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10 pages, 351 KiB

Open AccessArticle

Gender Patterns in Immigrants’ Health Profiles in France: Tobacco, Alcohol, Obesity and Self-Reported Health

by Myriam Khlat, Stéphane Legleye and Damien Bricard

Int. J. Environ. Res. Public Health 2020, 17(23), 8759; https://doi.org/10.3390/ijerph17238759 - 25 Nov 2020

Cited by 7 | Viewed by 2481

Abstract

Background: to date, little attention has been given to gender differences in the health of migrants relative to native-born. In this study, we examine the health profile of the largest immigrant groups in metropolitan France, considering several health indicators and with a special [...] Read more.

Background: to date, little attention has been given to gender differences in the health of migrants relative to native-born. In this study, we examine the health profile of the largest immigrant groups in metropolitan France, considering several health indicators and with a special interest in the gendered patterns. Methods: The data originate from the 2017 Health Barometer survey representative of metropolitan France. A subsample of 19,857 individuals aged 18–70 years was analysed using modified Poisson regression, and risk ratio estimates (RR) were provided for the different migrant groups regarding alcohol use, current smoking, obesity and less-than-good self-reported health, adjusting for age and educational level. Results: None of the groups of male migrants differs from the native-born in terms of self-reported health, and they have healthier behaviours for alcohol (men from sub-Saharan Africa: 0.42 (0.29–0.61)) and from the Maghreb: 0.30 (0.1–0.54)) and smoking (men from sub-Saharan Africa: 0.64 (0.4–0.84)), with less frequent obesity (men from the Maghreb: 0.61 (0.3–0.95)). The latter, however, more frequently report current smoking (1.21 (1.0–1.46)). For women, less-than-good health is more frequently reported by the groups from sub-Saharan Africa (1.42 (1.1–1.75)) and from the Maghreb (1.55 (1.3–1.84)). Healthier behaviours were found for alcohol (women from overseas départements: 0.38 (0.1–0.85)) and from the Maghreb: (0.18 (0.0–0.57)) and current smoking (women from southern Europe: 0.68 (0.4–0.97), from sub-Saharan Africa: 0.23 (0.1–0.38) and from the Maghreb: 0.42 (0.2–0.61)). Conversely, some were more frequently obese (women from overseas départements: 1.79 (1.2–2.56) and from sub-Saharan Africa: 1.67 (1.2–2.23)). In the latter two groups from Africa, there is a larger relative male excess for tobacco than in the native-born (male-to-female ratios of respectively 2.87 (1.6–5.09) and 3.1 (2.0–4.65) vs 1.13 (1.0–1.20)) and there is a female excess for obesity (0.51 (0.2–0.89) and 0.41 (0.2–0.67)) in contrast with the native-born (1.07 (0.9–1.16)). The female disadvantage in terms of less-than-good self-reported health is more pronounced among migrants from the Maghreb than among the natives (0.56(0.4–0.46) vs. 0.86 (0.8–0.91)). Conclusion: Considering a set of four health indicators, we provide evidence for distinctive gender patterns among immigrants in France. Male immigrants have a healthy behavioural profile in comparison with the natives and no health disadvantage. Female immigrants have a more mixed profile, with a health disadvantage for the non-Western groups from Africa. The contribution to this discordance of socioeconomic factors and gender relations needs to be investigated. Full article

(This article belongs to the Special Issue The Health and Wellbeing of Migrant Populations)

17 pages, 688 KiB

Open AccessArticle

Support and Emotional Well-Being of Asylum Seekers and Refugees in Spain

by Ruth León-Pinilla, Ana Soto-Rubio and Vicente Prado-Gascó

Int. J. Environ. Res. Public Health 2020, 17(22), 8365; https://doi.org/10.3390/ijerph17228365 - 12 Nov 2020

Cited by 3 | Viewed by 3012

Abstract

Although the world’s forcibly displaced population reached 79.5 million in 2019, their difficult situations and the issues they struggle with remain practically invisible in Spanish society. Therefore, it seems necessary to provide greater insight into an invisible reality to improve the refugees’ situation. [...] Read more.

Although the world’s forcibly displaced population reached 79.5 million in 2019, their difficult situations and the issues they struggle with remain practically invisible in Spanish society. Therefore, it seems necessary to provide greater insight into an invisible reality to improve the refugees’ situation. The present cross-sectional study aims to draw a general profile of refugees’ and asylum seekers’ main characteristics in Spain and their well-being. A total of 186 refugees living in Spain participated. An ad-hoc questionnaire was administered to obtain data regarding sociodemographic profile, language skills, and social and institutional support. A standardized instrument, SPANE, was used to measure well-being. It can be seen that healthcare, followed by legal aid, are the easiest to access. On the other hand, finding a job, having money, and finding housing are the most difficult. In general, it seems possible to say that the refugees present more positive feelings than negative ones, which implies a positive emotional balance, although the average score obtained for emotional balance is quite far from the highest possible score. We consider this to be a pivotal first step which can provide useful information for the further design of aid strategies to improve this vulnerable group’s situation. Full article

(This article belongs to the Special Issue The Health and Wellbeing of Migrant Populations)

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21 pages, 442 KiB

Open AccessArticle

The Health Consequences of Neocolonialism for Latin American Immigrant Women Working as Caregivers in Spain: A Multisite Qualitative Analysis

by Erica Briones-Vozmediano, Natalia Rivas-Quarneti, Montserrat Gea-Sánchez, Andreu Bover-Bover, Maria Antonia Carbonero and Denise Gastaldo

Int. J. Environ. Res. Public Health 2020, 17(21), 8278; https://doi.org/10.3390/ijerph17218278 - 9 Nov 2020

Cited by 5 | Viewed by 4293

Abstract

In Spain, most jobs available for Latin American immigrant women are in intimate labour (caregiving and domestic work). This work is usually performed under informal employment conditions. The objective of this study was to explain how the colonial logic mediates the experiences of [...] Read more.

In Spain, most jobs available for Latin American immigrant women are in intimate labour (caregiving and domestic work). This work is usually performed under informal employment conditions. The objective of this study was to explain how the colonial logic mediates the experiences of Latin American women working in intimate labour in Spain, and the effects of such occupation on their health and wellbeing, using a decolonial theoretical framework. A multi-site secondary data analysis of qualitative data from four previous studies was performed utilizing 101 interviews with Latin American immigrant women working as caregivers in Spain. Three interwoven categories show how the dominant colonial logic in Spain creates low social status and precarious jobs, and naturalizes intimate labour as their métier while producing detrimental physical and psychosocial health consequences for these immigrant caregivers. The caregivers displayed several strategies to resist and navigate intimate labour and manage its negative impact on health. Respect and integration into the family for whom they work had a buffering effect, mediating the effects of working conditions on health and wellbeing. Based on our analysis, we suggest that employment, social, and health protection laws and strategies are needed to promote a positive working environment, and to reduce the impact of caregiving work for Latin American caregivers. Full article

(This article belongs to the Special Issue The Health and Wellbeing of Migrant Populations)

14 pages, 565 KiB

Open AccessArticle

Trajectories of Depressive Symptoms among Multicultural Adolescents in Korea: Longitudinal Analysis Using Latent Class Growth Model

by Min Kyung Song, Ju Young Yoon and Eunjoo Kim

Int. J. Environ. Res. Public Health 2020, 17(21), 8217; https://doi.org/10.3390/ijerph17218217 - 6 Nov 2020

Cited by 11 | Viewed by 3469

Abstract

The purpose of this study was to investigate the trajectory of depressive symptoms in multicultural adolescents using longitudinal data, and to identify predictive factors related to depressive symptoms of multicultural adolescents using latent class analysis. We used six time-point data derived from the [...] Read more.

The purpose of this study was to investigate the trajectory of depressive symptoms in multicultural adolescents using longitudinal data, and to identify predictive factors related to depressive symptoms of multicultural adolescents using latent class analysis. We used six time-point data derived from the 2012 to 2017 Multicultural Adolescents Panel Study (MAPS). Latent growth curve modeling was used to assess the overall features of depressive symptom trajectories in multicultural adolescents, and latent class growth modeling was used to determine the number and shape of trajectories. We applied multinomial logistic regression analysis to each class to explore predictive factors. We found that the overall slope of depressive symptoms in multicultural adolescents increased. Latent class analysis demonstrated three classes: (1) high-increasing class (i.e., high intercept, significantly increasing slope), (2) moderate-increasing class (i.e., moderate intercept, significantly increasing slope), and (3) low-stable class (i.e., low intercept, no significant slope). In particular, we found that the difference in the initial intercept of depressive symptoms determined the subsequent trajectory. There is a need for early screening for depressive symptoms in multicultural adolescents and preparing individual mental health care plans. Full article

(This article belongs to the Special Issue The Health and Wellbeing of Migrant Populations)

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14 pages, 701 KiB

Open AccessArticle

Well-Being without Employment? Promoting the Employability of Refugees

by Lucía I. Llinares-Insa, Manuel Roldán-Pardo, Pilar González-Navarro and María Desamparados Benedito-Monleón

Int. J. Environ. Res. Public Health 2020, 17(21), 7775; https://doi.org/10.3390/ijerph17217775 - 23 Oct 2020

Cited by 3 | Viewed by 2853

Abstract

There are more than 25 million refugees in the world. Many of them try to reach the Mediterranean in order to enter Europe. Spain is one of the countries that receive refugees and have to integrate them. Many refugees have experienced persecution in [...] Read more.

There are more than 25 million refugees in the world. Many of them try to reach the Mediterranean in order to enter Europe. Spain is one of the countries that receive refugees and have to integrate them. Many refugees have experienced persecution in their countries, as well as forced migration, rape, diseases, etc. Their integration requires support and coordination from the government, health services, and social agents. The first step in achieving this integration is getting a job, which is currently an important issue. Thus, we aim to analyze the employability of a specific group of refugees in Spain and then develop and implement an intervention program to improve their employability. Our framework is based on the Bioecological Model of Employability. The results obtained show that the program is effective in improving employability, and they highlight the importance of labor inclusion for refugees’ well-being. Moreover, the findings reveal the need to create labor market policies and further evaluations, diagnostics, and intervention programs that improve employability and other types of personal-community growth. It is necessary to focus on refugees’ needs and develop appropriate services. Full article

(This article belongs to the Special Issue The Health and Wellbeing of Migrant Populations)

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19 pages, 7397 KiB

Open AccessArticle

Therapeutic Nature Activities: A Step Toward the Labor Market for Traumatized Refugees

by Dorthe Varning Poulsen, Anna María Pálsdóttir, Sasja Iza Christensen, Lotta Wilson and Sigurd Wiingaard Uldall

Int. J. Environ. Res. Public Health 2020, 17(20), 7542; https://doi.org/10.3390/ijerph17207542 - 16 Oct 2020

Cited by 10 | Viewed by 4975

Abstract

Background: Globally, the number of refugees is growing. For many refugees, entering the labor market in their new country of residence is challenging. Some remain forever dependent on welfare services, and this not only weakens their chances of integration, but also harms [...] Read more.

Background: Globally, the number of refugees is growing. For many refugees, entering the labor market in their new country of residence is challenging. Some remain forever dependent on welfare services, and this not only weakens their chances of integration, but also harms their health and well-being. Methods: This qualitative single case study focused on a group of war-stricken refugees in Denmark. The study investigated the impact of an eight-month horticultural vocational program aimed at improving their ability to complete an education program or to work. A total of 29 interviews were conducted and analyzed using the interpretative phenomenological analysis (IPA) method. Results: The natural environment in the eco-village evoked a feeling of safety as well as positive memories in the participants, in contrast to the traumatic memories they had of their flight. Horticultural activities and the positive and respectful attitude from staff initiated a recovery process. New skills were achieved at an individual pace, and feelings of isolation decreased. These findings can be implicated in future interventions. Full article

(This article belongs to the Special Issue The Health and Wellbeing of Migrant Populations)

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11 pages, 735 KiB

Open AccessArticle

Community-Based Intervention to Improve the Well-Being of Children Left Behind by Migrant Parents in Rural China

by Minmin Jiang, Lu Li, Wei Xing Zhu and Therese Hesketh

Int. J. Environ. Res. Public Health 2020, 17(19), 7218; https://doi.org/10.3390/ijerph17197218 - 2 Oct 2020

Cited by 11 | Viewed by 3105

Abstract

In rural China around 60 million left-behind children (LBC) experience prolonged separation from migrant worker parents. They are vulnerable to a range of psychosocial problems. The aim of this study was to determine whether a community-based intervention consisting of Children’s Centres can improve [...] Read more.

In rural China around 60 million left-behind children (LBC) experience prolonged separation from migrant worker parents. They are vulnerable to a range of psychosocial problems. The aim of this study was to determine whether a community-based intervention consisting of Children’s Centres can improve psychosocial well-being and school performance of these children. The intervention was carried out in 20 villages, for children aged 7 to 15 years, irrespective of left-behind status. Nine hundred and twenty children, 438 LBC and 256 children living with parents (RC) attended the Centres. At follow-up after one year, there were improvements compared to baseline in total difficulties (measured with the Strengths and Difficulties Questionnaire) in children left behind by both parents (p = 0.009), children left behind by one parent (p = 0.008) and RC (p = 0.05). Postintervention school performance significantly improved in both categories of LBC (p < 0.001), but not RC (p = 0.07); social support score increased in both categories of LBC (p < 0.001) and RC (p = 0.01). Findings from interviews with key stakeholders were overwhelmingly positive about the impacts. With strong local leadership and community motivation, a low-cost intervention can improve children’s psychosocial well-being in these settings. Allowing communities to adapt the model to their own situation fosters local ownership, commitment, with benefits for children, parents, carers, and communities. Full article

(This article belongs to the Special Issue The Health and Wellbeing of Migrant Populations)

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15 pages, 395 KiB

Open AccessArticle

“Work Like a Chinese”: Aspirations, Patterns of Work, and Working Conditions of the Chinese Immigrant Community in Southern Spain

by Bárbara Badanta, María González-Cano Caballero, Elena Fernández-García, Rocío de Diego-Cordero, Giancarlo Lucchetti, Rafael-Jesús Fernández-Castillo and Sergio Barrientos-Trigo

Int. J. Environ. Res. Public Health 2020, 17(19), 7063; https://doi.org/10.3390/ijerph17197063 - 27 Sep 2020

Cited by 6 | Viewed by 3550

Abstract

Expanding businesses was the main reason for the immigration of Chinese people in Spain, which consists the fifth largest nationality of immigrants in this country. Nevertheless, few studies have been carried out to understand the working conditions of this population. Using an ethnographic [...] Read more.

Expanding businesses was the main reason for the immigration of Chinese people in Spain, which consists the fifth largest nationality of immigrants in this country. Nevertheless, few studies have been carried out to understand the working conditions of this population. Using an ethnographic design, this study examined the work patterns and working conditions among Chinese immigrants living in southern Spain and how these factors affected their health. Observing participants, field notes, and semi-structured interviews with question script were conducted with 133 Chinese immigrants. Five main themes were defined: “Economic improvement as a migratory reason”, “Conception to Work”, “Labor Sector”, “Work conditions”, and “Occupational health”. Our results showed that Chinese immigrants worked in the provision of services, with long working hours and little rest. Although they had low rates of unemployment, the working conditions had an important impact on their dietary patterns and their family life. Ergonomic and psychosocial risks also explained high rates of musculoskeletal problems and stress. In conclusion, Chinese immigrants living in southern Spain work actively in the service sector of the economy, but with many work hours. These characteristics seem to impact their health at a physical, psychological, and social level. Full article

(This article belongs to the Special Issue The Health and Wellbeing of Migrant Populations)

15 pages, 747 KiB

Open AccessArticle

Uncertainties, Fear and Stigma: Perceptions of Zika Virus among Pregnant Women in Spain

by Elena Marbán-Castro, Ana Villén-Gonzalvo, Cristina Enguita-Fernàndez, Anna Marín-Cos, Clara Menéndez, Maria Maixenchs and Azucena Bardají

Int. J. Environ. Res. Public Health 2020, 17(18), 6643; https://doi.org/10.3390/ijerph17186643 - 11 Sep 2020

Cited by 20 | Viewed by 4165

Abstract

Similar to other epidemics, knowledge about Zika virus (ZIKV) relies upon information often coming from outside the health system. This study aimed to explore views, perceptions and attitudes towards ZIKV among migrant women from Central and South America, diagnosed with ZIKV infection during [...] Read more.

Similar to other epidemics, knowledge about Zika virus (ZIKV) relies upon information often coming from outside the health system. This study aimed to explore views, perceptions and attitudes towards ZIKV among migrant women from Central and South America, diagnosed with ZIKV infection during pregnancy, and to comprehend healthcare professionals’ perceptions of ZIKV. An exploratory qualitative study, based on phenomenology and grounded theory, was conducted in Barcelona, Spain. Data were collected through in-depth and paired interviews with women diagnosed with ZIKV infection during pregnancy, and semi-structured interviews with healthcare professionals. Women showed good level of awareness of ZIKV, despite some knowledge gaps. The most consulted source of information about ZIKV was the Internet. Women expressed they suffered from anxiety and depression due to potential effects of ZIKV on their babies. They conveyed their sources of support came primarily from their partners and relatives, as well as healthcare professionals. This study stresses the dramatic health, social and emotional burden that the epidemic imposed on migrant women infected with ZIKV during pregnancy. These results may help guide psychosocial support and health measures for pregnant women and their children as part of the public health emergency response in emergent epidemics. Full article

(This article belongs to the Special Issue The Health and Wellbeing of Migrant Populations)

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12 pages, 710 KiB

Open AccessArticle

Prejudice and Feeling of Threat towards Syrian Refugees: The Moderating Effects of Precarious Employment and Perceived Low Outgroup Morality

by Macarena Vallejo-Martín, Jesús M. Canto, Jesús E. San Martín García and Fabiola Perles Novas

Int. J. Environ. Res. Public Health 2020, 17(17), 6411; https://doi.org/10.3390/ijerph17176411 - 3 Sep 2020

Cited by 11 | Viewed by 4132

Abstract

Refugees frequently experience traumatic situations that result in the deterioration of their psychological well-being. In addition, perceived prejudice and discrimination against them by the host society can worsen their mental health. In this research study, using a Spanish sample, prejudice towards Syrian refugees [...] Read more.

Refugees frequently experience traumatic situations that result in the deterioration of their psychological well-being. In addition, perceived prejudice and discrimination against them by the host society can worsen their mental health. In this research study, using a Spanish sample, prejudice towards Syrian refugees is analyzed taking into account feeling of threat (realistic or symbolic), precarious employment, and perceived outgroup morality. Using a total of 365 participants, our results reveal that individuals feel more prejudice towards refugees when the former scored higher in realistic threat and symbolic threat, were in a highly precarious situation of employment and perceived refugees as being more immoral. Furthermore, it was found that persons who scored high in realistic threat and at the same time were in a situation of precarious employment, were those who displayed greater prejudice. The results likewise pointed to individuals who scored high in symbolic threat and in outgroup morality as being those who felt greater rejection towards the refugees. Accordingly, our results confirm the importance of feeling of threat in relation to prejudice, and highlight two important moderating factors: precarious employment and perceived outgroup morality. Full article

(This article belongs to the Special Issue The Health and Wellbeing of Migrant Populations)

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13 pages, 361 KiB

Open AccessArticle

Determinants of Refugee and Migrant Health Status in 10 European Countries: The Mig-HealthCare Project

by Elena Riza, Pania Karnaki, Alejandro Gil-Salmerón, Konstantina Zota, Maxwell Ho, Maria Petropoulou, Konstantinos Katsas, Jorge Garcés-Ferrer and Athena Linos

Int. J. Environ. Res. Public Health 2020, 17(17), 6353; https://doi.org/10.3390/ijerph17176353 - 31 Aug 2020

Cited by 19 | Viewed by 4371

Abstract

In this study, we collect and synthesize information on the health status of the refugee/migrant population in ten European countries in order to map refugee/migrant health needs. With this information, we identify areas of intervention and healthcare system strengthening to provide the basis [...] Read more.

In this study, we collect and synthesize information on the health status of the refugee/migrant population in ten European countries in order to map refugee/migrant health needs. With this information, we identify areas of intervention and healthcare system strengthening to provide the basis for future health planning and effective healthcare provision to migrants, asylum-seekers and refugees in the European Union (EU). Methods: 1407 migrants in ten European Union countries (consortium members of the Mig-HealthCare project) were surveyed on general health, mental health, and specific diseases using an interviewer-administered questionnaire. Descriptive statistics and multivariable linear regression analyses were conducted to investigate the risk factors on general quality of life for migrants and refugees in the EU. Results: Mean age was 31.9 (±11.05) years and 889 (63.1%) participants were males. The majority came from Syria, Afghanistan, Iraq, Nigeria, and Iran. Having a mental health disorder or a chronic disease such as a heart or respiratory disease was associated with worse general health. On the other hand, having permission to stay in the country of interview and being interviewed in the country of final destination was associated with better general health. Access to health care services was fragmented or unavailable for some interviewees because of linguistic, cultural, or administrative barriers. Conclusions: The management of chronic diseases and mental health conditions in European migrants and refugees is a key priority for health service provision. Further efforts should be made to guarantee healthcare access for migrant and refugee populations. Full article

(This article belongs to the Special Issue The Health and Wellbeing of Migrant Populations)

17 pages, 313 KiB

Open AccessArticle

Comparison of Illness Concepts and Coping Strategies among Cancer Patients of Turkish and German Origin

by Katja Thein, Yesim Erim and Eva Morawa

Int. J. Environ. Res. Public Health 2020, 17(15), 5580; https://doi.org/10.3390/ijerph17155580 - 2 Aug 2020

Cited by 3 | Viewed by 2679

Abstract

Background: The aim of this study was to compare illness concepts and coping strategies among native German cancer patients and those with a Turkish migration background. Methods: Guideline-based, semi-structured interviews were conducted with 11 German (♂: 8, ♀: 3) and 11 Turkish (♂: [...] Read more.

Background: The aim of this study was to compare illness concepts and coping strategies among native German cancer patients and those with a Turkish migration background. Methods: Guideline-based, semi-structured interviews were conducted with 11 German (♂: 8, ♀: 3) and 11 Turkish (♂: 2, ♀: 9) cancer patients. The transcripts were evaluated using a qualitative content analysis in accordance with Mayring. Results: We identified eight categories of illness concepts: stressful life events, environmental influences, the will of God, medical factors, fate, trauma, health behaviour, and psychological causes. German patients frequently attributed their illness to environmental influences, persistent stress, or medical factors, whereas Turkish patients blamed persistent stress, the will of God, or trauma. The last two categories are not found among German patients. We classified the coping strategies into 11 main categories: social support, activity, patient competence, fighting spirit/positive thinking, use of health services/alternative healing methods, lifestyle, emotional coping, cognitive coping, religious coping, spiritual coping, and culture-specific methods for patients of Turkish origin. For German patients, activities as well as social support played primary roles in coping. Turkish patients also often used social support. However, in contrast to the German patients, they are less active and use much more religious coping and culture-specific means. In addition, negative emotions occur more often when processing the illness than in the German patients. Conclusion: Common illness representations and coping strategies could be found for Turkish and German patients, but also specific ones for the respective group. It is particularly noticeable that German patients attach more importance to medical factors and try more actively to cope with the illness. For Turkish patients, cultural and religious factors play an important role, which should also be considered in treatment. Full article

(This article belongs to the Special Issue The Health and Wellbeing of Migrant Populations)

20 pages, 1111 KiB

Open AccessArticle

The Policy Information Gap and Resettlers’ Well-Being: Evidence from the Anti-Poverty Relocation and Resettlement Program in China

by Cong Li and Minglai Li

Int. J. Environ. Res. Public Health 2020, 17(8), 2957; https://doi.org/10.3390/ijerph17082957 - 24 Apr 2020

Cited by 12 | Viewed by 3631

Abstract

The widespread dissemination of policy information is necessary for the success of the public policy, but the distribution of information among vulnerable groups has received little attention. We examined a public policy that focuses on the poorest people in China, the anti-poverty relocation [...] Read more.

The widespread dissemination of policy information is necessary for the success of the public policy, but the distribution of information among vulnerable groups has received little attention. We examined a public policy that focuses on the poorest people in China, the anti-poverty relocation and settlement program (ARSP). The infrastructure in the region where the policy is implemented is weak, and the information literacy of resettlers is low. This study analyses the impact of the policy information gap on the subjective well-being of resettlers. We found that the distribution of policy information among the poor is uneven, and the resettlers compare the policy information they obtain with a reference group (working-age people and less-educated people in the same village/community) to generate a policy information gap. The policy information gap indirectly affects subjective well-being by affecting the probability that people will be exposed to risks due to policy. As the policy information gap increases, the subjective well-being of resettlers changes in an inverted U-shape. This impact varies significantly among different groups, policy implementation stages, and resettlement methods. Attention should be paid to the information acquisition ability of the vulnerable groups and the welfare effects of social comparison, and to improve the method of publicizing policy information, which helps to improve the well-being of resettlers. Full article

(This article belongs to the Special Issue The Health and Wellbeing of Migrant Populations)

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11 pages, 1652 KiB

Open AccessArticle

Contact Mixing Patterns and Population Movement among Migrant Workers in an Urban Setting in Thailand

by Wiriya Mahikul, Somkid Kripattanapong, Piya Hanvoravongchai, Aronrag Meeyai, Sopon Iamsirithaworn, Prasert Auewarakul and Wirichada Pan-ngum

Int. J. Environ. Res. Public Health 2020, 17(7), 2237; https://doi.org/10.3390/ijerph17072237 - 26 Mar 2020

Cited by 4 | Viewed by 5273

Abstract

Data relating to contact mixing patterns among humans are essential for the accurate modeling of infectious disease transmission dynamics. Here, we describe contact mixing patterns among migrant workers in urban settings in Thailand, based on a survey of 369 migrant workers of three [...] Read more.

Data relating to contact mixing patterns among humans are essential for the accurate modeling of infectious disease transmission dynamics. Here, we describe contact mixing patterns among migrant workers in urban settings in Thailand, based on a survey of 369 migrant workers of three nationalities. Respondents recorded their demographic data, including age, sex, nationality, workplace, income, and education. Each respondent chose a single day to record their contacts; this resulted in a total of more than 8300 contacts. The characteristics of contacts were recorded, including their age, sex, nationality, location of contact, and occurrence of physical contact. More than 75% of all contacts occurred among migrants aged 15 to 39 years. The contacts were highly clustered in this age group among migrant workers of all three nationalities. There were far fewer contacts between migrant workers with younger and older age groups. The pattern varied slightly among different nationalities, which was mostly dependent upon the types of jobs taken. Half of migrant workers always returned to their home country at most once a year and on a seasonal basis. The present study has helped us gain a better understanding of contact mixing patterns among migrant workers in urban settings. This information is useful both when simulating disease epidemics and for guiding optimal disease control strategies among this vulnerable section of the population. Full article

(This article belongs to the Special Issue The Health and Wellbeing of Migrant Populations)

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10 pages, 487 KiB

Open AccessArticle

The Impact of Spousal Migration on the Mental Health of Nepali Women: A Cross-Sectional Study

by Nirmal Aryal, Pramod R. Regmi, Edwin van Teijlingen, Steven Trenoweth, Pratik Adhikary and Padam Simkhada

Int. J. Environ. Res. Public Health 2020, 17(4), 1292; https://doi.org/10.3390/ijerph17041292 - 17 Feb 2020

Cited by 8 | Viewed by 5325

Abstract

Spousal separation, lack of companionship, and increased household responsibilities may trigger mental health problems in left-behind female spouses of migrant workers. This study aimed to examine mental ill-health risk in the left-behind female spouses of international migrant workers in Nepal. A cross-sectional survey [...] Read more.

Spousal separation, lack of companionship, and increased household responsibilities may trigger mental health problems in left-behind female spouses of migrant workers. This study aimed to examine mental ill-health risk in the left-behind female spouses of international migrant workers in Nepal. A cross-sectional survey was carried out in the Nawalparasi district. Study areas were purposively chosen; however, participants were randomly selected. Nepali versions of the 12-item General Health Questionnaire (GHQ), Beck Depression Inventory (BDI), and Connor–Davidson Resilience Scale (CD-RISC) were used. Mental ill-health risk was prevalent in 3.1% of the participants as determined by GHQ. BDI identified mild or moderate depression in 6.5% of the participants with no one having severe depression. In bivariate analysis, a high frequency of communication with the husband was associated with lower mental ill-health risk and depression, as well as increasing resilience. Reduced return intervals of husbands and a high frequency of remittance were also associated with a low GHQ score. In a multiple regression model, adjusting for potential confounding variables, participants who communicated with their husbands at least once a day had a greater mean CD-RISC score (i.e., high resilience against mental ill-health risk) compared to those who did so at least once a week; a mean difference of 3.6 (95% CI 0.4 to 6.9), P = 0.03. To conclude, a low mental ill-health risk was found in the female spouses of migrants. Full article

(This article belongs to the Special Issue The Health and Wellbeing of Migrant Populations)

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15 pages, 575 KiB

Open AccessArticle

The Role of Emotional Intelligence and Sociocultural Adjustment on Migrants’ Self-reported Mental Well-Being in Spain: A 14 Month Follow-Up Study

by José Luis González-Castro, Silvia Ubillos Landa, Alicia Puente Martínez and Maria Vera Perea

Int. J. Environ. Res. Public Health 2020, 17(4), 1206; https://doi.org/10.3390/ijerph17041206 - 13 Feb 2020

Cited by 5 | Viewed by 3096

Abstract

The analysis of mental and psychological health is a relevant public issue in modern societies. Migration is a process that may have a lasting impact on a person’s mental well-being. In this study, perceived health, emotional intelligence, sociocultural adjustment and the participants’ perceived [...] Read more.

The analysis of mental and psychological health is a relevant public issue in modern societies. Migration is a process that may have a lasting impact on a person’s mental well-being. In this study, perceived health, emotional intelligence, sociocultural adjustment and the participants’ perceived general situation, not only economical, were analyzed to attest their impact on psychological distress as a measure of mental well-being. Sixty-three migrants from Romania and Ecuador were contacted twice during a 14 month period in a middle-sized Spanish city. Attrition analyses show no significant differences in perceived psychological distress between those who participated only one time or who participated in both waves. Less psychological distress is related to less attention to one’s feelings and higher mood repair in both data waves. Stronger behavioral adjustment is also linked to less distress. Less distress in time 1 led to better perceived health, sociocultural adjustment and a perception of a better general situation in Spain in comparison to their home country in time 2. In general, more attention to negative feelings triggered more perceived psychological distress, whereas mood repair elicited less psychological distress, in time 2. The relevance of understanding the impact of emotional intelligence to health promotion programs with migrants is discussed. Full article

(This article belongs to the Special Issue The Health and Wellbeing of Migrant Populations)

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14 pages, 765 KiB

Open AccessArticle

School-Class Co-Ethnic and Immigrant Density and Current Smoking among Immigrant Adolescents

by Matthias Robert Kern, Andreas Heinz and Helmut Erich Willems

Int. J. Environ. Res. Public Health 2020, 17(2), 598; https://doi.org/10.3390/ijerph17020598 - 17 Jan 2020

Cited by 2 | Viewed by 2895

Abstract

Although the school-class is known to be an important setting for adolescent risk behavior, little is known about how the ethnic composition of a school-class impacts substance use among pupils with a migration background. Moreover, the few existing studies do not distinguish between [...] Read more.

Although the school-class is known to be an important setting for adolescent risk behavior, little is known about how the ethnic composition of a school-class impacts substance use among pupils with a migration background. Moreover, the few existing studies do not distinguish between co-ethnic density (i.e., the share of immigrants belonging to one’s own ethnic group) and immigrant density (the share of all immigrants). This is all the more surprising since a high co-ethnic density can be expected to protect against substance use by increasing levels of social support and decreasing acculturative stress, whereas a high immigrant density can be expected to do the opposite by facilitating inter-ethnic conflict and identity threat. This study analyses how co-ethnic density and immigrant density are correlated with smoking among pupils of Portuguese origin in Luxembourg. A multi-level analysis is used to analyze data from the Luxembourg Health Behavior in School-Aged Children study (N = 4268 pupils from 283 classes). High levels of co-ethnic density reduced current smoking. In contrast, high levels of immigrant density increased it. Thus, in research on the health of migrants, the distinction between co-ethnic density and immigrant density should be taken into account, as both may have opposite effects. Full article

(This article belongs to the Special Issue The Health and Wellbeing of Migrant Populations)

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12 pages, 323 KiB

Open AccessArticle

HIV Care Outcomes among Hispanics/Latinos with Diagnosed HIV in the United States by Place of Birth-2015–2018, Medical Monitoring Project

by Hanna B. Demeke, Qingwei Luo, Ruth E. Luna-Gierke, Mabel Padilla, Gladys Girona-Lozada, Sandra Miranda-De León, John Weiser and Linda Beer

Int. J. Environ. Res. Public Health 2020, 17(1), 171; https://doi.org/10.3390/ijerph17010171 - 25 Dec 2019

Cited by 8 | Viewed by 2975

Abstract

Relocation from one’s birthplace may affect human immunodeficiency virus (HIV) outcomes, but national estimates of HIV outcomes among Hispanics/Latinos by place of birth are limited. We analyzed Medical Monitoring Project data collected in 2015–2018 from 2564 HIV-positive Hispanic/Latino adults and compared clinical outcomes [...] Read more.

Relocation from one’s birthplace may affect human immunodeficiency virus (HIV) outcomes, but national estimates of HIV outcomes among Hispanics/Latinos by place of birth are limited. We analyzed Medical Monitoring Project data collected in 2015–2018 from 2564 HIV-positive Hispanic/Latino adults and compared clinical outcomes between mainland US-born (referent group), Puerto Rican (PR-born), and those born outside the United States (non-US-born). We reported weighted percentages of characteristics and used logistic regression with predicted marginal means to examine differences between groups (p < 0.05). PR-born Hispanics/Latinos were more likely to be prescribed antiretroviral therapy (ART) (94%) and retained in care (94%) than mainland-US-born (79% and 77%, respectively) and non-US-born (91% and 87%, respectively) Hispanics/Latinos. PR-born Hispanics/Latinos were more likely to have sustained viral suppression (75%) than mainland-US-born Hispanics/Latinos (57%). Non-US-born Hispanics/Latinos were more likely to be prescribed ART (91% vs. 79%), retained in care (87% vs. 77%), and have sustained viral suppression (74% vs. 57%) than mainland-US-born Hispanics/Latinos. Greater Ryan White HIV/AIDS-funded facility usage among PR-born, better mental health among non-US-born, and less drug use among PR-born and non-US-born Hispanics/Latinos may have contributed to better HIV outcomes. Expanding programs with comprehensive HIV/AIDS services, including for mental health and substance use, may reduce HIV outcome disparities among Hispanics/Latinos. Full article

(This article belongs to the Special Issue The Health and Wellbeing of Migrant Populations)

12 pages, 302 KiB

Open AccessArticle

Living a Healthy Life in Australia: Exploring Influences on Health for Refugees from Myanmar

by Carrie K. Wong, Carolynne White, Bwe Thay and Annie-Claude M. Lassemillante

Int. J. Environ. Res. Public Health 2020, 17(1), 121; https://doi.org/10.3390/ijerph17010121 - 23 Dec 2019

Cited by 11 | Viewed by 4359

Abstract

Background: Humanitarian migrants from Myanmar represent a significant refugee group in Australia; however, knowledge of their health needs and priorities is limited. This study aims to explore the meaning and influencers of health from the perspectives of refugees from Myanmar. Method: Using a [...] Read more.

Background: Humanitarian migrants from Myanmar represent a significant refugee group in Australia; however, knowledge of their health needs and priorities is limited. This study aims to explore the meaning and influencers of health from the perspectives of refugees from Myanmar. Method: Using a community-based participatory research (CBPR) design, a partnership was formed between the researchers, Myanmar community leaders and other service providers to inform study design. A total of 27 participants were recruited from a government-funded English language program. Data were collected using a short demographic survey and four focus groups, and were analysed using descriptive statistics and thematic analysis methods. Results: Key themes identified included: (1) health according to the perspectives of Australian settled refugees from Myanmar, (2) social connections and what it means to be part of community, (3) work as a key influence on health, and (4) education and its links with work and health. Conclusions: This study outlined the inter-relationships between health, social connections, work and education from the perspectives of refugees from Myanmar. It also outlined how people from Myanmar who are of a refugee background possess strengths that can be used to manage the various health challenges they face in their new environment. Full article

(This article belongs to the Special Issue The Health and Wellbeing of Migrant Populations)

15 pages, 366 KiB

Open AccessArticle

Nothing Like Living with a Family: A Qualitative Study of Subjective Well-Being and its Determinants among Migrant and Local Elderly in Dongguan, China

by Yuxi Liu, Rassamee Sangthong, Thammasin Ingviya and Chonghua Wan

Int. J. Environ. Res. Public Health 2019, 16(23), 4874; https://doi.org/10.3390/ijerph16234874 - 3 Dec 2019

Cited by 26 | Viewed by 4492

Abstract

Chinese economic development has led to a significant rise in internal migration over the last 20 years, including large numbers of elderly. When elderly Chinese people migrate, they still register their residency to their place of origin and often do not register with [...] Read more.

Chinese economic development has led to a significant rise in internal migration over the last 20 years, including large numbers of elderly. When elderly Chinese people migrate, they still register their residency to their place of origin and often do not register with the new administrative office at the destination due to the household registration (hukou) system in China. Thus, most of these migrant elderly do not receive full social services, possibly leading to poor subjective well-being. This study aims to qualitatively examine the level of subjective well-being and its determinants among migrants and local elderly in Dongguan City of Guangdong province, one of the most rapid economically developing areas in China. We also present the results of in-depth interviews among 27 elderly, 15 elderly migrants and 12 local elderly living in Dongguan. The results reveal that the overall subjective well-being of the two groups were good. Most migrants believed their well-being had remained stable or even improved over time due to family reunion and a better physical environment. Elderly’s most valuable needs and the main reason of migration is family reunion; however, inadequacy of social support, including community support and government support (e.g., gift during holiday season, free health examination, healthcare expenditure reimbursement), cannot be neglected for maintaining a good level of well-being. The well-being of migrant elderly can be further enhanced by promoting social services and welfare, recreational activities, and enhancing healthcare reimbursement in their new home. Full article

(This article belongs to the Special Issue The Health and Wellbeing of Migrant Populations)

16 pages, 997 KiB

Open AccessArticle

Professional and Volunteer Refugee Aid Workers–Depressive Symptoms and Their Predictors, Experienced Traumatic Events, PTSD, Burdens, Engagement Motivators and Support Needs

by Andrea Borho, Ekaterini Georgiadou, Theresa Grimm, Eva Morawa, Andrea Silbermann, Winfried Nißlbeck and Yesim Erim

Int. J. Environ. Res. Public Health 2019, 16(22), 4542; https://doi.org/10.3390/ijerph16224542 - 17 Nov 2019

Cited by 12 | Viewed by 3715

Abstract

In 2016, the Department of Psychosomatic Medicine and Psychotherapy of the University Hospital of Erlangen started conducting training for professional and voluntary aid workers. In total, 149 aid workers took part in the training courses, of which 135 completed the corresponding questionnaires. Engagement [...] Read more.

In 2016, the Department of Psychosomatic Medicine and Psychotherapy of the University Hospital of Erlangen started conducting training for professional and voluntary aid workers. In total, 149 aid workers took part in the training courses, of which 135 completed the corresponding questionnaires. Engagement motivators, perceived distress in refugee work and training needs were examined. Moreover, depressive symptoms, the prevalence of traumatic experiences and symptoms of posttraumatic stress disorder were explored. Participants named helping others as the highest motivating factor for their work with refugees and communication problems as the main burden. Thirteen aid workers (10.1%) showed clinically relevant depressive symptoms. In total, 91.4% of refugee aid workers had experienced at least one traumatic event personally or as a witness but only three (3.6%) fulfilled the psychometric requirements of a PTSD diagnosis. These three participants all belonged to the professional aid workers (6.3%). More severe symptoms of depression were significantly associated with female gender (β = 0.315, p = 0.001), higher perceived burdens of refugee work (β = 0.294, p = 0.002), and a larger number of experienced traumatic events (β = 0.357, p < 0.001). According to our results, we recommend psychological trainings and regular screenings for psychological stress in order to counteract possible mental illnesses. Full article

(This article belongs to the Special Issue The Health and Wellbeing of Migrant Populations)

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18 pages, 946 KiB

Open AccessArticle

Exploring the Experiences of West African Immigrants Living with Type 2 Diabetes in the UK

by Folashade Alloh, Ann Hemingway and Angela Turner-Wilson

Int. J. Environ. Res. Public Health 2019, 16(19), 3516; https://doi.org/10.3390/ijerph16193516 - 20 Sep 2019

Cited by 6 | Viewed by 4483

Abstract

The increasing prevalence and poorer management of Type 2 diabetes among West African immigrants in the UK is a public health concern. This research explored the experiences of West African immigrants in the management of Type 2 diabetes in the UK using a [...] Read more.

The increasing prevalence and poorer management of Type 2 diabetes among West African immigrants in the UK is a public health concern. This research explored the experiences of West African immigrants in the management of Type 2 diabetes in the UK using a constructivist grounded theory approach. In-depth individual interviews were conducted with thirty-four West African immigrants living with Type 2 diabetes in the London area. Fifteen male and nineteen female adult West African immigrants with age range from 33–82 years participated in the study. Participants were recruited from five diabetes support groups and community settings. Initial, focused and theoretical coding, constant comparison and memos were used to analyse collected data. Three concepts emerged: Changing dietary habits composed of participants’ experiences in meeting dietary recommendations, improving physical activity concerned with the experience of reduced physical activity since moving to the UK and striving to adapt which focus on the impact of migration changes in living with Type 2 diabetes in the UK. These address challenges that West African immigrants experience in the management of Type 2 diabetes in the UK. The findings of this research provide a better understanding of the influencing factors and can be used to improve the support provided for West Africans living with Type 2 diabetes in the UK, presenting a deeper understanding of socio-cultural factors that contribute to supporting individuals from this population. Full article

(This article belongs to the Special Issue The Health and Wellbeing of Migrant Populations)

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17 pages, 845 KiB

Open AccessArticle

Generalized Violence as a Threat to Health and Well-Being: A Qualitative Study of Youth Living in Urban Settings in Central America’s “Northern Triangle”

by Maria De Jesus and Carissa Hernandes

Int. J. Environ. Res. Public Health 2019, 16(18), 3465; https://doi.org/10.3390/ijerph16183465 - 18 Sep 2019

Cited by 14 | Viewed by 5995

Abstract

El Salvador, Guatemala, and Honduras rank among the top 10 countries experiencing violence in the world, despite not being at war. Although there is abundant literature on generalized violence in this “northern triangle” of Central America as a driver of out-migration to the [...] Read more.

El Salvador, Guatemala, and Honduras rank among the top 10 countries experiencing violence in the world, despite not being at war. Although there is abundant literature on generalized violence in this “northern triangle” of Central America as a driver of out-migration to the United States, very little is known about the perspectives and experiences of youth who do not migrate. This study aimed to elicit the emic perspectives of youth residing in the region on how the day-to-day generalized violence produces a pervasive threat to the overall health and human security of youth as well as the key protective factors and resiliencies at work. We conducted two separate waves of qualitative research in 2015 and 2018 over a 6-month period, which included 60 in-depth interviews and six focus groups among Salvadoran, Guatemalan and Honduran youth living in urban areas. Qualitative thematic analysis revealed two meta-themes: (1) ‘Lack of health,’ defined as not experiencing peace within the family, the community, and the country’ and (2) ‘Resilience.’ Thematic clusters that reflect the first meta-theme are: (1) violence as a common occurrence; (2) living in fear and insecurity; (3) victimization; and (4) lack of state protection and services. Thematic clusters for the second meta-theme are: (1) a positive future outlook and a commitment to education; (2) transnational and local family network support; and (3) engagement in community-based youth groups. To interpret the findings, we adopt the Latin American Social Medicine and Collective Health (LASM-CH) approach that prioritizes perspectives from the region. Generalized violence is conceptualized as a systemic phenomenon that is generated and reproduced through the complex interactions of structural inequities and unequal power relations. The findings of this study provide new insights into the implementation of a different approach to address the generalized violence, insights that may guide multi-sectoral health policies and interventions both in the region and transnationally. Full article

(This article belongs to the Special Issue The Health and Wellbeing of Migrant Populations)

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11 pages, 284 KiB

Open AccessArticle

Factors Associated with Access of Marital Migrants and Migrant Workers to Healthcare in Taiwan: A Questionnaire Survey with Quantitative Analysis

by Feng-Yuan Chu, Hsiao-Ting Chang, Chung-Liang Shih, Cherng-Jye Jeng, Tzeng-Ji Chen and Wui-Chiang Lee

Int. J. Environ. Res. Public Health 2019, 16(16), 2830; https://doi.org/10.3390/ijerph16162830 - 8 Aug 2019

Cited by 9 | Viewed by 3987

Abstract

In Taiwan, migrants come mostly for marriage and work. Several researchers have conducted health-related studies of marital migrants and migrant workers, but the access of the two groups to healthcare has not been studied. Therefore, our study investigated the factors associated with migrants’ [...] Read more.

In Taiwan, migrants come mostly for marriage and work. Several researchers have conducted health-related studies of marital migrants and migrant workers, but the access of the two groups to healthcare has not been studied. Therefore, our study investigated the factors associated with migrants’ access to healthcare, with the main foci being marital migrants and migrant workers in Taiwan. A structured and cross-sectional questionnaire was anonymously self-administered by migrants recruited to participate in this survey on a voluntary basis from 11 medical centers and 11 migrant-helping associations in Taiwan between May 1st and September 21st, 2018. A total of 753 questionnaires were analyzed. The majority of marital migrants (n = 243) and migrant workers (n = 449) surveyed were enrolled in Taiwan’s National Health Insurance system (92.7 vs. 93.5%, p = 0.68). More of the migrant workers (n = 205) than the marital migrants (n = 42) encountered language barriers while seeking medical services (48.0 vs. 17.1%, p < 0.001). A professional interpreter at the point of care was considered important by more of the migrant workers (n = 316) than the marital migrants (n = 89) (70.2 vs. 39.6%, p < 0.001). Although more than 90% of the surveyed migrants were enrolled in the health insurance system in Taiwan, many, especially among the migrant workers, still faced language barriers while seeking medical services. Full article

(This article belongs to the Special Issue The Health and Wellbeing of Migrant Populations)

12 pages, 326 KiB

Open AccessArticle

Evaluating the Provision of Health Services and Barriers to Treatment for Chronic Diseases among Syrian Refugees in Turkey: A Review of Literature and Stakeholder Interviews

by Jude Alawa, Parmida Zarei and Kaveh Khoshnood

Int. J. Environ. Res. Public Health 2019, 16(15), 2660; https://doi.org/10.3390/ijerph16152660 - 25 Jul 2019

Cited by 39 | Viewed by 7358

Abstract

Background: While Turkey hosts the largest number of Syrian refugees, the provision of health services for chronic disease among Syrian refugees in Turkey has been inadequate and understudied. This paper explores Turkish healthcare policies surrounding Syrian refugees’ access to health services for chronic [...] Read more.

Background: While Turkey hosts the largest number of Syrian refugees, the provision of health services for chronic disease among Syrian refugees in Turkey has been inadequate and understudied. This paper explores Turkish healthcare policies surrounding Syrian refugees’ access to health services for chronic diseases. Methods: We conducted a literature review and supplementary stakeholder interviews to evaluate the provision of chronic health services and the most common barriers to healthcare access among Syrian refugees in Turkey. Results: Though access to treatment for displaced Syrians has improved throughout the past five years, five primary barriers persist: registration procedure regulations, navigation of a new health system, language barriers, fear of adverse treatment, and cost. Conclusions: To drive improvements in healthcare for chronic diseases among Syrian refugees in Turkey, we recommend making registration procedures more accessible, developing more healthcare options in patients’ native language, increasing human resources, and advocating for more research surrounding chronic health conditions among refugees. Full article

(This article belongs to the Special Issue The Health and Wellbeing of Migrant Populations)

21 pages, 896 KiB

Open AccessArticle

Health System Responses to the Health Needs of Refugees and Asylum-seekers in Malaysia: A Qualitative Study

by Fiona Leh Hoon Chuah, Sok Teng Tan, Jason Yeo and Helena Legido-Quigley

Int. J. Environ. Res. Public Health 2019, 16(9), 1584; https://doi.org/10.3390/ijerph16091584 - 6 May 2019

Cited by 29 | Viewed by 7844

Abstract

Background: This study was conducted to examine the responses and challenges in addressing the health needs of refugees and asylum-seekers in Malaysia from a health systems and policy perspective. Methods: Twenty semi-structured in-depth interviews were conducted with key informants comprising experts, [...] Read more.

Background: This study was conducted to examine the responses and challenges in addressing the health needs of refugees and asylum-seekers in Malaysia from a health systems and policy perspective. Methods: Twenty semi-structured in-depth interviews were conducted with key informants comprising experts, healthcare professionals and program personnel with professional experience in refugee health issues. Deductive and inductive analyses were conducted to identify themes. Results: Our study identified a broad range of actors involved in the response to refugee health locally, of which a greater alignment of interests, collaboration and sharing of responsibility is needed. From a health systems and policy perspective, financial constraints are among the key challenges in addressing the health needs of the refugee and asylum-seeker population in Malaysia. While participants reported high quality healthcare being present in Malaysia, this was not affordable to refugees and asylum seekers. Cultural and language discordance are also key challenges faced by healthcare workers in the delivery of services; accentuating the need for greater cultural competence and language support. Improved access to medication is needed for those with chronic illnesses in order to effectively address the comprehensive health needs of the refugee and asylum-seeker population. Conclusions: Suggested ways forward include adopting a comprehensive health advocacy strategy grounded in the right to healthcare for all; adopting a multi-sectoral approach; tackling the social determinants of health; seeking diversified funding at the global and national level; and improving coordination and collaboration between the various actors. Full article

(This article belongs to the Special Issue The Health and Wellbeing of Migrant Populations)

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18 pages, 1215 KiB

Open AccessArticle

Why I Can’t, Won’t or Don’t Test for HIV: Insights from Australian Migrants Born in Sub-Saharan Africa, Southeast Asia and Northeast Asia

by Corie Gray, Roanna Lobo, Lea Narciso, Enaam Oudih, Praveena Gunaratnam, Rachel Thorpe and Gemma Crawford

Int. J. Environ. Res. Public Health 2019, 16(6), 1034; https://doi.org/10.3390/ijerph16061034 - 21 Mar 2019

Cited by 35 | Viewed by 6092

Abstract

People born in sub-Saharan Africa and Southeast Asia are overrepresented in HIV notifications in Australia. Just under half of all notifications among people from sub-Saharan Africa and Southeast Asia are diagnosed late. Increased HIV testing among these communities is necessary to ensure early [...] Read more.

People born in sub-Saharan Africa and Southeast Asia are overrepresented in HIV notifications in Australia. Just under half of all notifications among people from sub-Saharan Africa and Southeast Asia are diagnosed late. Increased HIV testing among these communities is necessary to ensure early diagnosis, better care and reduce likelihood of HIV onward transmission. Recently, Australia has made new HIV testing methods available: rapid HIV testing and self-testing kits. We conducted 11 focus groups with 77 participants with people from sub-Saharan Africa, Southeast Asia and Northeast Asia in four jurisdictions in Australia. Focus groups discussed barriers to HIV testing and the acceptability of new testing methods. Barriers to HIV testing included: cost and eligibility of health services, low visibility of HIV in Australia, HIV-related stigma, and missed opportunities by general practitioners (GPs) for early diagnosis of HIV and linkage into care. Participants had low levels of knowledge on where to test for HIV and the different methods available. Diverse opportunities for testing were considered important. Interventions to increase HIV testing rates among sub-Saharan African, Southeast Asia and Northeast Asian migrants in Australia need to be multi-strategic and aimed at individual, community and policy levels. New methods of HIV testing, including rapid HIV testing and self-testing, present an opportunity to engage with migrants outside of traditional health care settings. Full article

(This article belongs to the Special Issue The Health and Wellbeing of Migrant Populations)

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19 pages, 1285 KiB

Open AccessArticle

The Devil Is in the Detail—Understanding Divergence between Intention and Implementation of Health Policy for Undocumented Migrants in Thailand

by Rapeepong Suphanchaimat, Nareerut Pudpong, Phusit Prakongsai, Weerasak Putthasri, Johanna Hanefeld and Anne Mills

Int. J. Environ. Res. Public Health 2019, 16(6), 1016; https://doi.org/10.3390/ijerph16061016 - 20 Mar 2019

Cited by 23 | Viewed by 5162

Abstract

Migrants’ access to healthcare has attracted attention from policy makers in Thailand for many years. The most relevant policies have been (i) the Health Insurance Card Scheme (HICS) and (ii) the One Stop Service (OSS) registration measure, targeting undocumented migrants from neighbouring countries. [...] Read more.

Migrants’ access to healthcare has attracted attention from policy makers in Thailand for many years. The most relevant policies have been (i) the Health Insurance Card Scheme (HICS) and (ii) the One Stop Service (OSS) registration measure, targeting undocumented migrants from neighbouring countries. This study sought to examine gaps and dissonance between de jure policy intention and de facto implementation through qualitative methods. In-depth interviews with policy makers and local implementers and document reviews of migrant-related laws and regulations were undertaken. Framework analysis with inductive and deductive coding was undertaken. Ranong province was chosen as the study area as it had the largest proportion of migrants. Though the government required undocumented migrants to buy the insurance card and undertake nationality verification (NV) through the OSS, in reality a large number of migrants were left uninsured and the NV made limited progress. Unclear policy messages, bureaucratic hurdles, and inadequate inter-ministerial coordination were key challenges. Some frontline implementers adapted the policies to cope with their routine problems resulting in divergence from the initial policy objectives. The study highlighted that though Thailand has been recognized for its success in expanding insurance coverage to undocumented migrants, there were still unsolved operational challenges. To tackle these, in the short term the government should resolve policy ambiguities and promote inter-ministerial coordination. In the long-term the government should explore the feasibility of facilitating lawful cross-border travel and streamlining health system functions between Thailand and its neighbours. Full article

(This article belongs to the Special Issue The Health and Wellbeing of Migrant Populations)

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Review

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19 pages, 722 KiB

Open AccessReview

Prevalence, Determinants, and Effects of Food Insecurity among Middle Eastern and North African Migrants and Refugees in High-Income Countries: A Systematic Review

by Reima Mansour, Pranee Liamputtong and Amit Arora

Int. J. Environ. Res. Public Health 2020, 17(19), 7262; https://doi.org/10.3390/ijerph17197262 - 4 Oct 2020

Cited by 33 | Viewed by 6466

Abstract

Issues related to poverty and income inequality in high-income countries have led to food insecurity among some population groups, such as migrants and refugees. While there are some studies on the experience of some migrant groups (and other subpopulations), little is known about [...] Read more.

Issues related to poverty and income inequality in high-income countries have led to food insecurity among some population groups, such as migrants and refugees. While there are some studies on the experience of some migrant groups (and other subpopulations), little is known about food security among Middle Eastern and African migrants and refugees. This systematic review identified the prevalence of food insecurity and its effects among Middle Eastern and North African (MENA) migrants and refugees in high-income countries. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed in this systematic review. Four databases, namely MEDLINE (Ovid), Embase (Ovid), CINAHL (EBSCO), and PubMed were searched. Three studies met the inclusion criteria, all of which were conducted in USA: two among Sudanese migrant families, and one among Somali refugee women. The rates of reported food insecurity ranged from 40% to 71% and were significantly higher than for the general population. Food insecurity was associated with acculturation and socio-economic factors. Food insecurity adversely impacts the health of MENA migrants and refugees, creating economic implications for individuals, families, the broader community in which they now live, and for governments. Full article

(This article belongs to the Special Issue The Health and Wellbeing of Migrant Populations)

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