescent non-immigrants. Chinese adolescent immigrants also showed more favorable perceptions of the school environment and moral character, social trust and social responsibility of adolescents in Hong Kong. This pioneer Chinese study provides support for the healthy immigration hypothesis (immigration paradox hypothesis) but not the immigration morbidity hypothesis within the specific sociocultural context of Hong Kong in China. Full article

(This article belongs to the Special Issue Health of Migrant Children)

14 pages, 365 KiB

Open AccessArticle

Migration as a Determinant in the Development of Children Emotional and Behavior Problems: A Quantitative Study for Lisbon Region, Portugal

by Zélia Muggli, Thierry Mertens, Silva -Sá, Regina Amado, Ana L. Teixeira, Dora Vaz and Maria Rosário O. Martins

Int. J. Environ. Res. Public Health 2021, 18(2), 375; https://doi.org/10.3390/ijerph18020375 - 6 Jan 2021

Cited by 7 | Viewed by 3660

Abstract

The role of migration as a determinant in child mental health has been demonstrated in a number of studies. However, results are not always consistent, and the research continues to be scarce, especially in Portugal. We examined the association between sociodemographic profiles and the chance for the development of emotional and behavioral difficulties in a group of 420 children, immigrant (n = 217) and born in Portugal to Portuguese born parents (n = 203). We used a structured questionnaire to obtain sociodemographic information and the Strength and Difficulties Questionnaire (SDQ). Descriptive statistics were used to characterize children and their families; variables were compared between groups using the Chi-squared, Fisher’s Exact Test, or the Mann–Whitney U test and logistic regression was used to analyze the association between socio-demographic factors and emotional and behavioral difficulties. Results showed a pattern of social and mental health inequalities with immigrant children at a disadvantage: they are more often part of families with low income and where parents had low skilled jobs. Internalizing behaviors are more frequent in immigrants than in children born in Portugal to Portuguese-born parents (p = 0.001) whereas a high total SDQ difficulties score (p = 0.039) and externalizing behaviors were more frequent in 1st generation immigrant children (p = 0.009). A low family income (aOR 4.5; 95% CI: 1.43–13.95), low parental education level (aOR 2.5; 95% CI: 1.11–5.16), and being a first-generation immigrant child (aOR 2.2; 95% CI: 1.06–4.76) increased significantly the chance of developing emotional and behavioral difficulties. This study contributes to the identification of children vulnerable to mental health problems who can benefit from monitoring, early detection and preventive interventions in order to mitigate possible negative outcomes in the future. Full article

(This article belongs to the Special Issue Health of Migrant Children)

13 pages, 305 KiB

Open AccessArticle

Body Composition, Physical Activity, and Convenience Food Consumption among Asian American Youth: 2011–2018 NHANES

by Soyang Kwon, Meme Wang-Schweig and Namratha R. Kandula

Int. J. Environ. Res. Public Health 2020, 17(17), 6187; https://doi.org/10.3390/ijerph17176187 - 26 Aug 2020

Cited by 6 | Viewed by 3035

Abstract

The primary purpose of this study was to describe obesity, body composition, convenience food consumption, physical activity, and muscle strength among Asian American youth compared to other racial/ethnic groups. The secondary purpose was to examine whether obesity, body composition, convenience food consumption, physical activity, and muscle strength differed by acculturation levels among Asian American youth. A secondary analysis was conducted using data from 12,763 children aged 2 to 17 years that participated in the 2011–2018 US National Health and Nutrition Examination Survey (NHANES). In the NHANES interview, acculturation, dietary behavior, and physical activity questionnaires were administered. The acculturation level was indicated by the language spoken at home. In the NHANES examination, anthropometry, dual-energy X-ray absorptiometry (DXA), and muscle strength assessments were conducted. Compared to non-Hispanic White American boys, Asian American boys had similar levels of obesity, central obesity, and fat mass. Among the five racial/ethnic groups examined, lean body mass, muscle mass, convenience food consumption, and daily physical activity were the lowest in the Asian group. More acculturated Asian American boys, but not girls, were more likely to be obese (OR = 3.28 (1.63, 6.60)). More acculturated Asian American youth more frequently consumed convenience food (1.4 more meals/month (1.2, 1.6)). This study highlights the obesity problem among Asian American boys, which worsens with acculturation to America. The study results also suggest that although Asian American youth consume less convenience food overall than non-Hispanic White American youth, increasing acculturation may negatively influence food choices. Full article

(This article belongs to the Special Issue Health of Migrant Children)

Review

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21 pages, 758 KiB

Open AccessReview

A Scoping Review of the Health of African Immigrant and Refugee Children

by Bukola Salami, Higinio Fernandez-Sanchez, Christa Fouche, Catrin Evans, Lindiwe Sibeko, Mia Tulli, Ashley Bulaong, Stephen Owusu Kwankye, Mary Ani-Amponsah, Philomina Okeke-Ihejirika, Hayat Gommaa, Kafuli Agbemenu, Chizoma Millicent Ndikom and Solina Richter

Int. J. Environ. Res. Public Health 2021, 18(7), 3514; https://doi.org/10.3390/ijerph18073514 - 28 Mar 2021

Cited by 18 | Viewed by 8165

Abstract

Migration is a growing phenomenon around the world, including within the African continent. Many migrants, especially African children, face challenges related to health and social inclusion and can face increased health risks. A systematic scoping review of available literature on the health of African migrant children across the globe was conducted to offer insight into these health risks. The review was conducted over a 15-month period from January 2019 to April 2020, yielding 6602 articles once duplicates were removed. This search included electronic databases, reference lists of articles reviewed, and searches of libraries of relevant organisations. A total of 187 studies met the inclusion criteria, of which 159 were quantitative, 22 were qualitative, and 6 used mixed methods. The findings reveal decreased health in this population in areas of nutrition, infectious diseases, mental health, birth outcomes, sexual and reproductive health, physical and developmental health, parasitic infections, oral health, respiratory health, preventative health, endocrine disorders, health care services, and haematological conditions. The findings offer insights into factors influencing the health of African immigrant and refugee children. Further studies, especially qualitative studies, are needed to determine barriers to service access after migration and to investigate other underexplored and overlooked health concerns of African migrant children, including pneumonia and child maltreatment. Full article

(This article belongs to the Special Issue Health of Migrant Children)

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