Subgroups Of Migrants Research Articles

Acculturation and self-management abilities of well-being among older Moroccans in the Netherlands

Abstract Background Migration involves a variety of stressors. Their accumulation over time may negatively impact migrants’ well-being. The extent that older migrants can integrate into a host society may determine their readiness to adopt behaviors such as self-management of well-being. Research regarding this relation among older Moroccans, one of the largest migrant groups in the Netherlands, has not been examined. This study aimed to investigate the relationship between acculturation and self-management abilities of well-being among older Moroccans and to examine differences in subgroups. Methods This cross-sectional study included 290 older Moroccans (≥ 65) living in Rotterdam, the Netherlands. Linear regression was applied to explore associations between acculturation (attachment to Moroccan and Dutch cultures) and self-management abilities of well-being. Independent samples t-tests were used to test differences between subgroups. Results Older Moroccans who received low education were found to be less attached to the Dutch culture [3.24 (0.72) vs. 3.54 (0.73); p = 0.016]. They were also poorer self-managers of their well-being [2.60 (0.59) vs. 2.86 (0.58); p = 0.012], along with those with multi-morbidity [2.55 (0.60) vs. 2.77 (0.54); p = 0.006] and those lacking comprehension of Dutch [2.46 (0.56) vs. 2.69 (0.59); p = 0.011]. Self-management abilities of well-being had a negative association with multi-morbidity (β = −0.18, p = 0.007) and lack of Dutch comprehension (β = −0.16, p = 0.031), and a positive association with attachment to Moroccan (β = 0.17, p = 0.012) and Dutch (β = 0.18, p = 0.010) cultures. Conclusions Findings indicate that attachment to Moroccan and Dutch cultures is beneficial for older Moroccans’ self-management of well-being. Efforts need to support older migrants’ integration for them to adequately function and feel at home. Interventions promoting integration and self-management need to consider the characteristics of older migrant populations Key messages • Attachment to origin and host cultures benefits older migrants’ self-management of well-being. The cultural context of older migrants needs to be considered when promoting values of self-management. • Differences in acculturation and self-management of well-being existed between older migrant subgroups. Interventions promoting these values should account for the diversity that exists among migrants.

Priority setting and migration health policies for European countries.

The 2030 Sustainable Development Goals (SDG) agenda has committed to 'ensuring that no one is left behind'. Applying the right to health of non-citizens and international migrants is challenging in today's highly polarized political discourse on migration governance and integration. We explore the role of a priority setting approach to help support better, fairer and more transparent policy making in migration health. A priority setting approach must also incorporate migration health for more efficient and fair allocation of scarce resources. Explicitly recognizing the trade-offs as part of strategic planning, would circumvent ad hoc decision-making during crises, not well-suited for fairness. Discussions surrounding decisions about expanding services to migrants or subgroups of migrants, which services and to whom should be transparent and fair. We conclude that a priority setting approach can help better inform policy making by being more closely aligned with the practical challenges policy makers face towards the progressive realization of migration health.

Association between Hometown Landholdings and Housing Quality of Rural Migrants in Urban Areas: Evidence from China

Urbanization progress in developing countries is reflected in the urban living conditions of their rural migrants. Housing quality, in particular, is linked to migrants’ social integration and development of human capital. In China, where urban housing is highly stratified by urban citizenship via the “hukou” or household registration system, improving housing quality is a top priority for the central government in its pursuit of human-centered urbanization. Despite some social and economic elements affecting migrants’ housing quality being documented, few studies have analyzed the determinants of rural migrants’ housing quality from the perspective of rural landholdings or possession of use rights of rural lands, which is endowed by the land system of China. Using large micro-data from the China Migrant Dynamic Survey (CMDS), this study investigates the association between hometown landholdings and rural migrants’ housing quality in their host cities. The empirical results suggest that possessing rural landholdings in their hometown is negatively correlated with rural migrants’ housing quality in their host cities, wherein rural migrants’ hukou transfer intention is found as an intermediary factor. Furthermore, the heterogeneity of the relationship across demographic characteristics and regions was investigated. In addition, short-term revenue derived from hometown landholdings is also verified to have a very limited positive effect on migrants’ housing quality. Land transfer policies customized for subgroups of rural migrants across sociological attributes and urban stratification are concluded finally.

Linking migration and hospital data in England: linkage process and evaluation of bias.

Difficulties ascertaining migrant status in national data sources such as hospital records have limited large-scale evaluation of migrant healthcare needs in many countries, including England. Linkage of immigration data for migrants and refugees, with National Health Service (NHS) hospital care data enables research into the relationship between migration and health for a large cohort of international migrants. We aimed to describe the linkage process and compare linkage rates between migrant sub-groups to evaluate for potential bias for data on non-EU migrants and resettled refugees linked to Hospital Episode Statistics (HES) in England. We used stepwise deterministic linkage to match records from migrants and refugees to a unique healthcare identifier indicating interaction with the NHS (linkage stage 1 to NHS Personal Demographic Services, PDS), and then to hospital records (linkage stage 2 to HES). We calculated linkage rates and compared linked and unlinked migrant characteristics for each linkage stage. Of the 1,799,307 unique migrant records, 1,134,007 (63%) linked to PDS and 451,689 (25%) linked to at least one hospital record between 01/01/2005 and 23/03/2020. Individuals on work, student, or working holiday visas were less likely to link to a hospital record than those on settlement and dependent visas and refugees. Migrants from the Middle East and North Africa and South Asia were four times more likely to link to at least one hospital record, compared to those from East Asia and the Pacific. Differences in age, sex, visa type, and region of origin between linked and unlinked samples were small to moderate. This linked dataset represents a unique opportunity to explore healthcare use in migrants. However, lower linkage rates disproportionately affected individuals on shorter-term visas so future studies of these groups may be more biased as a result. Increasing the quality and completeness of identifiers recorded in administrative data could improve data linkage quality.

Infectious risk profile and strategies for prevention and control of outbreaks in refugee, asylum seekers and migrant populations in EU/EEA countries: a systematic narrative review of evidence.

The recent surge in migration to and within the European Union and European Economic Area has brought the development of migration policy, including health policy, to the forefront of regional priorities. While migrants, in general, do not pose a health threat to the host population, specific subgroups of migrants, including refugees, asylum seekers, and irregular migrants, are particularly vulnerable to infectious diseases. To support public health policies in this area, the Emergency Preparedness and Management' working group of the Italian Society of Hygiene, Preventive Medicine and Public Health has conducted a systematic narrative review with the aim to comprehensively analyze the infectious disease risk within the refugee and asylum seeker populations in EU, EEA, and EU-applicant countries. Forty-two studies were systematically selected from scientific articles in the MEDLINE/PubMed database from January 1, 2008, to June 1, 2023. The infectious risk associated with each infectious disease among refugees and asylum seekers, as well as the strategies to prevent and control outbreaks, was collected from all available studies. The congregate living conditions in refugee camps, transit centers, and temporary housing facilities make this population particularly vulnerable to infectious diseases. As such, implementing stringent hygiene and preventive measures is critical to safeguarding the health of refugees and reducing the risk of outbreaks that may affect both the refugee population and the host communities. Effective vaccination and preventive strategies for migrants, refugees, and asylum seekers are vital for public health and the well-being of these populations. They should be delivered as part of universal health care. By addressing barriers and implementing tailored programs, we can ensure equitable access to vaccines and protect the health of these vulnerable individuals.

Migration and migrants in Chinese cities: New trends, challenges and opportunities to theorise with urban China

This introductory article to the special issue discusses some of the latest trends in migration research in urban China and focuses on three areas which have generated new understandings on migration and migrants in Chinese cities. Firstly, it identifies the various similarities and intersections between urban resettlement and migration studies by drawing on the case of China where the livelihoods and experience of migrants and resettled residents have been affected by China’s rapid urbanisation. Secondly, the paper discusses the enduring significance of the residential neighbourhood in influencing the place attachment, social relationships and career development of migrant residents. Finally, it delves deeper into the various ways studies have sought to categorise and differentiate between different migrant sub-groups in urban China and reveals that more fine-grained migration studies have helped better understand China’s large and ever more diverse migrant population and their variegated living experiences and challenges.

Factors that influence the uptake and delivery of HPV vaccines in migrants: a systematic review

Abstract Background Migrants are known to be an under-immunised group for many routine vaccinations. We did a global systematic review to explore and assess factors that influence uptake of vaccines for human papillomavirus (HPV) infection, using the WHO-endorsed Behavioural and Social Driver of Vaccination Framework (BeSD). Methods Using PRISMA guidelines, 3,075 records were found from 7 databases (2006-2023), with no exclusions based on country or language. After title/abstract screening and full-text review, data were extracted for thematic analysis using BeSD (4 domains for vaccine behavioural change) and qualitative synthesis. Results We included 104 studies from 16 countries: two thirds from the US, 25% from Europe, and only 2% from LMICs. The majority focused on vaccine eligibility and/or parents; 10% looked at providers’ views; 2% involved wider stakeholders, and most research focused on females. Migrant sub-groups reported diverse views and experiences about HPV vaccines. Many examined vaccine initiation and identified low awareness/knowledge of HPV/HPV vaccine. “What people think/feel” domain: barriers such as concerns on vaccine safety, cultural belief, lack of information, vaccine unnecessary; mixed view on vaccine benefit. “Social process”: doctor recommendation and information via providers/peers was influential but depended on framing and migrant characteristics. “Motivation” domain was understudied. “Practical issues” that impact uptake included cost, mobility, accessibility, and language. Conclusions Culturally sensitive education to address misconception and enhance importance of HPV vaccines were considered important, alaongside practical efforts to address mobility (mHealth), proactive vaccine behaviour and strong provider recommendation. A comprehensive strategy along the BeSD pathway, using a multipronged approach, would be valuable, and may be further enhanced by exploring wider macro-level factors. Key messages • Special efforts will be needed to engage mobile groups in HPV vaccination, with further research needed in LMICs. • Culturally sensitive education to address misconception and enhance importance of HPV vaccines were considered important.

Informal childcare arrangements: a comparison between Italians and migrants

As migrants settle in their destination country, for those who reunited the family or after childbirth childcare becomes a priority. Most studies on migrants’ childcare arrangements have focused on parental use of formal childcare rather than on different informal childcare solutions by analysing only families with preschool-age children. Italy poses an interesting case study because its welfare system is characterised by a familistic model of care, based on solidarity between generations. In familistic countries, migrants’ childcare solutions are more constrained. In this study, we analysed differences in informal childcare needs and arrangements for children younger than 14 between Italians and migrants from different countries of origin. We merged two surveys conducted by the Italian National Statistics Institute in 2011–2012: ‘Social Condition and Integration of Foreign Citizens’, a sample of households with at least one migrant with foreign citizenship, and ‘Multiscopo—Aspects of Daily Life’, a sample of households in Italy. We found that household composition and parents’ employment status play an important role in shaping informal childcare arrangements. Overall, migrants are less likely to use informal childcare, especially grandparents, than Italians but when they do, they rely more on other relatives and non-relatives than Italians. Moreover, differences emerge across migrant subgroups. This study is the first in Italy to contribute to an understanding of the role of migrant status in determining parents’ childcare arrangements for children up to 13 years.

Structural Origins of Poor Health Outcomes in Documented Temporary Foreign Workers and Refugees in High-Income Countries: A Review.

Despite growing evidence of racial and institutional discrimination on minoritized communities and its negative effect on health, there are still gaps in the current literature identifying health disparities among minoritized communities. This review aims to identify health barriers faced by relatively less studied migrant subgroups including documented temporary foreign workers and refugees residing in high-income Organisation for Economic Co-operation and Development (OECD) countries focusing on the structural origins of differential health outcomes. We searched Medline, CINAHL, and Embase databases for papers describing health barriers for these groups published in English between 1 January 2011 and 30 July 2021. Two independent reviewers conducted a title, abstract, and full text screening with any discrepancies resolved by consensus or a third reviewer. Extracted data were analyzed using an inductive thematic analysis. Of the 381 articles that underwent full-text review, 27 articles were included in this review. We identified housing conditions, immigration policies, structural discrimination, and exploitative labour practices as the four major emerging themes that impacted the health and the access to healthcare services of our study populations. Our findings highlight the multidimensional nature of health inequities among migrant populations and a need to examine how the broader context of these factors influence their daily experiences.

Investigating pathways for predisposing, enabling and need factors in predicting the use of STI/HIV-testing services among Syrian and Iraqi migrants in Scania, Sweden – a cross-sectional study with directed acyclic graphs for modelling pathways to testing

BackgroundSome groups of migrants have increased vulnerability to Sexually Transmitted Infections (STI) and Human Immunodeficiency Virus (HIV) transmission partly due to a lower uptake of disease preventive activities targeting the general population in receiving country. Limited access to economic and social resources and poor language skills may exacerbate exposure to sexual risks and utilization of health services.AimTo explore general and migrant specific predictors for STI/HIV-testing among Syrian and Iraqi migrants in Sweden and to investigate potential pathways that link predisposing, enabling and need- factors to STI/HIV-testing.MethodCross-sectional study design based on a migration specific framework for health care utilization. Directed acyclic graphs (DAGs) were used to model assumptions about factors associated with the uptake of STI/HIV-testing services. Bi-variable and multivariable logistic regression analyses assessed individual predictors while adjusting for covariates. The magnitude of the indirect effect of mediating variables were estimated with bootstrap analyses and a method for decomposing the total effect.ResultThe pathways between younger age, unmarried, and self-identifying as bi- or homosexual and testing were mainly indirect, mediated by experiences of sexual coercion and other risk behaviours. One third of the indirect mediating effect of the pathway between higher education and testing could be attributed to Swedish language skills.ConclusionUtilization of STI/HIV-testing services among Syrian and Iraqi migrants seemed to be motivated by sexual risk exposure and risk awareness. Interventions should focus on language-adapted information about available screening services and where to go for advice on sexual wellbeing and sexual rights. Such activities should be implemented within an integration promoting framework, addressing structures that increase STI/HIV risk exposure, specifically targeting vulnerable subgroups of migrants.

Mental health of migrants during the COVID-19 pandemic: additional stressors, increased inequalities

Abstract The COVID-19 pandemic has resulted in an unprecedent range of negative mental health outcomes across populations worldwide. Such effects are increasingly being documented, however an evidence gap persists on the consequences on most vulnerable groups, as certain subgroups of migrants. These populations already suffer from increased psychological burden, and the pandemic effects may potentially exacerbate adverse experiences and outcomes. This study aims to uncover the perceived impact of the COVID-19 pandemic on the mental health of migrants in Portugal and the associated sociodemographic aspects. A survey was conducted with a community-based sample of 1126 adult migrants in Portugal, assessing sociodemographics, migration-related characteristics and the perceived impact of the pandemic on mental health. Association between sociodemographics and mental health indicators was measured through bivariable analysis. In total, 1126 adult migrants were surveyed: 53.4% female, mean age of 35.8 years (range 18-77), 48.9% from African countries, 29.5% from Middle East/Asian countries, 21.6% from Brazil. Most participants (80%) reported feelings of agitation, anxiety or sadness during the pandemic period with 26.4% experiencing these feelings most days. The pandemic had a disproportionate impact on women (86.9% reported negative impact compared to 72.5% of men, p < 0.05), those undocumented (83.3% vs 75.4%, p < 0.05), those whose financial situation got worse since the pandemic (82.8% vs. 77.3%, p < 0.05) and those who had increased food shortages (84.4% vs 79%, p < 0.05). Migrants perceived an elevated deterioration of their mental health during the COVID-19 pandemic. In addition, particular groups such as women and those with a more insecure income or residence status are particularly susceptible to experiencing negative mental health outcomes. Key messages • There is a need to recognize the detrimental mental health impact of the COVID-19 pandemic on particular migrant groups and to develop interventions that target their unique needs. • Investigating sociodemographic and migration aspects could help identifying migrants at a higher risk of experiencing mental health distress.

Understanding the relationship between social support and mental health of humanitarian migrants resettled in Australia

BackgroundForced migration can lead to loss of social support and increased vulnerability to psychological distress of displaced individuals. The aims were to ascertain the associations of sociodemographic characteristics and social support received by resettled adult humanitarian migrants in Australia; determine the relationship between social support and mental health at different intervals following humanitarian migration; and examine the modification effects of gender, age and migration pathway on that relationship.MethodsA secondary analysis was conducted of data generated in Waves One (three to six months after resettlement), Three (three years after resettlement) and Five (five years after resettlement) of the Building a New Life in Australia prospective cohort study. The association between sociodemographic characteristics and mental health were examined at each timepoint using a multivariate regression model. Exploratory factor analysis was used to develop a two-factor social support scale (emotional/instrumental and informational support) from a larger set of items collected in the BNLA. Psychological distress was measured by the Kessler-6 scale. Path analysis was used to analyse the relationships between social support and psychological distress among the three time points considering socio-demographic characteristics simultaneously.ResultsA total of 2264 participants were included in the analyses. Age, gender, birth region, migration pathway, education level and English proficiency were significantly associated with both social support types. Main source of income was only significantly associated with informational support. Remoteness area was only significantly associated with emotional/instrumental support. As emotional/instrumental support increased by one standard deviation (SD) at Wave One, psychological distress at Wave Three decreased by 0.34 score [95% CI (− 0.61; − 0.08)]. As informational support at Wave Three increased by one SD, psychological distress at Wave Five decreased by 0.35 score [95% CI (− 0.69; − 0.01)]. The relationships between social support and psychological distress varied between genders, age groups and migration pathways.ConclusionFindings demonstrate the importance of emotional/instrumental support and informational support for the medium and long-term mental health of humanitarian migrants. This study also highlights the important of extending current social support provisions and tailoring programs to enhance support received by humanitarian migrant subgroups years after resettlement to improve mental health.

COVID-19 Vaccine Acceptance and Its Determinants among Migrants in Germany-Results of a Cross-Sectional Study.

Vaccinations are a core element of infection control. Migrants have been reported to have low vaccination rates for many infectious diseases, including COVID-19. Still, determinants of migrants’ uptake of COVID-19 vaccinations are not sufficiently clear. The present study addresses this gap and examines the respective influence of three potential determinants: barriers to access, attitude towards vaccinations in general, and towards COVID-19 vaccines. The study uses a cross-sectional online survey among migrants in Germany. The questionnaire assessed the aforementioned determinants using standardized tools. Information on 204 individuals was available. The vaccination rate in the sample was 80%. Vaccinated as compared to unvaccinated respondents reported more often the absence of financial barriers (71% (95%CI: 64–73%) vs. 45% (95%CI: 28–63%)), short waiting times (51% (95%CI: 43–59%) vs. 22% (95%CI: 5–38%)), and the presence of a vaccination center close-by (91.5% (95%CI: 87–96%) vs. 69.7% (95%CI: 54–85%)). Concerning COVID-19 vaccine acceptance, the majority of respondents (68%) agreed that the vaccine is important. Unvaccinated respondents more often feared side effects, were convinced that the vaccine is not safe, and assumed that COVID-19 is not dangerous. Correspondingly, acceptance of vaccinations in general was higher among vaccinated respondents. In line with findings from previous studies, our survey found that all three determinants seem to influence migrants’ vaccination status while their overall vaccination rate was comparable to the general population. Hence, migration background per se does not sufficiently explain vaccine acceptance and further research is needed to identify subgroups of migrants that should be specifically addressed to increase their vaccination rate.

A Systematic Scoping Review on Migrant Health Coverage in Thailand.

(1) Background: Thailand is a major migrant receiving country and pioneer of migrant health policy in the ASEAN region. However, on the ground, coverage of migrants is faced with multiple barriers. (2) Objectives: We aim to scope and analyse the types of available evidence on migrant health coverage in Thailand and identify knowledge gaps. Specifically, we characterise the literature along year of publication, migrant subpopulation, health domain, scope of coverage, methods, study design, objectives and results. (3) Methods: We searched PubMed, Web of Science, Google Scholar, Cochrane Database, Worldwide Science and the Asian Citation Index for peer-reviewed and grey literature in October 2021 for studies analysing original data on health coverage of migrants in Thailand. To conceptualise health coverage, we used the three dimensions availability, accessibility and acceptability. (4) Results: 101 articles were included in the final analysis. Sixty-three were published after 2016, 39 focused on migrant workers and 18 on migrants in general. Forty-two concentrated on health in broader terms, followed by reproductive and maternal health (n = 31). Thirty-eight assessed coverage of specific services and 36 health coverage in general. Migrants themselves and key informants were the main data sources in 80 and 43 of the articles, respectively. Forty publications were qualitative, while 38 applied quantitative methods (22% descriptive; 7% analytical). Among the health coverage components, 79 articles included aspects of accessibility, followed by acceptability (n = 59) and availability (n = 30). (5) Conclusions: While there is a high number and broad range of studies on migrant health coverage in Thailand, we found that research on migrant subgroups, such as victims of trafficking and migrant children, as well as on the health domains, non-communicable diseases and occupational and mental health is neglected.

Behaviour change interventions to promote health and well-being among older migrants: A systematic review.

BackgroundWhether behaviour change interventions are effective for the maintenance of older migrants’ health and well-being is uncertain. A systematic review was conducted to assess evidence for the capacity of behaviour change techniques (BCTs) to promote the health and well-being of older migrants.MethodsElectronic databases (Cochrane CENTRAL, Embase, Ovid MEDLINE and Web of Science) were searched systematically to identify relevant randomised controlled trials, pre–post studies and quasi-experimental studies published before March 2021. Additional articles were identified through citation tracking. Studies examining BCTs used to promote the health and/or well-being of older migrants were eligible. Two independent reviewers used the Behaviour Change Technique Taxonomy version 1 to extract data on BCTs. Data on intervention functions (IFs) and cultural adaption strategies were also extracted. Intervention contents (BCTs, IFs, culture adaption strategies) were compared across effective and ineffective interventions according to health and well-being outcome clusters (anthropometrics, health behaviour, physical functioning, mental health and cognitive functioning, social functioning and generic health and well-being).ResultsForty-three studies (23 randomised controlled trials, 13 pre–post studies and 7 quasi-experimental studies) reporting on 39 interventions met the inclusion criteria. Thirteen BCTs were identified as promising for at least one outcome cluster: goal-setting (behaviour), problem-solving, behavioural contract, self-monitoring of behaviour, social support (unspecified), instruction on how to perform the behaviour, information about health consequences, information about social and environmental consequences, demonstration of the behaviour, social comparison, behavioural practice/rehearsal, generalisation of a target behaviour and addition of objects to the environment. Three BCTs (instruction on how to perform the behaviour, demonstration of the behaviour, and social comparison) and two IFs (modelling and training) were identified as promising for all outcome clusters.ConclusionsThirteen distinct BCTs are promising for use in future interventions to optimise health and well-being among older migrants. Future research should focus on the effectiveness of these BCTs (combinations) in various contexts and among different subgroups of older migrants, as well as the mechanisms through which they act. Given the scarcity of interventions in which cultural adaption has been taken into account, future behavioural change interventions should consider cultural appropriateness for various older migrant (sub)groups.Trial registrationPROSPERO CRD42018112859.

Children's longitudinal bodyweight in Australia: Influence of migrant mothers' long-term residency, attachment to, and level of childhood overweight in country-of-birth.

Immigration creates opportunities and imposes constraints associated with acculturation. We used the Australian national longitudinal survey of children aged 2 to 17 to evaluate the influence of mothers' long-term residency in Australia, mothers' attachment to country-of-birth, and macro indicators of childhood overweight environment at mothers' country-of-birth on children's longitudinal bodyweight. Both mothers' long-term exposure to the Australian environment and attachment to country-of-birth were associated with increased children's bodyweight z-scores. The childhood overweight environment in mothers' country-of-birth continued to influence their children's bodyweight after immigration. A better understanding of factors related to mothers' migration and children's bodyweight status is necessary to identify risk factors and migrant sub-groups needing extra support.

The Role of Immigrant Admission Classes on the Health and Well-being of Immigrants and Refugees in Canada: A Scoping Review.

Many countries offer different pathways through which migrants can enter a new country. In Canada, there are three main immigrant admission classes: economic, family, and refugee. Previous research suggests that there are differences in health outcomes among various subgroups of migrants. A scoping review was conducted to characterize the role of immigrant admission classes on the health and well-being of immigrants and refugees in Canada. MEDLINE, Embase, PsycINFO, Sociological Abstracts, and EconLit databases were searched for quantitative studies published in English after 1990. The screening and selection process identified 27 relevant studies. Studies were categorized into four key reported outcomes: health care and services utilization, self-rated health and mental health, medical conditions and chronic illnesses, and social integration and satisfaction. Findings confirm that certain subgroups have worse health outcomes after arrival, particularly refugees, family class and other dependent immigrants. Health outcomes vary significantly across immigrant subgroups defined by the admission class through which they entered Canada.

Socioeconomic Determinants of Cardiovascular Diseases, Obesity, and Diabetes among Migrants in the United Kingdom: A Systematic Review.

There has been little agreement on the role that socioeconomic factors play in the aetiology of cardiovascular diseases (CVDs), obesity, and diabetes among migrants in the United Kingdom (UK). We systematically reviewed the existing evidence on this association to contribute to filling this gap in the literature. Two reviewers were involved at each stage of the review process to ensure validity. We comprehensively searched through several electronic databases and grey literature sources to identify potentially eligible papers for our review. We extracted data from our finally included studies and appraised the methodological rigour of our studies. A narrative synthesis approach was used to synthesise and interpret the extracted data. We sieved through 2485 records identified from our search and finally obtained 10 studies that met our inclusion criteria. The findings of this review show that there is a trend towards an association between socioeconomic factors and CVDs, diabetes, and obesity among migrants in the UK. However, the picture was more complex when specific socioeconomic variables and migrant subgroups were analysed. The evidence for this association is inconclusive and its causal relationship remains speculative. There is, therefore, the need for further research to understand the exact association between socioeconomic factors and CVD, diabetes, and obesity among migrants in the UK.

Service User and Service Provider Perceptions of Enablers and Barriers for Refugee and Asylum-Seeking Women Accessing and Engaging with Perinatal Mental Health Care Services in the WHO European Region: A Scoping Review Protocol.

There is a need to understand the specific perinatal mental health care needs of migrant subgroups who often have differing health care needs and specific barriers to accessing and engaging with health care services. It is important to have evidence about the WHO European context given the rising numbers of refugees and asylum seekers in the region. The aim of this scoping review is to map the factors that enable and prevent access and engagement of refugee and asylum-seeking women with perinatal mental health care services in the WHO European Region, from the perspectives of service providers and service users. The database search will include PsycINFO, Cochrane, Web of Science, MEDLINE, EMBASE, CINAHL complete, Scopus, Academic Search Complete, and Maternity and Infant Care (OVID). Search results will be exported to an online tool that provides a platform to help manage the review process, including title, abstract, and full-text screening and voting by reviewers independently. Data concerning access and engagement with health care services will be mapped on to the candidacy framework. Systematically searching evidence within the WHO European region and examining this evidence through the candidacy lens will help develop a more comprehensive and a deeper conceptual understanding of the barriers and levers of access and engagement with perinatal mental health care services, whilst identifying gaps in existing evidence. Exploring factors that influence access and engagement for refugee and asylum-seeking women from the perspective of key stakeholders in the service provision and/or service utilisation of perinatal mental health care services will add a more comprehensive understanding of the recursive relationship between service provision and use.

Differences in quality of care, mortality, suicidal behavior, and readmissions among migrants and Danish-born inpatients with major depressive disorder

The increasing global migration has made migrants' health a pertinent topic. This article aimed to examine whether migrants were less likely than Danish-born residents to receive guideline recommended care when hospitalized for major depressive disorder (MDD) and potential differences in clinical outcomes, including all-cause mortality, suicidal behavior, and readmissions during 1-year follow-up after first-time admission. A national cohort study was performed, including all adult MDD inpatients at mental care units in the period 2011-2017. Migrants and two migrant subgroups (non-Western and Western) were compared with Danish-born patients. Quality of care was examined using multivariable Poisson and linear regression models. Clinical outcomes were examined using Cox proportional hazards regression analysis. Migrant-status was associated with a non-significantly lower chance of receiving high-quality care (relative risk [RR]=0.93, confidence interval [CI] 0.86:1.01) and lower readmission rates for depression (hazard rate ratio [HR]=0.93, CI 0.86:1.01), and significantly higher all-cause mortality (HR=1.55, CI 1.19:2.01) and lower all-cause readmission rate (HR=0.88, CI 0.83:0.94). No clear association was found regarding suicidal behavior. While associations were comparable for migrant subgroups regarding readmission, the associations with low quality of care and of all-cause mortality appeared strongest among Western migrants. Among inpatients with MDD in a universal tax-financed healthcare system, being a migrant was associated with a potential lower quality of in-hospital care and worse clinical outcomes. These results warrant further investigation to clarify the underlying explanation for these inequalities and to develop and test interventions to ensure better quality of care and clinical outcomes for migrant patients.