Migration Background Research Articles

Media engagement during Russia’s war against Ukraine

The contribution explores the contested relationship with media among young Russian-speaking Estonians from migrant family backgrounds since Russia’s invasion of Ukraine. Our analysis sheds light on how the war context, characterized by the securitization of Russian state-controlled media usage and ideological tensions within the Estonian Russian-speaking community, impacts the media-related perceptions and practices of young Russian-speaking Estonians. We also investigate media professionals’ views on building relationships with their audience. Our investigation reveals an existing gap in connectivity between Estonian local Russian-language media outlets and their young audience. This gap is rooted in the production logic of these media platforms, which has previously hindered effective engagement. The context of Russia’s war against Ukraine exacerbates this disconnect. Improving the currently poor professional practices of audience engagement, particularly production-oriented approaches, would enhance connectivity and the epistemic power of Estonian Russian-language media and motivate young Russian-speaking Estonians to use it as a vehicle for their social agency.

Unravelling demographic and socioeconomic patterns of COVID-19 death and other causes of death: results of an individual-level analysis of exhaustive cause of death data in Belgium, 2020.

The COVID-19 pandemic led to significant excess mortality in 2020 in Belgium. By using microlevel cause-specific mortality data for the total adult population in Belgium in 2020, three outcomes were considered in this study aiming at predicting sociodemographic (SD) and socioeconomic (SE) patterns of (1) COVID-19 specific death compared to survival; (2) all other causes of death (OCOD) compared to survival; and (3) COVID-19 specific death compared to all OCOD. Two complementary statistical methods were used. First, multivariable logistic regression models providing odds ratios and 95% confidence intervals were fitted for the three study outcomes. In addition, we computed conditional inference tree (CIT) algorithms, a non-parametric class of classification trees, to identify and rank by significance level the strongest predictors of the three study outcomes. Older individuals, males, individuals living in collectivities, first-generation migrants, and deprived SE groups experienced higher odds of dying from COVID-19 compared to survival; living in collectivities was identified by the CIT as the strongest predictor followed by age and sex. Education emerged as one of the strongest predictors for individuals not living in collectivities. Overall, similar patterns were observed for all OCOD except for first- and second-generation migrants having lower odds of all OCOD compared to survival; age group was identified by the CIT as the strongest predictor. Older individuals, males, individuals living in collectivities, first- and second-generation migrants, and individuals with lower levels of education had higher odds of COVID-19 death compared to all OCOD; living in collectivities was identified by the CIT as the strongest predictor followed by age, sex, and migration background. Education and income emerged as among the strongest predictors among individuals not living in collectivities. This study identified important SD and SE disparities in COVID-19 mortality, with living in collectivities highlighted as the strongest predictor. This underlines the importance of implementing preventive measures, particularly within the most vulnerable populations, in infectious disease pandemic preparedness to reduce virus circulation and the resulting lethality.

Balancing between reality, ideality, and equity: critical reflections from recruiting key informants for qualitative health research.

Key informant interviews (KII) are a widely used method in qualitative health research to gain in-depth insights from individuals with specialized knowledge, experience, or access that is crucial to the research topic. However, there is growing criticism regarding how the selection of key informants is insufficiently described in research. This opacity is problematic as the authority and knowledge of key informants may be given undue weight in research findings, potentially overshadowing other non-expert samples. The resulting imbalance in representation can lead to favoring certain viewpoints while marginalizing others, and thereby reinforcing existing inequities. Using our KII study as an example, we demonstrate how we initially composed an ideal sample based on theoretical considerations and subsequently operationalized it in the field. We employed a selective recruitment strategy informed by intersectional theory, targeting physicians with migration backgrounds from Middle Eastern countries for a study on cancer prevention and screening. Our recruitment process combined direct methods, including database searches and email outreach, with indirect methods like snowball sampling and engagement with multipliers. The recruitment strategy was iterative, allowing for ongoing assessment and adaptation to ensure a diverse and representative sample. The KII study successfully recruited 21 physicians with diverse social categories, including different genders, migration backgrounds, language skills, and medical specialties. Direct recruitment was more effective than indirect methods and allowed for greater control in reaching out to specific subsamples. It highlights the importance of flexible and persistent recruitment strategies to achieve the desired sample. This KII study underscores the interplay between methodological ideals and the practical realities of recruiting a diverse, carefully composed sample of key informants in health research. Our intersectional approach aimed to ensure equitable representation by considering power dynamics and refining recruitment strategies, while balancing the challenges of real-world fieldwork-such as engaging busy physicians with specific recruitment criteria-with practical adaptability. Our KII study emphasizes the need for ongoing reflexivity to balance ideality and equity with practical feasibility.

Aging in place or aging out of place? Family caregivers' perspectives on care for older Pakistani migrants in Norway.

The aging population in Europe is increasing, with growing ethnic diversity among older individuals due to migration. Public policies emphasize 'aging in place' to address financial challenges and reduce the burden on the healthcare system. However, research often overlooks the heterogeneity among older people, especially non-European migrants. Also, research on family caregivers' role in enabling 'aging in place' for older relatives with migrant backgrounds is limited, despite many older non-European migrants' preference for family care in comparison to long-term institutional care. This study aims to explore the experiences and perspectives of family caregivers in the context of formal and informal care and their preferences regarding the place of care for older family members with migrant backgrounds, particularly the Pakistani Ahmadiyya community in Norway. Eighteen semi-structured individual interviews and two group interviews were conducted in Urdu and English with nineteen female family caregivers of older relatives, ages 25-62, residing in Norway. The analysis yielded three main themes: (1) "Nursing homes are not for the ones who love their parents", (2) Preferences for home with the possibility of sharing care, and (3) Mismatch between family care needs and formal care. Family caregivers' perception of health services has a decisive impact on their older relatives' demand and use of formal health services, emphasizing the need for trust. Even though home care services were seen as a viable option, they should be adapted so that the family caregivers can use them and feel supported in enabling 'aging in place' for older migrants.

Mapping Anti-Refugee Attitude Networks in the Classroom: Examining the Relationship Between Migrant Children’s Attitude Alignment and National Identification

ABSTRACT Irish schools have been rapidly diversifying since the early 2000s. As increased diversity often leads to increased prejudicial attitudes, children with migration backgrounds may struggle to gain acceptance and a sense of belonging as Irish. There are several strategies migrant children may take in response to prejudicial attitudes they perceive in their classroom, including adopting prejudicial attitudes toward other migrant groups – such as refugees – to align with the majority, or distancing themselves from the negative attitudes of the majority at the expense of national identification. We examine these strategies using a novel network method which identifies the positions of each child in relation to others in their classroom based on their attitude similarity. The study uses data from 54 primary school classes (N = 969 children). We find that migrant children were not identifiable by distinct patterns of anti-refugee attitudes compared to those of Irish national children. National identification was not related to the alignment of attitudes to Irish peers. Alignment of attitudes toward one’s classmates, however, was associated with higher identification with the class, for both migrant and non-migrant children. These findings highlight the class context as a relevant environment in which attitudes and identity are jointly navigated.

The Role of Networks in Mobilization for Ethnic Minority Interest Parties

AbstractRecently, parties that are run by and for ethnic minority citizens with a migration background have become more prominent. They can be considered a manifestation of ethnic political segregation. A key example of such a party is DENK in the Netherlands. So far, the explanatory literature has focused on how programmatic considerations drives voting for these parties. Other factors, such as the role of social networks in mobilization, have received limited testing and limited exploration in more detail. Furthermore, the literature on social networks is mainly based on majority populations. To inform our understanding of the role of social networks in voting (in general but also particularly among ethnic minority communities and for ethnic minority interest parties) this paper analyzes the voting behavior for DENK focusing on the role of personal, online and religious networks. The paper uses both qualitative interviews (with bicultural youth in the third largest city of the Netherlands in 2022) and quantitative surveys (the 2021 Dutch Ethnic Minority Electoral Study). Our analysis points to the importance of religious and personal networks for voting for DENK, whereas online networks appear to be less relevant.

Digital Communication in work and family life in Europe

ABSTRACT This special issue brings together innovative research on the use and implications of digital communication in work and family life. It examines the context dependence of the use of digital communication and the consequences for work-family integration and conflict in a comparative design. It also broadens the perspective to new technological developments. The editorial gives an overview of the existing literature and presents the main findings of the articles in this special issue. It also provides initial descriptive information on digital communication with children, parents, line managers and colleagues, based on the initiated module on ‘Digital Social Contacts in Work and Family Life’ in the European Social Survey Round 10. There are apparent differences across European countries, social groups (age, gender, migration background, class) and with respect to the inclusion in the labor market (in paid employment, working from home, occupational status). Overall, the special issue demonstrates that digital communication in work and family life is interrelated, is inherent to gendered strategies to combine work and family, and is also a matter of digital skills, emotional and physical closeness and the institutional context. Work-family conflict enhancing implications are identified but do not seem to be an indispensable attribute.

Facial attractiveness does not modify the perceived trustworthiness of ethnic minority men

Immigrants, and particularly immigrant men, are often stereotyped as untrustworthy in European societies. However, little research has examined how stereotypes of characteristics other than ethnicity might impact natives’ perceptions of the trustworthiness of immigrants. Here, I test whether facial attractiveness, a trait associated with a variety of positive stereotypes, might modify ethnic biases in trustworthiness perceptions. I vary facial attractiveness and ethnicity using photo and name stimuli presented in a hypothetical “lost wallet” vignette, in which respondents assess the likelihood of the pictured man returning their lost wallet. Results from an German online panel survey indicate that while attractiveness has a modest positive effect on perceived trustworthiness, the value of attractiveness does not differ between ethnic majority German men and men with a Turkish migration background. Rather, the largest differences in the perceived trustworthiness of Turkish-origin men are found between respondents with inclusionary and exclusionary immigration attitudes, with inclusionary respondents reporting that Turkish-origin vignette persons are more trustworthy than ethnic majority German vignette persons. These results suggest that physical attractiveness does not act as a substantial moderator of ethnic biases in trustworthiness perceptions, but that immigration attitudes are highly relevant.

The Morality of Care: Female Family Caregivers' Motivations for Providing Care to Older Migrants.

Finding suitable long-term care arrangements for older migrants in Europe, including Norway, has been a major concern for healthcare policymakers in the last decade. However, many older people with migrant backgrounds, and to a certain extent their descendants, often prefer that care arrangements are managed within the family. Although caring for family members may be personally satisfying, it can also be a source of distress. This study explores the motivations of care among female family caregivers of older Pakistani migrants within the Norwegian Ahmadiyya community. Our data are derived from a qualitative study including individual and group interviews with 19 female family caregivers. The study participants were aged 25-62 and resided in Norway. The interviews were conducted in Urdu and English and later transcribed verbatim in English. Our findings resulted in four main themes regarding motivations for caregiving: (1) "Who else, if not the family?": care perceived as a family obligation; (2) The divine duty of caregiving; (3) Women are better at caregiving; and (4) "What will people say?": fear of judgments. The intersection of culture, religion, gender, and migration shaped caregiving as a moral practice, and those providing care were considered individuals with high moral identity. The moral identity assigned to the role of family caregivers appears to exacerbate rather than alleviate the care burden on women of migrant origin. Understanding the motivations for caregiving can shed light on ways in which better support can be provided to ethnic minority families with aging members.

Language background and language self-assessment of Spanish-Swedish public service interpreters in Sweden

Advanced language proficiency is a requirement for public service interpreting, and yet, research has not described this construct holistically in interpreting studies. Previous studies have suggested that public service interpreters primarily have a migration background, and asymmetrical language proficiency. The present study reports findings of these aspects from a questionnaire that was conducted to investigate the linguistic background of Spanish-Swedish public service interpreters in Sweden. A total of 118 Spanish-Swedish interpreters answered the questionnaire. Results show that the interpreters have asymmetrical language proficiency but do not primarily have a migration background. Moreover, it is indicated that asymmetrical language proficiency and migration background have an impact on the likelihood of public service interpreters being state authorized. However, there is a need for further research on these aspects to better understand details regarding both public service interpreters in Sweden and public service interpreters internationally.

Metalinguistic awareness in L2 Italian children with a migrant background: a trade-off between cognitive advantages and syntactic vulnerabilities

Metalinguistic awareness is a domain where bilingual advantages have been reported, with bilinguals outperforming monolinguals in tasks that require separating syntactic form from semantic content, demonstrating higher selective attention, interference suppression, and inhibition skills (Adesope et al., 2010). However, these cognitive advantages may be counterbalanced by weaknesses in specific linguistic domains, such as morphosyntactic processing. This study investigates the presence of such trade-offs in a Sentence-Judgment Task adapted fromBialystok (1986)in which monolinguals and bilinguals are compared in their ability to judge syntactically well-formed and ungrammatical utterances, regardless of their meaning.We assessed 80 school-aged children, including 36 Italian monolinguals and 44 bilinguals with Italian as a second language, using a task that involved 48 sentences varying in syntactic accuracy and semantic congruency across four conditions. Results from mixed-effects logistic regressions indicated that while both groups performed similarly when judging grammatical and semantically plausible sentences, bilinguals showed superior skills in evaluating syntactically correct but semantically anomalous sentences. Conversely, they underperformed in detecting grammatically incorrect but semantically plausible sentences, highlighting weaker morphosyntactic processing. These findings thussupportthe trade-off hypothesis (Leivada et al., 2023), revealing that while bilinguals display cognitive advantages in metalinguistic awareness, they also may face challenges in linguistic domains. Importantly, this study addressed bilingual children with a migrant backgrounds, a population less studied and potentially more vulnerable, ultimately underscoring the importance of maintaining the home language and providing rich, high-quality input to enhance both their cognitive and linguistic development.

Stress and the City: Mental Health in Urbanized vs. Rural Areas in Salzburg, Austria

Background: Living in the city is associated with a higher risk of suffering from stress, anxiety, and depression. Due to an increase of migration to the city, the association between mental health and city life is highly relevant to society. Methods: We analyzed data of 9573 participants (Ø 55.3 years, SD = 7.4) of the Paracelsus 10,000 study (Salzburg, Austria) who were classified into having or not having depressive symptoms. Population density, green space, and noise around the home address of the participants were collected and tested for correlations with mental health defined by depressive symptoms. We additionally tested whether migration status influenced the effect of urbanization on mental health. Results: There is a positive correlation between degree of urbanization and the probability of suffering from depressive symptoms (p = 0.011), yet this effect is independent of the migration background (p = 0.581). Participants in areas with high residential density were significantly more likely to suffer from poor mental health (p = 0.006 unadjusted). No significant association could be found between mental health and noise (p = 0.126 unadjusted) or green space neither regarding distance to closest green space (p = 0.549 unadjusted), nor size of green space (p = 0.549 unadjusted). Conclusions: In the Paracelsus 10,000 cohort, living in the city is associated with lower mental health, especially in participants with a high population density in the direct neighborhood. This might be due to social stress yet does not reflect minority stress in migrants. However, the influence of noise pollution and green space on mental health is limited in this cohort.

Femicide coverage in German-language news. A content analysis of Austrian, German, and Swiss newspaper articles from 2018 to 2020

ABSTRACT The study examines the coverage of femicides in a period of 3 years (January 2018 – December 2020) in German-language news. The content of 383 articles from 14 different Austrian, German and Swiss quality and tabloid newspapers was analysed, focusing on used labels, the contextualisation as a structural or individual issue, as well as on reported crime scenes, victim–perpetrator relationships, migration backgrounds and religious faith. The results inter alia show that femicides are rather contextualized as an individual tragedy than as a structural problem. Furthermore, the use of euphemistic and sensationalist labels such as “relationship drama” or “blood deed” differ significantly depending on the reported victim–perpetrator relationship. Gender-focusing labels such as “femicide” or “murder of women” were rather used when a perpetrator’s migration background was mentioned.

Intercultural education and mother tongues of immigrant children: The case of Slovenia

PURPOSE. Intercultural education has become an important topic and one of the priorities for schools and education systems worldwide. Teachers should acquire knowledge about inclusion and intercultural education during their university education, but despite evidence that principals, teachers and schools feel ill-equipped to teach and engage in intercultural education, it in many countries, including Slovenia, this is not the case. For this reason in this paper, we present an intercultural model of education that offers teachers concrete support in the inclusion of migrant children. APPROACH. In addition to the comprehensive model of intercultural education, the article also presents some changes in legislation based on an analysis of educational regulations on inclusion and the development of intercultural education in Slovenia in recent years, which have a direct impact on the inclusion of immigrant pupils and students. The article also points out that teaching of mother tongues and cultures lessons for immigrant children is a very important part of intercultural education. Mother tongue and culture lessons in schools can be an opportunity to develop intercultural dialogue, and intercultural competence of all students, teachers and parents. Figures in Slovenia show that the number of schools offering mother tongues and cultures for children with a migrant background is slowly growing, but there are fewer languages to choose from. FINDINGS. Teachers do not feel competent in the area of inclusion of migrant students, intercultural education and teaching in culturally and linguistically diverse classrooms. This article therefore presents an intercultural model of education that offers teachers concrete support and actively involves all stakeholders in the integration process: Teachers, students, parents, migrants and their organizations, and local communities. KEY MESSAGE. As classrooms are becoming more culturally and linguistically diverse as a result of migration, systemic solutions and a holistic approach are needed to integrate immigrant pupils into the education system. The article focuses on the case of Slovenia, but the proposed holistic model is also transferable to other national contexts.

Prioritising communities: barriers to climate activism and political imagination among minoritised youth groups

ABSTRACT Minoritised youth voices are often underrepresented in climate action research. Despite the increasing interest in youth climate activism, there is still an overall lack of attention to the perspectives of young people struggling with discrimination, poverty, and other social injustices. In this article, we focus on a diverse group of minoritised youth in Portugal to explore their experiences of climate activism, perceived agency, and political imaginaries of the future. We conducted a qualitative study involving seven focus groups with 55 participants, including young people with a migrant background and/or living in underserved communities in Portugal. Based on a Reflexive Thematic Analysis, we generated three main themes that illustrate participants’ ways of engaging with climate change issues, the barriers that constrain their engagement with climate activism and the challenges in the political imagination of the future. Our findings suggest that minoritised youth would like to have a voice in political debates about climate change and that more inclusive dialogues about climate futures could help bridge existing territorial and social divides.

Labour Market Disadvantages of Citizens with a Migration Background in Belgium: A Systematic Review

AbstractLabour markets struggle to be inclusive, while diversity is increasing. This literature review examines labour market challenges faced by first- and second-generation migrants in Belgium. We systematically review articles published between 2010 and 2023 in the Web of Science Core Collection to delineate underlying mechanisms, associated solutions, policy recommendations and literature gaps. The literature reveals that individuals with a migration background generally experience poorer labour market outcomes than natives. These outcomes vary based on specific origin and gender and persist from the first into the second generation. The mechanisms underlying these poorer outcomes are discrimination, individual preferences, and human and social capital differences. Recommendations for employers include implementing standardised hiring procedures and fostering awareness of discrimination among recruiters. On the employee side, investing in human capital, increasing labour market knowledge, and having competencies formally recognised can help to narrow employment gaps. Our review also advocates for policy refinement to combat biases and suggests that alternative pathways to attaining employment, such as self-employment and volunteering, are promising areas for future research.

Differences in incidence, nature of symptoms, and duration of long COVID among hospitalised migrant and non-migrant patients in the Netherland: a retrospective cohort study

Abstract Background and aim Comprehensive data on long-COVID across ethnic and migrant groups are lacking. We investigated incidence, nature of symptoms, clinical predictors, and duration of long-COVID among COVID-19 hospitalised patients in the Netherlands by migration background. Methods We used COVID-19 admissions and follow up data (January 2021-July 2022) from Amsterdam University Medical Centers. We calculated long-COVID incidence proportions by migration background and assessed for clinical predictors via robust Poisson regressions. We then examined associations between migration background and long COVID using robust Poisson regressions and adjusted for derived clinical predictors, and other biologically relevant factors. Results 1886 patients were included. 483 patients had long-COVID (26%, 95% CI 24-28%) at 12 weeks post-discharge. Symptoms like dizziness, joint pain, and headache varied by migration background. Clinical predictors of long-COVID were female sex, hospital admission duration, intensive care unit admission, and receiving oxygen, or corticosteroid therapy. Long-COVID risk was higher among patients with migration background than Dutch origin patients after adjustments for derived clinical predictors, age, smoking, vaccination status, comorbidities and remdesivir treatment. Conclusions There are significant differences in occurrence, nature of symptoms, and duration of long-COVID by migration background. Studies assessing functional limitations and access to post-COVID healthcare are needed to help plan for appropriate and accessible healthcare interventions.

Ethnic disparities in clinical severity of COVID-19 as predictor of long COVID

Abstract Background Recent studies from Europe have shown a higher incidence of long COVID among ethnic minorities compared to the majority population. Little is known of these disparities, but they might be related to factors such as COVID-19 disease severity, barriers in access to health and individual factors such as working and living conditions. This study will elucidate possible predictors of long COVID related to COVID-19 disease severity in an ethnic diverse hospitalised cohort. Methods A retrospective cohort study of 1648 patients admitted with COVID-19 at three hospitals in Copenhagen, Denmark, between 1st February 2020 and 31st May 2022. Clinical data was extracted from health care records, and subsequently linked to data from Statistics Denmark on long COVID diagnosis (ICD-10 “DB948A”) as well as migration status. Results 1361 patients were discharged alive and of those, 113 (8,3%) patients got a long COVID diagnosis. Preliminary analyses show no excess risk of getting a long COVID diagnosis as a migrant compared to patients of Danish origin (RR = 1,20, p = 0,35). Some ethnic disparities are seen in disease severity among all patients discharged alive. Patients with migrant background were admitted to the hospital later (6,8 vs 5,6 days, p < 0,0001), and at a greater risk of needing high flow oxygen administration upon admission (RR = 1,46, p = 0,0012) compared to patients of Danish origin. Furthermore, a higher degree of systemic inflammation is seen among migrants with regards to lactate dehydrogenase (LDH) compared to patients of Danish origin (349,7 vs 317,2 U/L, p = 0,0014). No significant differences in c-reactive protein (CRP) levels (92,8 vs 85,9 mg/L, p = 0,11). Conclusions Preliminary analyses indicates possible ethnic disparities in COVID-19 disease severity among patients discharged alive possibly playing a role as predictors of long COVID. Low health literacy or language barriers might partly explain this. Further analyses are needed. Key messages • In preliminary analyses of 1381 patients previously admitted with COVID-19, we find no excess risk of a long COVID diagnosis (DB 948B) among patients with migrant background. • Preliminary analyses show some ethnic disparities in COVID-19 disease severity that might act as possible predictors of long COVID.

Increasing inequalities in mortality among individuals with a foreign background in Sweden

Abstract Background Previous research indicates that migrants in high-income destination countries not only experience a mortality advantage but also demonstrate lower or absent socioeconomic inequalities in mortality compared to the general native population. Yet the extent to which an income mortality gradient may also be evident among the descendants of migrants has been largely unexamined. Existing evidence has revealed that descendants of migrants face mortality risks higher than both migrants and their native-born peers. Methods This study utilizes longitudinal population registries covering the entire registered population of Sweden from 2004 to 2016. The study population comprises individuals aged 25 to 64, employing an open cohort design. Using Poisson regression, we examine the relationship between income rank position and cause-specific mortality among native-origin Swedes and eight nativity groups based on individuals’ country/region of birth, age of migration or parental origin. Results While foreign-born individuals who migrated as adults exhibited lower inequalities in all-cause mortality compared to native-origin Swedes, descendants of immigrants, particularly those with non-European backgrounds, show larger inequalities. Examination of specific causes of mortality revealed that external causes, notably accidents and assaults, account for increased disparities among non-European foreign-born men who migrated during childhood and male descendants of immigrants with non-European backgrounds. Conclusions Income-related inequalities in mortality are less pronounced among migrants compared to the native-born majority population in Sweden and tend to be higher among descendants of migrants, depending on gender and parental origin. The analysis highlights the role of external causes of mortality in shaping these inequalities, indicating that income disadvantages, augmented by a migrant background during upbringing, amplify specific health risks within these groups. Key messages • The study reveals lower mortality inequalities among migrant adults but a higher magnitude of inequalities among male descendants of immigrants, especially with non-European backgrounds. • Income disparities, combined with migrant backgrounds, amplify health risks among descendants of migrants in Sweden, underscoring the need for tackling social inequalities.

Factors influencing emigration decisions among Bulgarian health professionals

Abstract Background Migration patterns of health professionals are influenced by a variety of factors, including personal, economic, social, political, and cultural ones. This study aims to investigate the factors that influence the emigration decisions of both Bulgarian health professionals who have been abroad and those without such experience. Methods A cross-sectional study was conducted in 2022 using an online questionnaire among 447 health workers in Bulgaria. The influence of factors on health professionals’ decision to migrate was measured on a 4-point scale (from “no influence” to “very strong influence”). The factors were grouped into three levels - macro (country and health system), meso (health facility) and micro (individual). Mann-Whitney U test was used to examine differences between the two groups of health professionals at a 0.05 significance level. Results At macro level, a higher standard of living in the destination country was the primary factor influencing the emigration decisions of the individuals who have been abroad (n = 109), with a mean value of 3.62 (p < 0.001). Conversely, the opportunity to work in a better-organized health system was the predominant motivator for those without such experience (3.36, p < 0.035). At meso level, remuneration received (3.70, p < 0.001) was the most significant driver for the individuals with a migration background, while better working conditions (3.31, p < 0.006) had the strongest influence for the other group. At micro level, both groups agreed on the importance of enhanced recognition of the medical profession abroad (3.69 vs. 3.49, p < 0.013) as a key determinant. Conclusions On the whole, health professionals with no migration experience exhibited lower mean values for the observed factors. Furthermore, economic drivers appeared to be more significant for respondents with a migration background, while the other group attached greater importance to the motives related to the health system and the profession. Key messages • Health workers migrate for a variety of reasons with economic motives playing a pivotal role in shaping migration decisions. • Recognizing the motives that predominantly impact migration attitudes is a crucial step in the development of appropriate retention policies.