Finnish Migrant Health Research Articles

Potentially traumatic experiences pre-migration and adverse pregnancy and childbirth outcomes among women of Somali- and Kurdish-origin in Finland

BackgroundWomen in precarious conditions in their countries of origin, especially those who have left the country as refugees, may have been victims of serious mental and physical violence. These potentially traumatic experiences may threaten women’s reproductive health. This study examines the prevalence of potentially traumatic experiences pre-migration and female genital mutilation/cutting (FGM/C) and their associations with adverse reproductive outcomes among migrant women of Somali- and Kurdish-origin who have been pregnant in Finland.MethodsSurvey and register data of the participants of the Finnish Migrant Health and Wellbeing Study (Maamu), conducted in 2010–2012, were used. Women of 18 to 64 years of age, 185 Somali- and 230 Kurdish-origin, who had at least one pregnancy or birth in Finland were included in the analysis. The survey data were linked to the Finnish Medical Birth Register, the Register of Induced Abortions, and the Care Register for Health Care until 2018. For each outcome, logistic regression was used and adjusted for age, body mass index, time lived in Finland, and the number of births.ResultsA total of 67% of Somali-origin and 71% of Kurdish-origin women had experienced potentially traumatic experiences pre-migration and 64% of Somali- and 32% of Kurdish-origin women had also undergone FGM/C. In Kurdish-origin women, complications during pregnancy (e.g. bleeding in the first trimester, known or suspected fetal abnormality, signs of fetal hypoxia, death of the fetus and other problems) were significantly more common among women without potentially traumatic experiences (70%) than among women with potentially traumatic experiences (48%) (p-value 0.005). No associations between potentially traumatic experiences or FGM/C and other adverse reproductive outcomes were observed among Somali- or Kurdish-origin women.ConclusionPast trauma is common among Somali- and Kurdish-origin women and this needs to be evaluated in maternity care. However, we found no association between potentially traumatic experiences pre-migration and adverse reproductive outcomes.

The association of depressive and anxiety symptoms with the metabolic syndrome and its components among Russian, Somali, and Kurdish origin adults in Finland: A population-based study

ObjectivePositive association of depressive and anxiety symptoms with the metabolic syndrome (MetS) have been reported, however there is little information on these among migrant origin populations. The aim of this study was to examine these associations among diverse migrant origin populations in Finland. MethodsData of 318 Russian, 212 Somali, and 321 Kurdish origin participants in the cross-sectional Finnish Migrant Health and Wellbeing Study (Maamu) aged 30–64 years was used. The general population reference group constituted of 786 Health 2011 Survey participants. Depressive and anxiety symptoms were measured with HSCL-25 subscales. Harmonized definition of MetS was used. ResultsDepressive symptoms were associated with elevated blood pressure in Kurdish origin (30.1%, 95% CI 22.7–38.8 vs. 19.9%, 95%CI 15.4–25.4 for those with and without symptoms respectively); and elevated waist circumference (72.1%, 95%CI 56.9–83.5 vs. 55.0%, 95%CI 50.6–59.4) and triglycerides (30.8%, 95%CI 16.0–51.0 vs. 11.9%, 95%CI 9.3–15.0) in general population. Anxiety symptoms were associated with MetS (47.0%, 95%CI 37.6–56.7 vs. 31.9%, 95%CI 26.7–37.6) and elevated blood pressure (37.2%, 95%CI 28.3–46.9 vs. 18.8%, 95%CI 14.7–23.6), and with elevated triglycerides in Somali origin (33.0%, 95%CI 14.5–59.0 vs. 5.7%, 95%CI 3.3–9.6) and general population (30.2%, 95%CI 16.4–48.8, 12.8%, 95%CI 9.9–16.2). No associations between low HDL-cholesterol and depressive or anxiety symptoms were observed. ConclusionCardiometabolic health should be taken into account in mental health services. Future studies should explore the underlying pathways to the observed differences in strengths of associations of depressive and anxiety symptoms with MetS and its components across diverse migrant origin populations.

Iranian and Iraqi torture survivors in Finland and Sweden: findings from two population-based studies.

BackgroundMost refugees and other forced migrants have experienced potentially traumatic events (PTEs). Torture and other traumatic experiences, as well as various daily stressors, impact the mental health and psychosocial well-being of war-affected populations.MethodsThe study includes two population-based samples of Iranian and Iraqi men living in Finland and Sweden. The Finnish Migrant Health and Well-being Study (Maamu) was conducted in 2010–2012. The Linköping study was conducted in Sweden in 2005. In both samples, health and well-being measures, social and economic outcomes as well as health service utilization were reported.ResultsThe final sample for analysis consisted of two groups of males of Iranian or Iraqi origin: 278 residents in Finland and 267 residents in Sweden. Both groups were subdivided according to the reported PTEs: Torture survivors; Other PTEs; No PTEs. Migrants that reported PTEs, torture survivors in particular, had significantly poorer social and health outcomes. Torture survivors also reported lower trust and confidence in authorities and public service providers, as well as more loneliness, social isolation and experiences of discrimination.ConclusionsTorture and other PTEs prevalent in refugee and migrant populations create a wide-ranging and long-term impact in terms of increased risk of various types of adverse social and health conditions. Early identification through systematic and effective screening should be the first step in guiding migrants and refugees suffering from experiences of torture and other PTEs to flexible, multidisciplinary services.

The Association between Pre- and Post-Migration Wellbeing Factors with Integration among Russian, Somali, and Kurdish Origin Women in Finland

Pre- and post-migration related factors are likely to influence integration outcomes of migrants. This study aimed to investigate which pre-migration factors (basic education and potentially traumatic experiences) and post-migration wellbeing factors (quality of life and loneliness) are associated with integration outcomes (employment status, language skills, voting, media use, having host country’s native friends, participation inleisure activities) of migrant background men and women. The Finnish Migrant Health and Wellbeing Study (Maamu) was used, including working-aged adults of Russian, Somali, and Kurdish origin. Each integration outcome was analysed by each predictive factor with logistic regression, separately for the three groups and separately for men and women. The integration outcomes were somewhat differently associated with pre- and post-migration factors in the different groups. All these aspects are important to be taken into account in integration discourse to promote both integration and social wellbeing.

Are Self-rated Health, Native Finnish Friends and Having Children under School Age Associated with Employment?

In Western countries, entry into the labour market is difficult for humanitarian migrants, especially women. The aim of our study was to examine the association of health, native Finnish friends and having under school-age children with employment among humanitarian migrants.The data were drawn from the Finnish Migrant Health and Wellbeing Study. The sample comprised 479 migrants of Kurdish and Somali origin (men n=248; women n=231). We analysed the associations of self-rated health, having Finnish friends and under school age children with employment using multinomial regression modelling.After adjustment for several well-established determinants of employment, having Finnish friends and good health were robustly associated with employment among women. In the age-adjusted model, having 3–6 years old children was related to lower employment among women, but after all adjustments, the association became nonsignificant. All these associations were nonsignificant among male migrants.To conclude, good health and bridging social relations with natives play a role in strengtheningemployment opportunities among female humanitarian migrants.

Cervical Cancer Screening Participation among Women of Russian, Somali, and Kurdish Origin Compared with the General Finnish Population: A Register-Based Study.

Migrant-origin women are less prone to cervical screening uptake compared with host populations. This study examined cervical cancer screening participation and factors associated with it in the Finnish mass screening program during 2008–2012 in women of Russian, Somali and Kurdish origin compared with the general Finnish population (Finns) in Finland. The study population consists of samples from the Finnish Migrant Health and Well-being Study 2010–2012 and Health 2011 Survey; aged 30–64 (n = 2579). Data from the Finnish screening register linked with other population-based registry data were utilized. For statistical analysis we employed logistic regression. Age-adjusted screening participation rates were Russians 63% (95% CI: 59.9–66.6), Somalis 19% (16.4–21.6), Kurds 69% (66.6–71.1), and Finns 67% (63.3–69.8). In the multiple-adjusted model with Finns as the reference; odds ratios for screening were among Russians 0.92 (0.74–1.16), Somalis 0.16 (0.11–0.22), and Kurds 1.37 (1.02–1.83). Among all women, the substantial factor for increased screening likelihood was hospital care related to pregnancy/birth 1.73 (1.27–2.35), gynecological 2.47 (1.65–3.68), or other reasons 1.53 (1.12–2.08). Screening participation was lower among students and retirees. In conclusion, screening among the migrant-origin women varies, being significantly lowest among Somalis compared with Finns. Efforts using culturally tailored/population-specific approaches may be beneficial in increasing screening participation among women of migrant-origin.

Migrants Are Underrepresented in Mental Health and Rehabilitation Services-Survey and Register-Based Findings of Russian, Somali, and Kurdish Origin Adults in Finland.

Mounting evidence suggests that migration background increases the risk of mental ill health, but that problems exist in accessing healthcare services in people of migrant origin. The present study uses a combination of register- and survey-based data to examine mental health-related health service use in three migrant origin populations as well as the correspondence between the need and use of services. The data are from the Finnish Migrant Health and Wellbeing Study (Maamu), a comprehensive cross-sectional interview and a health examination survey. A random sample consisted of 5909 working-aged adults of Russian, Somali, and Kurdish origin of which 3000 were invited to participate in the survey and the rest were drawn for a register-based approach. Some of the mental health services, based on registers, were more prevalent in the Kurdish origin group in comparison with the general population and less prevalent in the Russian and Somali origin groups. All the migrant origin groups were underrepresented in rehabilitation services. When affective symptoms were taken into account, all the migrant origin groups were underrepresented in all of the services. This calls for actions to promote mental health, diminish the barriers to access services, and improve the service paths for migrants.

Substance use, affective symptoms, and suicidal ideation among Russian, Somali, and Kurdish migrants in Finland.

Comorbidity of substance use with affective symptoms and suicidality has been well documented in the general population. However, population-based migrant studies about this association are scarce. We examined the association of affective symptoms and suicidal ideation with binge drinking, daily smoking, and lifetime cannabis use among Russian, Somali, and Kurdish migrants in comparison with the Finnish general population. Cross-sectional data from the Finnish Migrant Health and Wellbeing Study (Maamu, n = 1307) and comparison group data of the general Finnish population (n = 860) from the Health 2011 Survey were used. Substance use included self-reported current binge drinking, daily smoking, and lifetime cannabis use. Affective symptoms and suicidal ideation were measured using the Hopkins Symptom Checklist-25 (HSCL-25). We performed multivariate logistic regression analyses, including age, gender, and additional socio-demographic and migration-related factors. Suicidal ideation (OR 2.4 95% CI 1.3–4.3) was associated with binge drinking among Kurds and lifetime cannabis use among Russians (OR 5.6, 95% CI 1.9–17.0) and Kurds (OR 5.5, 95% CI 1.9–15.6). Affective symptoms were associated with daily smoking (OR 1.6, 95% CI 1.02–2.6) and lifetime cannabis use (OR 6.1, 95% CI 2.6–14.5) among Kurdish migrants. Our results draw attention to the co-occurrence of suicidal ideation, affective symptoms, and substance use, especially among Kurdish migrants. These results highlight the variation of comorbidity of substance use and affective symptoms between the different populations. This implies that screening for substance use in mental healthcare cannot be neglected based on presumed habits of substance use.

Pre-migration traumatic experiences, post-migration perceived discrimination and substance use among Russian and Kurdish migrants-a population-based study.

Background and aimsThe associations between traumatic events, substance use and perceived discrimination have been rarely studied among migrants in host countries. We examined whether pre‐migration potentially traumatic experiences (PTEs) or perceived discrimination (PD) are associated with substance use among migrants with voluntary (Russians) and forced (Kurds) migration backgrounds.DesignCross‐sectional interview and health examination data from the Finnish Migrant Health and Wellbeing Study were used. The target sample (n = 1000 for each group) was drawn from the national population register using stratified random sampling by participants’ country of birth and native language.SettingPopulation‐based data were collected from six cities in Finland during 2010–12.ParticipantsThe participation rates were 68% (Russians) and 59% (Kurds). The analytical sample size varied (Russians n = 442–687, Kurds n = 459–613), as some participants completed only interview, health examination or short interview. The majority of Kurds had a refugee background (75%) while Russians had mainly migrated for other reasons (99%).MeasurementsThe three main outcomes were self‐reported binge drinking, daily smoking and life‐time cannabis use. PTEs and PD were self‐reported in the interview. Socio‐demographic background, migration‐related factors and current affective symptoms were adjusted for.FindingsAmong Kurds, PTEs were associated with binge drinking [adjusted odds ratio (aOR) = 2.65, 95% confidence interval (CI) = 1.30–5.42] and PD was associated with life‐time cannabis use (aOR = 3.89, 95% CI = 1.38–10.97) after adjusting for contextual factors. Among Russians, PTEs were associated with life‐time cannabis use adjusting for contextual factors (aOR = 2.17, 95% CI = 1.12–4.18).ConclusionsIn Finland, pre‐migration traumatic experiences appear to be associated with life‐time cannabis use among the Russian migrant population (voluntary migration) and binge drinking among the Kurdish migrant population (forced migration). Perceived discrimination in Finland appears to be associated with life‐time cannabis use among Kurdish migrants.

Mental health treatment gap in adults of Russian, Somali, and Kurdish origin in Finland

Abstract Background Migration affects migrating persons’ health in many levels. Populations of migrant origin, and in particular refugees, are known to have an increased risk of mental ill health. Previous research from Finland has shown that the prevalence of mental health symptoms is significantly higher among Russian origin women and Kurdish origin men and women than in the general population. Building on prior research, we explore the prevalence of perceived need for mental healthcare among Russian, Somali, and Kurdish origin populations and compare this to the general population in Finland. Additionally, we present prevalence of mental health treatment gap in these groups. Methods We used data from the Finnish Migrant Health and Wellbeing Study (n = 1404) and the Health 2011 Survey (n = 1459). Prevalence was calculated using predicted margins (95% confidence level). P-value of less than 0.05 was considered significant. Mental health treatment gap was examined by constructing a combined variable of perceived need for mental health services and prevalence of service use. Results The perceived need for mental health services was higher in Kurdish origin persons (16%) and lower in Somali origin persons (<1%) than in the general population (8%). Both Kurdish origin men (11%) and women (20%) expressed more need for mental health services than men (4%) and women (11%) in the general population. The mental health treatment gap was highest in Russian origin women (10%) and Kurdish origin women (10%) and men (8%). For the general population, the treatment gap was only 1% (men 2 %, women <1%). Conclusions Untreated mental health problems are unjust, problematic and can be a source of great human suffering. Evidence from Finland shows that especially persons of Kurdish origin experience a mental health treatment gap. To expand coverage and reduce inequalities in health services, national development projects (e.g. PALOMA) have been launched to improve mental healthcare. Key messages Perceived need for mental health services is more common among certain foreign-born populations than the general population in Finland; this is in line with prior research on mental health symptoms. Untreated mental health problems are unjust, problematic and can be a source of great human suffering; evidence of mental health treatment gap should lead to improved access to mental health services.

Enhancing Survey Participation among Foreign-Born Populations

The Finnish Migrant Health and Wellbeing Study (Maamu) is the first large-scale population-based health examination survey among the foreign-born population in Finland, unique also at the European level. It provides information on wellbeing of three major foreign-born groups: Russian, Somali, and Kurdish. In data collection, extra effort was put into reaching the sampled persons (n=3,000), for example by recruiting bilingual personnel to carry out the data collection, reaching participation rates as high as 70%, 51%, and 63%, respectively. A comparison group of the general population was available from a general population survey. The main challenges in fieldwork included reaching sampled persons, supervision of the fieldwork personnel, and special linguistic or cultural needs. Our experiences show that participation rate can be improved by engaging the target groups in all stages of the survey process and using several recruitment strategies, ending up with succeeding in pointing out health inequalities in the population.

Overweight and Obesity among Russian, Somali, and Kurdish Origin Populations in Finland

Previous studies have shown the prevalence of overweight and obesity to be higher in foreign-born populations than their native counterparts. This study aimed at assessing the prevalence of overweight and obesity in Russian, Somali and Kurdish origin populations in Finland in comparison with the general population, and determining which background factors associate with overweight and obesity. Data from the Finnish Migrant Health and Wellbeing Study (Maamu) were used. Prevalence of overweight and obesity was as high as 73% in Somali and 65% in Kurdish origin women. In contrast, Somali origin men had a significantly lower prevalence of overweight and obesity than men in the general population. Health promotion measures must be addressed towards decreasing the prevalence of overweight and obesity particularly among Somali and Kurdish origin women. Foreign-born people need to be taken into account when planning and implementing obesity prevention programs.

The association between discrimination and health: findings on Russian, Somali and Kurdish origin populations in Finland.

The Second European Union Minorities and Discrimination Survey recently demonstrated widespread discrimination across EU countries, with high discrimination rates observed in countries like Finland. Discrimination is known to negatively impact health, but fewer studies have examined how different types of perceived discrimination are related to health. This study examines (i) the prevalence of different types of perceived discrimination among Russian, Somali and Kurdish origin populations in Finland, and (ii) the association between different types of perceived discrimination (no experiences; subtle discrimination only; overt or subtle and overt discrimination) and health (self-rated health; limiting long-term illness (LLTI) or disability; mental health symptoms). Data are from the Finnish Migrant Health and Wellbeing Study (n = 1795). Subtle discrimination implies reporting being treated with less courtesy and/or treated with less respect than others, and overt discrimination being called names or insulted and/or threatened or harassed. The prevalence of discrimination and the associations between discrimination and health were calculated with predicted margins and logistic regression. Experiences of subtle discrimination were more common than overt discrimination in all the studied groups. Subtle discrimination was reported by 29% of Somali origin persons and 35% Russian and Kurdish origin persons. The prevalence of overt discrimination ranged between 22% and 24%. Experiences of discrimination increased the odds for poor self-reported health, LLTI and mental health symptoms, particularly among those reporting subtle discrimination only. To promote the health of diverse populations, actions against racism and discrimination are highly needed, including initiatives that promote shared belonging.

The prevalence of substance use among Russian, Somali and Kurdish migrants in Finland: a population-based study

BackgroundSubstance use is a well-known public health problem, but population-based research on migrants’ substance use in Europe is limited. Factors related to the cultural background and current life situation might influence substance use among migrants. Here, the prevalence of substance use in Russian, Somali and Kurdish migrants in Finland is reported in comparison with the general population, and the associations between substance use and socio-economic and migration-related background factors among migrants are analysed.MethodsCross-sectional data from the Finnish Migrant Health and Wellbeing Study (Maamu) and comparison group data of the general Finnish population (n = 1165) from the Health 2011 Survey were used. The survey participants were of Russian (n = 702), Somali (n = 512), and Kurdish (n = 632) origin. Substance use included self-reported alcohol use within previous 12 months (AUDIT-C questionnaire), current and lifetime daily smoking and lifetime use of cannabis and intravenous drugs.ResultsBinge drinking was less prevalent among all migrant groups than in the general Finnish population (Russian men 65%, p < 0.01; Russian women 30%, p < 0.01, Somali men 2%, p < 0.01, Kurdish men 27%, p < 0.01, Kurdish women 6%, p < 0.01, general population men 87% and women 72%). Current daily smoking was more prevalent among Russian (28%, p = 0.04) and Kurdish (29%, p < 0.01) migrant men compared with the reference group (20%). Younger age and employment were associated with binge drinking among migrants. Socio-economic disadvantage increased the odds for daily smoking in Russian, Somali and Kurdish migrant men. Several migration-related factors, such as age at migration and language proficiency, were associated with substance use.ConclusionsBinge drinking is less common among migrants than in the Finnish general population. However, current daily smoking was more prevalent among Russian and Kurdish migrant men compared with the general population. Younger age, level of education, employment, duration of residence in Finland and language proficiency were associated with binge drinking and daily smoking with varying patterns of association depending on the migrant group and gender. These findings draw attention to the variation in substance use habits among migrant populations.

Disparities in cervical screening participation: a comparison of Russian, Somali and Kurdish immigrants with the general Finnish population

BackgroundCervical cancer is currently ranked as the fourth commonly diagnosed cancer in women globally. A higher incidence has been reported in low- and-middle-income countries, and the disease poses significant public health challenges. Evidence suggests that this disease is preventable by means of regular screening using the Papanicolaou (Pap) test. However, limited knowledge exists about disparities in cervical screening participation among immigrants compared with non-immigrants, in countries with universal cervical screening programmes. We aimed to examine disparities in cervical screening participation among women of Russian, Somali, and Kurdish, origin in Finland, comparing them with the general Finnish population (Finns). We controlled for differences in several socio-demographic and health-related variables as potential confounders.MethodsWe employed data from the Finnish Migrant Health and Well-being Study 2010–2012 and the National Health 2011 Survey. Data collection involved face-to-face interviews. Data on screening participation in the previous five years from women aged 29–60 were available from 537 immigrants (257 Russians, 113 Somalis, 167 Kurds) and from 436 Finns. For statistical analyses, we used multiple logistic regression.ResultsAge-adjusted screening participation rates were as follows: Russians 79% (95% CI 72.9–84.4), Somalis 41% (95% CI 31.4–50.1), and Kurds 64% (95% CI 57.2–70.8), compared with 94% (95% CI 91.4–95.9) among Finns. After additionally adjusting for socio-demographic and health-related confounders, all the immigrant groups showed a significantly lower likelihood of screening participation when compared with Finns. The Odds Ratios were as follows: Russians 0.32 (95% CI 0.18–0.58), Somalis 0.10 (95% CI 0.04–0.23), and Kurds 0.17 (95% CI 0.09–0.35). However, when additionally accounting for country of origin-confounder interactions, such differences were attenuated.ConclusionsOur results indicate disparities in screening participation among these immigrants and a lower likelihood of screening participation compared with the general Finnish population. To improve equity in cervical cancer screening participation, appropriate culturally tailored intervention programmes for each immigrant group might be beneficial.

Immigrants' use of health care in their country of origin: the role of social integration, discrimination and the parallel use of health care systems.

The objective of this study was to elucidate the utilisation of Russian health care by immigrants of Russian origin living in Finland (cross-border health care). The study examined the association of cross-border health care with social integration and discrimination. Moreover, it studied whether cross-border health care was used as an alternative to the host-country's healthcare system. Data from the Finnish Migrant Health and Wellbeing Survey (Maamu) were utilised. The number of respondents of Russian origin was 545. The main analytical method was logistic regression. The outcome variable was based on a survey item on seeking physician's treatment or help abroad during the last 12months. Social integration was measured multi-dimensionally, and the indicator was extracted by multiple correspondence analysis. Ethical approval for the study was obtained from the Ethical Committee of the Uusimaa Hospital Region. We found that 15.4% of the respondents had visited a physician in Russia during the last 12months. 10.4% had experienced discrimination in Finnish health services during their stay in Finland. Stronger social integration predicted less frequent utilisation of cross-border health care. Experiences of discrimination or unfairness were associated with higher odds for seeking cross-border health care. Cross-border health care was typically used in parallel to the Finnish services. Our findings on integration and discrimination emphasise the importance of general integration policy as well as cultural competence in health care. Parallel use of healthcare systems entails both risks (e.g double medication, problems of follow-up) and opportunities (e.g. sense of agency), which should be further investigated.

Abstract 4225: Disparities in cervical cancer screening participation: a comparison of Russian, Somali and Kurdish immigrants with the Finnish general population

Abstract Background: Cervical cancer screening through Pap test has been shown as an effective preventive measure for early detection of precancerous in the cervix. Finland offers mass Pap test screening to all eligible women. Knowledge about disparities in the screening participation among immigrants compared with the Finnish general population is limited. Objectives: (1) To compare Pap test screening participation in the past five years among Russian, Somali and Kurdish immigrants living in Finland with the Finnish general female population; (2) to examine if the observed disparities remain similar when adjusted for socio- demographic and health-related confounding factors. Methods: Data from the Finnish Migrant Health and Well-being Study and Finnish Health 2011 Survey were used. Random samples of persons living in six cities in Finland were drawn from the national population registry. Data of self-reported cervical screening participation (Pap test) among women aged 29-60 were available from the women of Russian (n=257), Somali (n=113), Kurdish (n=167) origin and the general population (n= 436). Logistic regression was used for statistical analysis. Results: The age-adjusted Pap test participation rates were 79% among the Russian, 41% among the Kurdish, and 64% among the Somali, compared to 94% among the Finnish general population. After adjusting for age, socio - demographic, and health-related confounders, the immigrants had significantly lower likelihood for screening compared with the Finnish reference group (Russian Odds Ratio[OR] 0.33, 95% confidence interval [CI] 0.19-0.58; Somali [OR]0.08, [CI] 0.03-0.19; Kurdish [OR] 0.17 [CI]0.08-0.34). Conclusions: Initial results demonstrate significantly lower likelihood for Pap test screening among the immigrant groups compared with the Finnish general population. Note: This abstract was not presented at the meeting. Citation Format: Esther E. Idehen, Päivikki Koponen, Tommi Harkanen, Tellervo Korhonen. Disparities in cervical cancer screening participation: a comparison of Russian, Somali and Kurdish immigrants with the Finnish general population [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 4225. doi:10.1158/1538-7445.AM2017-4225

The Prevalence of Potentially Traumatic Pre-Migration Experiences: A Population- Based Study of Russian, Somali and Kurdish Origin Migrants in Finland

Background: On-going mass conflicts and the resulting flow of displaced persons have increased interest in potentially traumatic experiences (PTEs) of migrants. However, studies on the topic using population-based samples are still scarce. Aims: The present study aims 1) to assess the prevalence of specific PTEs in Finland's migrant population and 2) to determine whether socio-demographic and migration-related factors are associated with PTEs. Methods: Data from the Finnish Migrant Health and Wellbeing Study (Maamu), a cross-sectional interview and health examination survey, was used. The sample comprised Russian; Somali and Kurdish migrants aged 18-64. PTEs, with eight specified traumatic event items common among those exposed to war and conflict, were measured using interview questions. Results: The prevalence of having at least one PTE was 21% among Russian, 58% among Somalian and 77% among Kurdish origin migrants, higher in Kurdish men than women and lower in Somali men than women. The most typical forms of PTEs among Kurds and Somalis were war and witnessing a violent death or injury. The most severe events (e.g. torture) were more common and the highest cumulative number of PTEs was among Kurds. Migrating as a refugee or asylum seeker was not associated with higher prevalence of PTEs. Conclusions: Results indicated an alarmingly high overall PTE prevalence among Kurdish and Somali migrants in Finland, especially among Kurds. Results suggest that effort to identify PTEs and interventions should be targeted not only at those migrating with a refugee of asylum seeker status but all migrants from conflict areas.

Construct validity of the HSCL-25 and SCL-90-Somatization scales among Russian, Somali and Kurdish origin migrants in Finland

ABSTRACTOne of the most fundamental issues in psychiatric assessment across different sociocultural and linguistic groups is assuring test reliability and validity. We analyze the construct validity of the HSCL-25 depression and anxiety scales and the SCL-90-Somatization scale in a population-based study (Finnish Migrant Health and Wellbeing Study) among 1356 Russian, Somali and Kurdish origin migrants (aged 18–64 years old) in Finland using an Exploratory Structural Equation Modelling approach. The results revealed problems in establishing measurement invariance of the HSCL-25 depression and anxiety and SCL-90-Somatization scales. Two types of exploratory analysis (Exploratory Factor Analysis and Network Analysis) confirmed the mismatch between the theoretical structure and the data set. In addition, there were considerable group differences between the Russian, Somali and Kurdish groups, with the Somali group in particular showing differing results. The results are discussed in relation to sociocultural...

Traumatic pre-migration experiences: A population-based study of Russian, Somali and Kurdish origin migrants in Finland

Introduction Ongoing mass conflicts and the resulting flow of displaced persons have increased interest on pre-migration experiences of migrants, but population-based studies of entire migrant groups are still scarce. Objective We aim to assess the prevalence of a variety of possibly traumatic pre-migration experiences among Russian, Somali and Kurdish origin migrants in Finland and to determine which socio-demographic factors are associated with traumatic pre-migration experiences. Methods We used data from the Finnish Migrant Health and Wellbeing Study (Maamu). The survey sample comprised of Russian, Somali and Kurdish origin migrants, aged 18–64 years ( n =1000 per group). The data specified eight different traumatic events common to those exposed to war and conflict. The age-adjusted prevalence of traumatic pre-migration experiences were calculated in the ethnic groups by gender using predicted margins. Results Seventy-seven percent of Kurdish, 58% of Somali, and 21% of Russian origin migrants had experienced at least one traumatic event in the former host country. One third of the Kurdish men had been subject to torture. Surprisingly, migrating as a refugee or asylum seeker was not found to be associated with traumatic pre-migration experiences. Conclusion Results indicated an alarmingly high overall trauma exposure among Kurdish and Somali migrants in Finland. This should be taken into account in the planning of mental health services in the new host country.