Migrant Health Research Articles

Enhancing mental strength support for refugees through social principal: A comprehensive review

Refugees experience physical problems and extreme psychological as well as emotional stress as a result of the trauma of relocation, loss and the uncertainty of their future. Neglecting refugees' mental strength and social assistance needs can have long-term consequences for the individuals and the host communities. This highlights the need for comprehensive assistance programs that include basic requirements along with mental health treatment, education, skill training and chances for social inclusion. For this vulnerable category, we have limited information regarding social principle interventions at the individual and community levels that support mental health with little scientific data about the effectiveness of such interventions. This systematic review examines 536 publications on social-principle-based treatments for improving the mental health of refugees, 14 of which were chosen for examination. The material from these 14 publications assessed the studies, considering qualifying circumstances. The research results concentrate on many major issues, including mental health measurements, which provide insight into the assessment and evaluation instruments used to evaluate refugees' mental well-being. In addition, we discuss the difficulties that refugees encounter in obtaining appropriate mental health care, the amount of monitoring and its influence on their mental health outcomes. The study emphasizes the significance of tailored treatment options since customizing treatments to individual refugee needs is critical for effective mental health assistance. Finally, we explore the relevance of community-based therapeutic options, highlighting the importance of community engagement and support networks in boosting refugee mental health and well-being.

The Predictor Effect and Relationship Between Brain-Behavioral Systems, Cognitive Flexibility, Sensory Processing and Anxiety in Iranian Immigrant Students in Canada

Background: The rising prevalence of mental and psychological issues among immigrants has garnered increased attention due to the significant growth in immigrant populations in recent years. In this context, exploring the connection between psychological health, cognitive flexibility, brain-behavioral systems, and sensory processing in Iranian immigrants in Canada is becoming an essential research goal. Objectives: The aim of this study was to explore the relationships between psychological health, cognitive flexibility, brain-behavioral systems, and sensory processing among Iranian immigrants in Canada. Methods: A cross-sectional study design was used, gathering data from 400 Iranian students (198 males and 202 females) enrolled at universities in Canada and Iran. We collected participants' demographic details and assessed their psychological health, cognitive flexibility, brain-behavioral systems, and sensory processing through standardized instruments. Psychological health was evaluated using the Beck Anxiety Inventory, cognitive flexibility was measured with the Dennis and Vander Wall Cognitive Flexibility Questionnaire, and sensory processing was appraised via the adolescent/adult sensory profile. The Carver and White behavioral inhibition system (BIS)/behavioral activation system (BAS) scales were utilized to measure brain-behavioral systems. Statistical analyses, including correlation analysis and multivariate regression, were conducted to investigate the relationships among these variables. Results: The correlation analysis revealed significant positive associations between anxiety and low registration (r = 0.283, P < 0.001), sensory sensitivity (r = 0.442, P < 0.001), and sensory avoiding (r = 0.307, P < 0.001) in immigrant students. Anxiety also showed nonsignificant negative correlations with the behavioral activation system-drive (r = -0.042, P = 0.551) and behavioral activation system-reward responsiveness (r = -0.090, P = 0.203). The multivariate regression analysis found that low registration (B = 0.177, P = 0.036), sensory sensitivity (B = 0.336, P < 0.001), and cognitive flexibility (B = 0.119, P = 0.025) significantly predicted anxiety levels in immigrant students. An adjusted R-squared value of 0.191 indicated that these variables together explained 19.1% of the variance in anxiety levels. Conclusions: This study underscores the significant links between sensory processing patterns, cognitive flexibility, brain-behavioral systems, and anxiety among Iranian immigrant students. These findings highlight the need for interventions focusing on teaching cognitive skills strategies and increasing awareness of sensory needs to help reduce anxiety levels in this population.

Abstract 1310: Social determinants of migrant health factors impacting prostate cancer care and survivorship among sub-Saharan African immigrant men diagnosed with prostate cancer

Abstract Background: Sub-Saharan African Immigrants (SSAI) represent one of the fastest-growing segments of the immigrant population in the United States (US). Between 2010 and 2018, the SSAI population in the US increased by 53%, significantly outpacing the 12% growth rate for the overall foreign-born population in the US during that time frame. Despite these growing numbers, little is published about the extent to which SSAIs adapt to health behaviors more common in the US or remain immersed in the values, beliefs and practices reflective of their country of origin. Importantly, no study has comprehensively examined the Social Determinants of Health (SDOH) among this population relative to their migration experiences and their influence on health-seeking behaviors and decision-making regarding prostate cancer care and treatment options. Methods: This qualitative study employed grounded theory and the social determinants of migrant heath framework to better understand the needs of SSAI prostate cancer survivors in the United States and how to effectively support these survivors. In-depth interviews were conducted with 8 survivors who live in the states of Florida and Minnesota. Findings: Some participants reported limited access to care and financial challenges paying for drugs. In terms of coping with diagnosis and treatment, most of the participants relied on their faith, a positive outlook about survivorship and support of family members. Some participants relied on the coaching and support of a loved one who experienced prostate cancer in the past. Erectile dysfunction severely impacted the sexual life of most participants as they experienced difficulty getting an erection. Conclusion: Participants expressed the benefit of belonging to support groups with other survivors for social and emotional support. As the number of immigrants from sub-Saharan continue to rise, so too will the demand for culturally tailored care to address and reduce disparities in survivorship among this sub-population. Citation Format: Ernest Kaninjing, Gladys Asiedu, Kaitlin Van Voorhis, Mary Ellen Young, Ebenezer Erefah, Emmanuel Agboola, Folakemi Odedina, Roxana Dronca, Kimlin Ashing, Solomon Rotimi, Che Ngufor, Arnola Merriweather, John McCall, Anthony Hill. Social determinants of migrant health factors impacting prostate cancer care and survivorship among sub-Saharan African immigrant men diagnosed with prostate cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 1310.

Beyond Acculturation: Health and Immigrants' Social Integration in the United States.

Immigrants typically have more favorable health outcomes than their U.S.-born counterparts of the same race-ethnicity. However, little is known about how race-ethnicity and region of birth moderate the health outcomes of different immigrant groups as their tenure of U.S. residence increases. We study the association between time spent in the United States and health outcomes among non-Hispanic Black, non-Hispanic White, Asian, and Hispanic immigrants using National Health Interview Survey data. Although all immigrant groups initially report better health outcomes than their U.S.-born counterparts, the association between U.S. tenure and reported health outcomes varies among immigrants by race-ethnicity and region of birth. Black immigrants have the worst hypertension profiles, and Black and Hispanic immigrants have the worst obesity profiles. The results suggest that acculturation cannot fully explain racial-ethnic differences in the association between U.S. tenure and health outcomes. We advance a more complete sociological theory of immigrant integration to better explain disparate immigrant health profiles.

Abstract P152: Linguistic Acculturation is Associated With Better Cardiometabolic Health Among Bhutanese Refugees Living in the United States

Background: United States (US) South Asians are a fast-growing immigrant group that on average, while having a higher socioeconomic status, present with an increased prevalence and faster development of cardiometabolic health (CMH) conditions. Acculturation—the process of adapting norms of a host culture—can give rise to a unique set of stressful challenges and is associated with poor CMH outcomes among immigrant groups. However, the impact of acculturation on South Asian CMH is relatively unknown due to limited studies, especially when considering the Bhutanese community; the third largest US refugee group. Hypothesis: We hypothesize that increased English linguistic acculturation among US Bhutanese adults would be associated with poorer CMH. Methods: Using 2021-2022 Bhutanese Community of Central Ohio Health Study data, we examined associations of linguistic acculturation and sociodemographic characteristics in relation to CMH conditions among Bhutanese adults living in Central Ohio (N=495). A summed score for responses of very limited (1 point); limited (2 points); fair (3 points); good (4 points); and excellent (5 points) English language proficiency in speaking, listening and understanding, reading, and writing was used to capture limited (≤8), intermediate (9-19), and excellent (20) linguistic acculturation. CMH was assessed from participant self-report of clinical diagnosed or treated hypertension, type 2 diabetes, and dyslipidemia, as well as weight and height to calculate body mass index (BMI). Adjusting for sex, age, and BMI, we used Poisson regression to estimate prevalence ratios (PR) and 95% confidence intervals (CI) of associations of linguistic acculturation and sociodemographic characteristics in relation to CMH conditions. Results: Most participants were aged 18 to 44 years (69.8%) and migrated to the US ≥11 years ago (60.2%). Linguistic acculturation prevalence was 34.1% for very limited/limited and 65.9% for fair to excellent. Most participants reported no CMH condition (70%), while 12.9% reported one, 10.8% reported two, and 6.3% reported three. Fair to excellent vs. very limited/limited linguistic acculturation were associated with a lower prevalence of having three CMH conditions (PR=0.17 [95% CI: 0.03-0.97]). Migrating to the US ≥11 years vs. <11 years was associated with a higher prevalence of having two CMH conditions (PR=1.67 [95% CI: 0.95-2.95]). Conclusions: In conclusion, more linguistic acculturation was associated with better CMH among Bhutanese adults living in the US. Given the burden of CMH disparities among minoritized racial/ethnic groups in the US, future studies should consider acculturation to further explore the role of language in shaping immigrant and refugee health across the lifecourse.

Immigrant Perspectives of Social Connection in a Nontraditional Migration Area.

Social connection is a core dimension of health and wellness among all populations, yet the experience of moving to and living in a new country makes social and community-level influences particularly salient for immigrants. We interviewed 38 Latino immigrants living in a nontraditional migration area to explore the social and community foundations of health and wellness. Using hybrid (inductive/deductive) qualitative analysis, we identified seven domains of social connection from the perspective of the interviewed participants: (1) lens of the individual; (2) immigrant experience; (3) interpersonal support; (4) community belonging; (5) community capital; (6) community navigation; and (7) social acceptance. Social connection domains generated by participants are consistent with the scientific literature, but this study identifies the specific social factors that immigrants describe as most salient to their own health and wellness. Our community-generated understanding of social connection can be used by healthcare providers to reduce risks and build on assets that will improve the health of immigrants living in nontraditional migration areas. Additionally, these results might serve as a foundation for a quantitative measure that can be used by providers to more accurately and comprehensively assess the social connection of their patients and by researchers to evaluate the effectiveness of community-level interventions for immigrants.

Abstract P307: Differences in Cardiovascular Disease Burden, Screening, Education, and Care by Clinic Type in the 2022 Health Center Patient Survey (HRSA)

Background: Persons experiencing homelessness (PEH) have a 2-3-fold risk for cardiovascular disease (CVD) mortality. Evidence has repeatedly shown elevated chronic disease burden, reduced access to care, and lower utilization of medication to control CVD risk factors in this setting. Migrant communities also experience reduced access to care and the impacts from deferring care. There are targeted, federally-funded health clinics in place for both settings. However, these systems are frequently overwhelmed and limited by their scope of care to primary care. There is scarce evidence on differences between access, quality, and experiences of care delivered relative to other safety-net models. Method: The 2022 Health Center Patient Survey (HCPS) was collected on behalf of the Health Resources and Services Administration (HRSA). The HCPS is a nationally-representative, three-staged, sample-based survey collected via 1:1 interviews with clinic patients. The survey assessed sociodemographics, health conditions and behaviors, access to and utilization of care, and patients’ experiences with comprehensive services they received at HRSA-funded health centers, including: community health centers (CHC), healthcare for the homeless (HCH) clinics, migrant health centers (MHC), and public housing primary care (PHPC) clinics. A total of 103 unique awardees and 318 health center sites were recruited, and 4,414 patient interviews were completed. Investigators analyzed patient characteristics and multiple survey items related to AHA’s Essential 8 metrics for differences across clinic type. Results: MHC and HCH clinics had fewer elderly patients (~7%) than CHC and PHPC clinics (~17%). There were differences across sex, race, and ethnicity across all four clinic types. Cardiovascular disease history ranged from 4.9% (MHC) to 14.7% (HCH). Reported 7-day physical activity measures, average sleep below 7 hours per day, and Lifetime smoking (>100 cigarettes; OR=4.2, p<0.001) were all greatest among HCH patients. Fewer HCH and MHC patients reported ever having or recent lipid tests (both p<0.001). HCH patients were more likely to report hypertension (p=0.003), but less likely to report receiving nutrition advice (all p<0.05). MHC patients were less likely to be prescribed hypertension medication (p=0.044) and HCH patients were less likely to be taking medication even if it was prescribed (p<0.001). Adjustment for differences in age or CVD history were able to explain some observed differences, but increased the magnitude of other disparities. Conclusion: CVD burden differs across the various HRSA funding mechanisms for clinics, as do demographics and multiple metrics of health behaviors and biomarkers of cardiovascular health. Greater disease burden in HCH and MHC patients is likely compounded by increased risk factors and under performance in providing health education interventions.

Social Determinants of Health and Well-being: An Analysis of the Northeast Migrant Workers Living in Delhi

This research article aims to analyze migrants’ health and well-being in the context of Northeast Migrant Workers Living in Delhi. The World Health Organization (WHO) has considered the health of migrants as an important area of inquiry for policy making and the paper is post-migration lived experiences of the workers, which is related to the policy making agenda. An Existing conceptual framework of the social determinants of health and well-being are corroborated. The research design is an empirical work based on the selection of seven urban villages and five residential localities in Delhi. The study population is the Northeast migrant workers working in six occupational groups in the last 1-10 years in the age group 18-44 years with a sample of 120 respondents of both genders male and female including transgender persons. The data was collected through a semi-structured questionnaire followed by in-depth interviews from January 2017 to February 2018 and used qualitative and quantitative data analysis in my research. Among 120 migrant workers, 77.5% reported anxiety, 75.83% life insecurity, 70.83% alienation, 53.33% developed anger, 47.5% vulnerability, 43.33% lack of motivation, 42.5% loneliness, 41.66% feeling of resentment, 40.83% back and joint pains, 39.16% emotional crisis, 38.33% low self-esteem, 35.83% poor concentration, 33.33% self-depreciation, 25.83% poor vision, 2.5% miscarriage. The study shows that the distributions of self-reported health and well-being consequences are unevenly distributed and anxiety is to be found more reported among the migrant workers. The result was cross-checked among the Northeast migrant workers and it was found out that the social determinants such as socio-cultural differences, social discrimination, prejudice, and stereotypes against the migrants play important determinants influencing the health and wellbeing of the migrants at the place of destination. Post-migration experience has both positive and negative consequences of health and well-being. The more social networks there are, the better is resilience to adapt to the new environment for better health and well-being and its coping mechanism.

Emergency preparedness and response sensitive of migrant populations in Chile: post-pandemic perspectives.

On August 31, 2023, the Chilean government ended the health alert for COVID-19. This milestone invites us to reflect on lessons learned in emergency preparedness and response regarding migrant populations in the country. In this context, three perspectives are presented. The first focuses on avoiding pointing to individual responsibility for non-compliance with prevention measures, as this approach ignores structural and historical inequities. Emergency recommendations should be constructed considering a collective approach and diverse sociocultural and political contexts. The second perspective calls for considering and addressing migration as a social determinant of health. During the pandemic, changes in the governance of migration around the world made migration processes more precarious, with risks to the physical and mental health of migrants, which needs better planning and evidence-based decision-making in future pandemics. The third perspective focuses on promoting intercultural health, as effective communication of contagion risks and preventive measures were hampered among migrant populations with diverse worldviews and interpretations of health and disease processes. Responding to the needs of historically marginalized communities requires establishing ways of life that respect diversity in narratives and everyday practices. Governments and health systems must incorporate migration into their emergency preparedness and response strategies, creating the conditions for optimal compliance.

Refugee health and physiological profiles in transitional settlements in Serbia and Kenya: Comparative evidence for effects of gender and social support

When armed conflict compels people to flee from their homelands, they embark on protracted journeys during which they experience wide ranging physical, social, and psychological challenges. Few studies have focused on refugee psychosocial and physiological profiles during the transitional phase of forced migration that often involves temporary sheltering. Transient refugees’ experiences can vary substantially based on local socio-ecological conditions in temporary settlements, including the length of stay, living conditions, as well as the availability and accessibility of physical and social resources. In this study, we compared physiological and psychosocial data from refugees (N=365; 406 observations) in Serbia and Kenya, respectively, with divergent temporal (length of stay) and socio-ecological conditions. In Serbia, refugees resided in asylum centers (mean stay: 0.9 y); in Kenya they were living in Kakuma Refugee Camp (mean stay: 8.8 y), one of the world’s largest camps at the time. We had limited ability to directly compare psychosocial measures and used meta-analytic techniques to evaluate predictors of refugee mental and physical health at the two sites, including based on perceived social support. Refugees in Serbia had higher fingernail cortisol (p < 0.001) and were less likely to have elevated C-reactive protein (CRP) levels (p < 0.01) than refugees in Kakuma. We found common gender differences in both settings; women had lower cortisol but higher EBV antibody titers and higher likelihood of having elevated CRP compared to men (all p < 0.01). Woman also reported poorer mental and physical health (p < 0.001). These physiological and health differences may reflect variation between men and women in their psychosocial and physical experiences of factors such as stress, violence, and trauma during their journeys and as transitional refugees. Finally, we also found that refugees with lower levels of perceived social support reported poorer physical and mental health (p < 0.001). Although our results are cross-sectional, they suggest that this intermittent phase of the refugee experience is a key window for helping enhance refugee well-being through an emphasis on interpersonal and community support systems.

Study protocol for a systematic review of the social determinants of mental health and well-being of older migrants aged 50 years and above

Background Migration is a milestone event in a person’s life, bringing with it the challenges of settling down in an unfamiliar environment. The age at which migration takes place and the way migrants negotiate their old and new world significantly impacts their mental health. Thus, this systematic review seeks to analyse and summarize existing research detailing the contexts in which people migrate later in life and the associations between these contexts and social determinants of their mental health and well-being. Methods Seven databases including PsycINFO, Web of Science, PubMed, Applied Social Sciences Index, Abstracts: ASSIA, Ageline, CINAHL, and Informit will be searched systematically for original journal articles published in English. In the first screening stage, the first reviewer (PB) will screen all titles and abstracts and mark all potentially eligible texts for full-text screening. The second reviewer (HM) will review the decisions made. Any potential conflicts will be resolved with discussion. Afterward, full texts of potentially eligible studies will be assessed for eligibility by two reviewers (PB and HM). The methodological quality (or risk of bias) of individual studies will be appraised using the Mixed Method Appraisal Tool. The thematic synthesis of the data will be performed using a hybrid approach incorporating deductive (framed against a customised social determinants of health framework) and inductive data-driven processes. The review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (Reg: CRD42022359881).

The impact of long-distance travel to work on the health of commuting labour migrants: a literature review

This literature review analyzes the impact of commuting labour migration (CLM) on human health. Travel time is one of the major CLM factors affecting migrant health in both active and passive way. Fatigue and stress associated with commuting result in the increased blood pressure and risk of obesity. The paper also dwells upon the impact of CLM on worker stress by gender. The article also explores the relationship between CLM and mortality. Work-life balance plays a crucial role in migrant health, while satisfaction with life can be compromised due to insecure life style associated with CLM. There is an effect of adaptation that can influence migrant health in a positive way. In addition to negative aspects the article reviews benefits of CLM, including improved professional skills and higher income, and effective use of travel time. A special attention is payed to health of the Russian commuting migrants and their specific challenges and problems. The article is a comprehensive review of scientific literature on CLM impact of human health. the results obtained can be used to develop programs and policies aimed at improving health of labour migrants and mitigating negative effects of commuting labour migration.

What words can tell us about social determinants of mental health: A multi-method analysis of sentiment towards migration experiences and community life in Lima, Perú.

To support resilience in contexts of migration, a deeper understanding of the experiences of both receiving communities and migrants is required. Research on the impacts of migration on community life is limited in contexts with high internal migration (i.e., migrating within one's country of origin). Evidence suggests that cultural similarity, community relationships, and access to resources may be protective factors that could be leveraged to support the mental health of internal migrants. The current study uses data drawn from a sample of pregnant Peruvian women (N = 251), 87 of whom reported being internal migrants and 164 of whom reported being from the locale of the study (Lima, Perú). The aim was to better understand the social experience of internal migration for both local and migrant women. Inductive thematic analysis was used to examine migration experience and perceived impact of migration on community life. Internal migrants discussed three themes relative to their experiences: motivations, adjustment, and challenges. Experiences of women in receiving communities consisted of four themes related to migration: positive, negative, neutral, and mixed perceptions. Linguistic Inquiry and Word Count (LIWC-22) software was also used to assess sentiment towards migration. Across both analytic methods, migration motivations and perceptions were multifaceted and migrants reported a wide range of challenges before, during, and after migration. Findings indicated that attitudes toward migration are broadly positive, and that there is a more positive appraisal of migration's impact on the community life for internal as opposed to international migration.

Revisiting the impact of public spaces on the mental health of rural migrants in Wuhan: an integrated multi-source data analysis

Current research on public spaces and mental health often focuses on the independent relationship of one or more social mediators, neglecting the nuanced implications and serial mechanisms inherent in the progressive social process. Using Wuhan city, China, as a study case with multi-source data, this research applies Multilevel Generalized Structural Equation Modeling and deep learning techniques to explore the differential effects of public spaces with varying degrees of publicness (i.e., typical, semi-, and privately owned) on rural migrants’ mental health. Crucially, this study scrutinizes both explicit (social interaction) and implicit (perceived integration) social mechanisms to revisit the relationships. The findings reveal that not all public spaces equally influence mental health, with typical and privately owned public spaces conferring profound benefits. Notably, public spaces impact mental health chiefly through perceived integration instead of through direct social interaction. Social interaction improves mental health primarily by enhancing perceived integration, suggesting that meaningful connections beyond superficial encounters are critical. In particular, we observed significant social effects in typical and privately owned public spaces but limited social functionality in semi-public spaces. This evidence contributes to the knowledge required to create supportive social environments within public spaces, integral to nurturing inclusive urban development.

Need for Culturally Competent and Responsive Cancer Education for African Immigrant Families and Youth Living in the United States.

Cancer prevalence data for Black Americans is monolithic and fails to consider the diverse cultures and backgrounds within that community. For instance, African immigrants constitute a meaningful proportion of the foreign-born Black immigrants in the United States (42%), but the prevalence of cancer in the African immigrant community itself is unknown. Therefore, without accurate cancer prevalence data, it is impossible to identify trends and other key factors that are needed to support the health of African immigrants and their children. Moreover, it is impossible to understand how the culture and language of subgroups influence their cancer-related health behavior. While research in this area is limited, the existing literature articulates the need for culturally responsive and culturally tailored cancer education for African immigrants and their adolescent children, which is what we advocate for in this viewpoint paper. Existing projects demonstrate the feasibility of culturally responsive programming for adults; however, few projects include or focus on adolescents or children born to African immigrants. To best meet the needs of this understudied community, researchers must use culturally competent interventions alongside familiar, usable media. For adolescents, technology is ubiquitous thus, the creation of a culturally tailored digital intervention has immense potential to improve cancer awareness and prevention for youth and their community. More research is needed to address many of the existing research gaps and develop a rich understanding of the unique experience of cancer among African immigrant families that can be used to inform intervention development. Through this viewpoint, we review the current state of cancer-related research among African immigrant families in the United States. In this paper, we acknowledge the current knowledge gaps and issues surrounding measurement and then discuss the factors relevant to designing an educational intervention targeted at African immigrants and the role of African immigrant youth.

Determinants of ethnic harassment among first- and second-generation immigrants in Europe

Abstract The topic of this study is the experiences of ethnic harassment (EH) among first- and second-generation immigrants in Europe. EH is defined as unwanted conduct related to racial or ethnic origin that creates an intimidating, hostile, or offensive environment. Previous research has shown that EH has a negative impact on the health, well-being, and integration of immigrants. However, little is known about which immigrants are more likely to experience EH. This study aims to fill this gap. We develop a theoretical framework for understanding EH and use it to generate hypotheses about individual-level characteristics. We test these hypotheses using data from the Second European Union Minorities and Discrimination Survey and analyze the experiences of EH among 12,596 immigrants in 17 European countries. Largely in line with theoretical expectations, results from logistic regression models reveal that immigrants are more likely to experience EH if they are Muslim, wear religious clothing, are from the second generation, are higher educated, are proficient in the host-country language, and perceive themselves to be overqualified for their job and face more economic hardship.

Association of pre-migration socioeconomic status and post-migration mental health in Syrian refugees in Lebanon: a descriptive sex-stratified cross-sectional analysis

BackgroundRefugee populations present with high levels of psychological distress, which may vary among sociodemographic characteristics. Understanding the distribution across these characteristics is crucial to subsequently provide more tailored support to the most affected according to their specific healthcare needs. This study therefore seeks to investigate the association between pre-migration socioeconomic status (SES) and post-migration mental health separately for male and female Syrian refugees in Lebanon.MethodsIn a cross-sectional study, a cluster randomized sample of 599 refugees from Syria were recruited between 2016 and 2019 within 12 months after they fled to Lebanon. Logistic regression was used to determine the association between self-reported pre-migration SES and levels of anxiety and depressive symptoms assessed on the Hopkins Symptoms Checklist-25 (HSCL-25) scale, both for the entire sample and stratified by sex. To assess the informative value of self-reported SES, its correlation with education variables was tested. All analyses were conducted in R version 4.3.ResultsUsing complete cases, 457 participants (322 female, 135 male) were included in the analyses. Females showed on average more symptoms of anxiety (Median: 2.5) and depression (Median: 2.4) than males (Median: 2.10 and 2.07, respectively). Below average SES was associated with significantly higher odds for mental illness compared to average SES (anxiety: OR 4.28, 95% CI [2.16, 9.49]; depression: OR 1.85, 95% CI [1.06, 3.36]). For anxiety, differences between SES strata were larger for males than females. The self-reported SES measure showed only a weak positive correlation with education.ConclusionsThis study adds additional descriptive data highlighting mental health differences in Syrian refugees in Lebanon, whereby below average SES is associated with worse mental health outcomes compared to average SES. These findings demand further research into the underlying mechanisms. Improving our understanding of the observed differences will provide valuable insights that can contribute to the future development of targeted measures.

Maternal Trauma and Psychopathology Symptoms Affect Refugee Children's Mental Health But Not Their Emotion Processing.

Refugee children's development may be affected by their parents' war-related trauma exposure and psychopathology symptoms across a range of cognitive and affective domains, but the processes involved in this transmission are poorly understood. Here, we investigated the impact of refugee mothers' trauma exposure and mental health on their children's mental health and attention biases to emotional expressions. In our sample of 324 Syrian refugee mother-child dyads living in Jordan (children's Mage=6.32, SD = 1.18; 50% female), mothers reported on their symptoms of anxiety and depression, and on their children's internalising, externalising, and attention problems. A subset of mothers reported their trauma exposure (n = 133) and PTSD symptoms (n = 124). We examined emotion processing in the dyads using a standard dot-probe task measuring their attention allocation to facial expressions of anger and sadness. Maternal trauma and PTSD symptoms were linked to child internalising and attention problems, while maternal anxiety and depression symptoms were associated with child internalising, externalising, and attention problems. Mothers and children were hypervigilant towards expressions of anger, but surprisingly, mother and child biases were not correlated with each other. The attentional biases to emotional faces were also not linked to psychopathology risk in the dyads. Our findings highlight the importance of refugee mothers' trauma exposure and psychopathology on their children's wellbeing. The results also suggest a dissociation between the mechanisms underlying mental health and those involved in attention to emotional faces, and that intergenerational transmission of mental health problems might involve mechanisms other than attentional processes relating to emotional expressions.

Working conditions and mental health of migrants and refugees in Europe considering cultural origin– a systematic review

BackgroundMigrants and refugees/asylum seekers, as a large part of the European work force, are often confronted with unfavorable working conditions in the host country. Main aim of this systematic review was to compare the association of these working conditions with mental health between migrants and refugees/asylum seekers due to their diverse migration experiences and cultural origins, and between different European host countries.MethodsSystematic search for eligible primary studies was conducted in three electronic databases (PubMed/MEDLINE, PsycINFO and CINAHL) using quantitative study designs written in English, German, French, Italian, Polish, Spanish or Turkish and published from January 1, 2016 to October 27, 2022. Primary health outcomes were diagnosed psychiatric and psychological disorders, suicide and suicide attempts, psychiatric and psychological symptoms, and perceived distress. Secondary health outcomes were more general concepts of mental health such as well-being, life satisfaction and quality of life. Two reviewers independently completed screening, data extraction and the methodological quality assessment of primary studies using the Newcastle-Ottawa-Scale. Descriptive summary of primary studies on working conditions and their relationship with mental health were conducted, comparing migrants and refugees/asylum seekers, migrants and refugees/asylum seekers of different cultural backgrounds (collectivistic and individualistic) and migrants and refugees/asylum seekers living in different host countries.ResultsInclusion criteria were met by 19 primary studies. Voluntary migrants are more likely to experience overqualification in the host country than refugees. In all examined host countries, migrants and refugees suffer from unfavorable working conditions, with migrants from collectivistic countries being slightly at risk compared to migrants from individualistic countries. Most unfavorable working conditions are related to poor mental health, regardless of migrant status, cultural origin or host country.ConclusionsAlthough the results should be interpreted with caution due to the small number of studies, it is evident that to maintain both the mental health and labor force of migrants and refugees/asylum seekers, their working conditions in host countries should be controlled and improved. Special attention should be paid to specific subgroups such as migrants from collectivistic societies.Ethics and disseminationThis systematic review is excluded from ethical approval because it used previously approved published data from primary studies.Trial registration numberCRD42021244840.

Stress coping skills and strategies as antidote to mental health for adult male migrants – open space for CBT interventions

Migrants often encounter numerous stressors that can significantly impact their mental health. Understanding the coping strategies employed by migrants and assessing their mental health status is crucial for developing effective support systems. The main aim of this study was to examine the most common coping skills and strategies of young adult migrants in order to generate ideas for creating a comprehensive CBT support program. The study explored the frequency of different coping strategies employed by migrants in correlation with their levels of depression, anxiety, and stress. This study utilized a quantitative approach and recruited a sample of 184 male migrants from 14 different countries facing stressful situations. The findings revealed that religion was the most commonly used coping strategy, followed by planning for the next steps and actively coping with the situation. Substance use was identified as the least utilized coping strategy. The mental health scores of male migrants reflected moderate levels of depression, anxiety, and mild manifestations of stress symptoms. These results underscore the importance of understanding and addressing the coping mechanisms and mental health needs of migrants to provide appropriate support and interventions.