Immigration Status Research Articles

Psychological well-being and its associations with sociodemographic characteristics, physical health, substance use and other mental health outcomes among adults in Canada

Introduction Psychological well-being (PWB) is an important component of positive mental health (PMH) and an asset for population health. This study examined correlates of PWB among community-dwelling adults (18+ years) in the 10 Canadian provinces. Methods Using data from the 2019 Canadian Community Health Survey Rapid Response on PMH, we conducted linear regression analyses with sociodemographic, mental health, physical health and substance use variables as predictors of PWB. PWB was measured using six questions from the Mental Health Continuum—Short Form, which asked about feelings of self-acceptance, personal growth, environmental mastery, autonomy, positive relations and purpose in life during the past month. Results In unadjusted and adjusted analyses, older age, being married or in a commonlaw relationship and having a BMI in the overweight category (25.00–29.99) were associated with higher PWB, while reporting a mood disorder, anxiety disorder, high perceived life stress, engaging in heavy episodic drinking and frequent cannabis use were associated with lower PWB. Sex, having children living at home, immigrant status, racialized group membership, educational attainment, household income tertile, having a BMI in the obese category (≥30.00), major chronic disease and smoking status were not significantly associated with PWB. Conclusion This research identifies sociodemographic, mental health, physical health and substance use factors associated with PWB among adults in Canada. These findings highlight groups and characteristics that could be the focus of future research to promote PMH.

The hostile environment in primary care: Qualitative analysis of a cross sectional survey of health care professionals in primary care

BackgroundIn 2014 the UK government rolled out the then called hostile environment as a series of punitive policies designed to disenfranchise undocumented migrants from living in Britain. As part of these measures upfront charging was introduced in 2017 which saw patients being denied treatment without prior full payment based on their immigration status. AimAssess the knowledge of the charging regulations in a sample of primary care practitioners. Assess the impact of the regulations on both patients and practitioners in a primary care setting. MethodsBuilding on a previous survey by the RCPCH, a cross sectional survey was circulated through the RCGP faculties and GP training groups within England. Demographic information and likert responses were collected from over 300 responses. Thematic analysis of over 120 white space questions was undertaken to create themes and sub-themes. ResultsResults showed an overall poor knowledge of the regulations. Thematic analysis was split into two main categories, (i) human impact of the policies and (ii) the economic and political impact of the policies. Key points were (i) lack of knowledge and awareness of the regulations, (ii) evidence of patient harm through patients’ being denied care, avoiding care or having care delayed, (iii) evidence of clinician harm through burnout, stress, a loss of faith in practice and concerns over extra work and (iv) concerns over implicit bias and structural racism within primary care and (v) concerns over lack of economic analysis. ConclusionCharging of overseas visitors is poorly understood within primary care despite having an impact on both patients and practitioners within this setting. Recommendations to help tackle this issue and reduce harm include training of staff, systematic reporting of harm, and a system wide economic analysis.

The impact of admitting ward on resource utilization and outcomes among hospitalized cancer survivors.

36 Background: With improvements in both early detection and cancer treatment, there is a growing population of cancer survivors; with a corresponding increase in acute care use. However, models of inpatient care delivery for cancer survivors differ between hospitals and regions, which may impact resource use and outcomes. Understanding how different models influence outcomes may help define optimal models for cancer inpatient care delivery. Methods: We created a multicenter cohort of all cancer patients admitted to medical wards across 26 hospitals in Ontario, Canada from 2015 to 2022, and deterministically linked population level administrative data including ambulatory oncology data, with each hospital’s patient-level electronic information (pharmacy, orders, notes, labs/imaging and results). Multivariable regression models compared characteristics and outcomes between patients admitted on oncology wards vs non-oncology wards adjusting for age, sex, income quintile, rurality, immigrant status, receiving IV systemic therapy within 120 days and comorbidity scores. Results: In total, there were 370,118 hospitalizations from 191,990 unique patients. Among these hospitalizations, 38,075 episodes (10%) were on an oncology ward. Median time from cancer diagnosis to hospitalization was 4 years; 10% received IV systemic therapy within 120 days and 16% within 1 year. The most common disease sites were GU (21%), GI (20%), breast (12%) and lung (10%). The most common discharge diagnoses from oncology wards were inpatient chemotherapy (9%), febrile neutropenia (7%), NHL (4%), AML (4%), myeloma (3%); while for non-oncology wards were heart failure (5%), palliative care (4%), UTI (2%), pneumonia (2%), acute renal failure (2%). In general, cancer patients admitted on oncology wards were younger (64 vs 76), had shorter length of stay (LOS; 9.6 vs 10.1 days), less in-hospital mortality (8% vs 11%), greater 30-day re-admission rates (30% vs 15%) and were more likely to undergo CTs (28% vs 21%), MRIs (11% vs 9%) and interventional procedures (8% vs 6%) (p<0.001, all). Subgroup analysis focusing on the top 5 discharge diagnoses from non-oncology wards, showed that despite no difference in in-hospital mortality rates (aOR 0.92 95% CI [0.58-1.46] p=0.73), admission to a non-oncology ward for those diagnoses was associated with shorter LOS (aOR 0.84 [0.78-0.90] p<0.001), reduced 30-day re-admission rates (aOR 0.60 [0.48-0.75] p<0.001), and reduced use of CTs (aOR 0.60 [0.49-0.74] p<0.001), MRIs (aOR 0.36 [0.25-0.52] p<0.001), and interventional procedures (aOR 0.43 [0.29-0.64] p<0.001). Conclusions: There are differences in resource use and outcomes for cancer survivors hospitalized on oncology versus non-oncology wards, including for patients with the same discharge diagnosis. To optimize inpatient cancer care delivery for hospitalized cancer survivors, further exploration of care models is needed.

The link between teacher–student relations and sense of school belonging is not equal for all: The moderating role of immigrant status

AbstractTeachers' support and positive teacher–student bonds are key factors in promoting a sense of school belonging (SB) among adolescents. Previous research shows that immigrant‐origin adolescents (IOA's) report lower SB than their non‐immigrant peers do. This study examines if positive teacher–student bonds are equally beneficial for the SB of immigrant‐origin and non‐immigrant adolescents. Using PISA 2022 data, the moderating role of immigrant status in this relationship was assessed in European countries by multi‐level models (NStudents = 151,211, NSchools = 21,629, NCountries = 19). Country‐level analyses revealed that IOA's benefited less from positive teacher–student relations in 6 out of 19 countries. In Sweden, Belgium, and Portugal this moderation effect was conditional on the moderating role of school diversity promotion.

Discrimination in the Austrian rental housing market: The effect of information concerning first and second-generation immigrant status

This study investigates the previously unexplored effect that immigrant generation has on housing discrimination against immigrants. Property owners may perceive more recent immigrants as particularly “other” and fear that they will not be good tenants, e.g. because they will treat a property in an undesirable manner or not pay their bills. To test the effect of acculturation, we conduct an email correspondence test in Austria and compare landlords’ responses to inquiries from immigrants (with a Serbian, Syrian or Turkish name) of the first, first and a half, and second-generation to those who do not provide respective information about their immigration background. We find that when applicants indicate their place of birth and upbringing, discrimination is highest for first-generation immigrants and lowest for second-generation immigrants. This suggests an advantage for more acculturated applicants. However, compared to providing no information, actively signaling a second-generation background only benefits one of the immigrant groups tested (Syrians), who may be perceived as recent refugees otherwise.

The association of combinations of social factors and SARs-CoV-2 infection: A retrospective population-based cohort study in Ontario, 2020–2021

ObjectiveThe COVID-19 pandemic highlighted and exacerbated health inequities worldwide. While several studies have examined the impact of individual social factors on COVID infection, our objective was to examine how interactions of social factors were associated with the risk of testing positive for SARS-CoV-2 during the first two years of the pandemic. Study design and settingWe conducted an observational cohort study using linked health administrative data for Ontarians tested for SARS-CoV-2 between January 1st, 2020, and December 31st, 2021. We constructed multivariable models to examine the association between SARS-CoV-2 positivity and key variables including immigration status (immigrants vs. other Ontarians), and neighbourhood variables for household size, income, essential worker status, and visible minority status. We report main and interaction effects using odds ratios and predicted probabilities, with age and sex controlled in all models. ResultsOf 6,575,523 Ontarians in the cohort, 88.5 % tested negative, and 11.5 % tested positive for SARS-CoV-2. In all models, immigrants and those living in neighbourhoods with large average household sizes had greater odds of testing positive for SARS-CoV-2. The strength of these associations increased with increasing levels of neighbourhood marginalization for income, essential worker proportion and visible minority proportion. We observed little change in the probability of testing positive across neighbourhood income quintiles among other Ontarians who live in neighbourhoods with smaller households, but a large change in probability among other Ontarians who live in neighbourhoods with larger households. ConclusionOur study found that SARS-CoV-2 positivity was greater among people with certain combinations of social factors, but in all cases the probability of testing positive was consistently greater for immigrants than for other Ontarians. Examining interactions of social factors can provide a more nuanced and more comprehensive understanding of health inequity than examining factors separately.

Association Between Neighborhood-Level Income and the Incidence of Cardiovascular Events Varies by Immigration Status: A Population-Based Cohort Study.

Neighborhood-level income is inversely associated with cardiovascular events; however, it is uncertain whether this association varies with immigration status. We conducted a population-based cohort study of 5.2 million (53% women, 19% immigrants) urban-dwelling people aged ≥40 years without a prior history of cardiovascular disease in Ontario, Canada. Neighborhood-level income was measured in quintiles from quintile 1 (lowest) to quintile 5 (highest), and immigrants were defined as those born outside of Canada who moved to Canada after 1985. We estimated the association between neighborhood-level income and the rate of incident cardiovascular events (hospitalization for stroke or myocardial infarction, or cardiovascular death) using multivariable cause-specific hazards models and added an interaction term to see if the association varies by immigration status. The absolute difference in the rate of cardiovascular events across income quintiles was less pronounced in immigrants than in long-term residents: age- and sex-adjusted rate per 1000 person-years in quintile 1 versus quintile 5: 5.69 versus 4.10 in immigrants and 8.37 versus 5.87 in long-term residents. In adjusted models, the interaction between immigration status and neighborhoodl evel was significant (Pinteraction <0.001). The hazard of cardiovascular events declined with increasing income among long-term residents (hazard ratio [HR]Q1vsQ5, 1.46 to HRQ4vsQ5, 1.10) and immigrants, albeit with a smaller gradient (HRQ1vsQ5, 1.43 to HRQ4vsQ5, 1.20). The association between neighborhood-level income and cardiovascular disease incidence variesby immigration status. Understanding the social and structural factors associated with residing in low-income neighborhoods can help with the development of prevention programs that improve health for all.

Barriers to Reproductive Justice for Women Seeking Sanctuary in the UK: Narratives from Birth Companions and the Maternity Stream of Sanctuary

Women living in the UK with insecure immigration status are often from ethnic minority groups, have limited understanding of English, and have significant experience of trauma. Recent confidential inquiries into maternal deaths have repeatedly shown how intersecting and multiple disadvantage puts these women at higher risk of maternal mortality and morbidity. Multiple voluntary sector organisations are relied upon to support these women as they navigate the journey to parenthood. A reproductive justice framework is here employed to examine the multitude of factors intersecting to influence the access women with insecure migrant status have to maternity services. Narrative construction of three composite case studies took place to highlight the various ways reproductive justice is both violated and protected by the immigration and maternity systems in the UK. The discussion section comments on prevalent themes throughout each case study: gendered dynamics of insecure immigration status, structural barriers and complex systems, and reliance on the fragile voluntary sector. This article concludes that, alongside the work of the voluntary sector, women’s reproductive justice rights must also be emphasised and protected throughout statutory systems and services.

‘At some points you feel awful because you are going to start again’: The ambiguous role of education in highly skilled refugee women’s integration experiences

In refugee and migration studies, education has been situated as both a marker of integration and a facilitator of progress in other domains. This paper draws on the accounts of three highly skilled women who have experienced forced migration to highlight some of the ambiguities of education’s role in pathways to social and economic inclusion. A case study approach allows for a detailed and contextual exploration of how intersections of age, caring responsibilities and immigration status influence women’s ability to engage with education. Participants’ accounts confirm that accessing desired and appropriate educational provision can propel people towards their longer-term goals. However, provision that is inaccessible or perceived to be below women’s skill levels can be experienced as exclusionary and demoralising, with attendant impact on women’s perceptions of integration and hopes for the future. Women deploy several strategies to overcome these obstacles, including leveraging existing social connections and re-evaluating their future career pathways. Yet these strategies are not always fully successful. Our findings point towards the need for improved provision for adult refugees and a concerted effort by educational institutions to tackle continuing systemic barriers to education.

Taking an Intersectional Approach: Immigrant Women Language Teachers’ Lived Experience of Identity

This article explores skilled immigrant women language teachers’ lived experience of identity through an intersectional feminist lens. It examines how women teachers speak about themselves and their lives as immigrants and aims to understand the complex implications of identity and power relations by focusing on intersectional understanding of inequities. Data was generated through in-person and virtual individual interviews with six participants living and working across Canada. The findings revealed the following main challenges and ongoing barriers: discrimination, overqualification, financial limitations, a lengthy process of re-credentialing and professional reintegration, and insufficient government support. Furthermore, this study sheds light on how heteronormative frameworks pervade immigrant women’s personal and professional lives, intersecting with their identities vis-à-vis gender, race, ethnicity, country of origin, immigration status, and English as a second language. These categories collectively and individually present systemic barriers and sites of oppression that negatively impact an already marginalized minority group— internationally highly qualified immigrant women language teachers.

Abstract B074: Qualitative assessment of knowledge gaps and barriers to Hepatitis B and liver cancer screening in high-risk U.S. communities

Abstract Background: Up to 2.4 million people in the US live with chronic hepatitis B (HBV) infection (Wong et al., 2021). Foreign-born communities are most impacted, particularly those from Asia, the Pacific Islands, the Caribbean, and sub-Saharan Africa (Conners et al., 2023). Individuals with unmanaged HBV have a 15-40% lifetime risk of dying prematurely from cirrhosis or hepatocellular carcinoma (HCC) (McMahon, 2009). Low awareness, cultural norms, and misperceptions about HBV, HCC, and their connection contribute to low screening and care rates in affected communities. A more robust and comprehensive understanding of these barriers is needed to design effective awareness campaigns to improve HBV screening and care and prevent HCC. To this end, this study aimed to learn about existing knowledge and misconceptions about HBV and its relationship to HCC in high-risk communities, identify barriers to screening, and use the findings to develop effective communication strategies that raise awareness and dispel myths. Methods: Fifteen focus groups and two key informant interviews with community members, leaders, and public health experts were conducted to assess beliefs and attitudes about HBV and HCC and to identify preferred communication strategies. Results: The link between HBV and HCC remains poorly understood, and myths persist about the transmission and outcomes of both conditions. Multiple barriers to HBV and HCC screening exist, including concerns about insurance and immigration status, language barriers, cultural and religious beliefs, lack of general health literacy, lack of resources to cope with a positive diagnosis, widespread distrust of Western medicine, and fear of stigma and isolation. Ideas for effective communication methods included employing community health educators, primary care providers, ethnic media outlets and personal testimonials for delivery of information, and tailoring communications by community, age, and gender. These findings were used to create a suite of culturally and linguistically appropriate educational materials for use in each of twelve communities. Conclusions: Many challenges to increasing screening persist in groups most impacted by HBV and HCC, including a need for increased awareness about their connection. Community engagement is essential to overcoming these challenges, as are specific, targeted messaging and dissemination to improve the uptake of HBV screening and management. Behavioral and Social Science: Community-based Participatory Research Citation Format: Beatrice Zovich, Fiona Borondy-Jenkins, Suzanne Block, Kate Moraras, Thomas Chen, Chari Cohen. Qualitative assessment of knowledge gaps and barriers to Hepatitis B and liver cancer screening in high-risk U.S. communities [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B074.

Trends in Contacts Made by Immigrants to the National Domestic Violence Hotline, Before and During the COVID-19 Pandemic.

Immigrants in the United States are more likely than nonimmigrants to experience risk factors for intimate partner violence (IPV) and problems in getting support. The COVID-19 pandemic and recent incidents of xenophobia and anti-immigrant sentiment may have exacerbated exposure to IPV risk factors. We examined immigrant experiences of IPV before and during the COVID-19 pandemic. This study identified changes in characteristics of abuse, services used, referrals, and barriers to services among those who contacted the National Domestic Violence Hotline (NDVH) and identified as immigrants, reported immigration status as a concern, needed immigration support, and/or identified immigration status as a barrier to accessing services (N = 49 817). We used joinpoint regressions to examine whether the rate of change differed significantly from 2016-2019 (before the pandemic) to 2019-2021 (during the pandemic). The number of immigrant contacts to NDVH peaked in 2017 (n = 9333) and declined 25% to 6946 in 2021. During 2016-2019, the percentage of contacts reporting the following increased significantly: technology-facilitated violence (+12.7 percentage points), economic/financial abuse (+10.8 percentage points), and involvement of firearms (+4.8 percentage points); during 2019-2021, these trends reversed. The percentage of contacts reporting separation or divorce was relatively flat until 2019 and then increased from 14.6% in 2019 to 19.9% in 2021 (+5.2 percentage points). Housing instability increased during 2017-2020 (+9.3 percentage points), but requests for shelters decreased (-4.5 percentage points). Immigration status and personal finances were commonly reported barriers to services; both decreased during 2016-2019 but then increased during 2019-2021. This study can inform prevention and response strategies relevant for immigrants experiencing or reporting IPV.

Protected, Yet Undocumented: The U.S. Case of Growing Liminal Immigration Status and the Theoretical, Advocacy, and Policy Implications for the U.S. and Beyond

Often, undocumented immigrants are considered a population living in the shadows. But living below the radar of U.S. governmental authorities is no longer as accurate. As of the end of 2023, estimates indicate nearly six million, or nearly half, of the undocumented population has some level of liminal or protected status. At the same time, these protections are more temporary than before as most immigration policy now occurs in the executive, and not the legislative, branch, and is subject to dramatic shifts with a change in administration. Also, the diversity of protection types has grown. Using data for the U.S. case, this paper examines the broader implications of this trend on how the term “undocumented” is defined, as well as the advocacy and policy implications such new statuses portend. Having the world's largest undocumented population, the U.S. case can also shed light on our broader understanding of the undocumented label as a globally-referenced category.

Venezuelan migration to Brazil: teachers and students co-constructing multicultural education inside classrooms

PurposeThis study aims to show the complexities of engagement between students - Venezuelan and Brazilian - and their teachers. This qualitative ethnographic study documents the everyday pedagogies and practices that take place in elementary schools with high levels of refugee and immigrant children. While Brazilian law ensures the basic right to public education, forbidding discrimination based on nationality or immigration status (Lei de Diretrizes e Bases da Educação, 1996), the barriers remain. Through the frameworks of multicultural (USA) and intercultural (Brazil) education, this paper shows how Brazilian teachers and students of Venezuelan and Brazilian backgrounds engage, learn from one another and build welcoming spaces, but also how stereotypes are reinforced inside classrooms and schools.Design/methodology/approachThis qualitative study uses ethnography to understand how recent Venezuelan migratory flow influences Brazilian and Venezuelan children’s educational experiences in elementary education. Participants were Venezuelan (N = 57) and Brazilian (N = 76) children in two elementary schools in the city of Boa Vista. Data sources for the study are school observations in four elementary classrooms (1st and 2nd grade) and semi-structured interviews with caregivers, teachers, administrators and other educators. This paper also collected children’s drawings and writings and documents like curricula, strategic planning, guidelines, policies, grades, reports and any other textual or photographic material made available at the city level.FindingsIn the field of education, there is a critical need for understanding children’s education experiences. This paper focuses on the experiences of teachers and students in two elementary schools in Brazil. This paper focus on two findings: first that teachers promote the learning of Portuguese to show care toward their Venezuelan students. Second, children in the classroom show solidarity with one another and resist some of the more rigid Portuguese-only practices enacted by teachers. This work uses the frameworks of intercultural (more commonly used in Brazil) and multicultural education to inform the analysis.Research limitations/implicationsIn this study, this paper puts these frameworks of interculturalism, multiculturalism, language use and solidarity into conversation to understand the dynamics of two elementary classrooms in the city of Boa Vista, Brazil. While this paper shows the shortcomings of a seemingly multicultural and multilanguage classroom, it also shows how children actively resist the rigidity of teaching and learning in elementary schooling.Originality/valueThis study is a response both to the increasing South–South migration trend in Latin America and its consequences on public education systems. Through multicultural and intercultural lenses, this research highlighted the complexity of interactions within multicultural classrooms by delving into a two-year ethnographic study conducted in Boa Vista, Brazil, focusing on Venezuelan and Brazilian children in two local elementary schools. This paper focused on two main observations this paper refers to as “Teaching Portuguese as a Way of Caring” and “Children's Solidarity Work.” Teachers primarily centered their instruction on teaching Portuguese to migrant children, believing it to lead to quicker integration in the classroom and beyond – thus as a way of caring for their migrant students.

Fugitive Care: The Politics of Care Enacted by Afro-Caribbean Women Teachers

The future of teaching will increasingly rely on overseas-trained teachers (OTTs) to address teacher shortages. While research on OTTs in the United States is expanding, studies focusing on Afro-Caribbean teachers are emerging. Despite the growing call for more teachers of color, Afro-Caribbean OTTs’ contributions are often overlooked due to their immigrant status. We propose the concepts of “radical transparency” and “fugitive care” to articulate how these teachers’ classroom practices offer alternative possibilities for schooling, making the learning process both explicit and equitable for all students. Drawing on a Transnational Black Feminist Framework (TBF), we highlight the unique politics of care practiced by these teachers, revealing gaps in our cultural understanding and underscoring their vital, yet understudied, contributions to education.

English digital reading achievement for East Asian students: identifying the key predictors using a machine learning approach

ABSTRACT Students’ digital reading literacy has attracted increasing attention in the current digital era; however, few studies have been conducted to explore how factors at different levels influence students’ digital reading achievement. Grounded by socio-ecological theory, the current comprehensively explored the relative importance of 24 individual, microsystem, and mesosystem variables in predicting English digital reading achievement through the machine learning approach (i.e. random forest regression). The secondary data were retrieved from the Program for International Student Assessment (PISA) 2018, including 7,703 15-year-old students from Macao, Hong Kong, and Singapore. Our study identified 12 key factors that best predicted East Asian students’ English digital reading achievement. Among them, students’ socioeconomic status, subject-related ICT use during lessons, and interest in ICT ranked as the top three factors. The disparities in the roles played by disciplinary climate, gender, being bullied, immigrant status, and home language among the three economies were discussed.

The Immigration–Crime Nexus: Inner and Outer Containment Buffer or A Push Toward Delinquency

The ongoing debate over the immigration–crime nexus has continued to attract a wide range of research efforts in the criminal justice field. To build on these initiatives, this study not only examines the relationship between immigrants and adolescent crime but also explores attributes derived from containment effects that may contribute to or shield individuals from deviant behavior in America. Results showed that both immigrant and native-born adolescents share similar external attributes rather than internal traits that affect delinquency. For instance, inherent immigration status and identity is relatively more influential on self-reported substance problems among immigrant youth compared to their native-born counterparts. Interestingly, among external attributes, immigrant and native-born adolescents are responsive to legitimate opportunity and neighborhood order in different ways which thrust them into different deviant pathways.

Experiences and Supportive Care Needs of Latinx Millennial Caregivers.

Latinx Millennial caregivers are an understudied minority group in the United States. Due to life stage and cultural values, these caregivers struggle to balance conflicting priorities with career, family, and caregiving. They also face systemic barriers and healthcare disparities. Participants (N = 29) were recruited locally and nationally. Qualitative data were collected using five focus groups and one individual interview. Interviews were analyzed by seven coders using thematic analysis with an inductive approach. Meta-themes included (a) the Latinx experience with culture, immigrant status, and structural barriers; and (b) being a super caregiver: being everything to everyone. Additional main themes were identified including family well-being, occupational and financial well-being, social support dynamics, challenges and rewards of family caregiving, and coping strategies. Clinical interventions for Latinx Millennial caregivers should address cultural background, value of family/community, and systemic barriers for care and support.

Between a rock and a hard place: domestic abuse and being a migrant woman in England and Wales

Legal responses to domestic abuse have been a political priority of the UK Government since at least 2010, eventually leading to the passing of the seminal legislation in this area for England and Wales, the Domestic Abuse Act 2021. However, the exclusion of protection for migrant victim-survivors with precarious immigration statuses under the Act demonstrates a failure in understanding that the experience and risk of domestic abuse differ for these individuals from that of the mainstream, due to their intersectional identities as (predominantly) migrant women. Many migrant victim-survivors still find themselves trapped in abusive situations, as the law fails to safeguard their rights to reside legally should they choose to present themselves to authorities by reporting their abuse. A distinct lack of acknowledgment as to inequalities faced by those at the intersection of migrant status and gender (Crenshaw, 1989; 1991) has led to increased insecurity for some of the most vulnerable. This article shines a light on this discrimination under the law in England and Wales. It adopts an intersectionality framework to examine such inequality, analysing Appendix Violence Domestic Abuse and the Migrant Victim Domestic Abuse Concession in UK immigration law, as well as the Support for Migrant Victims Pilot and its relevant Evaluation Report, against the international standards of the Istanbul Convention. It argues that the UK Government is failing to tackle the problem of migrant victim-survivors’ protection concerning domestic abuse, and in some situations, has made it worse.This article aims to state the law as of 1 May 2024.

Long-Term Change in BMI for Children with Obesity Treated in Family-Centered Lifestyle Interventions

Introduction: Several evaluations of lifestyle interventions for childhood obesity exist; however, follow-up beyond 2 years is necessary to validate the effect. The aim of the present study was to investigate long-term weight development following children participating in one of two pragmatic family-centered lifestyle interventions treating childhood obesity. Methods: This real-life observational study included Danish children 4–17 years of age classified as having obesity. Data from 2010 to 2020, from two community-based family-centered lifestyle interventions (designated hereafter as the Aarhus- and the Randers-intervention) were merged with national registers and routine health check-ups, including height and weight. Adjusted mixed effect models were used to model changes in body mass index (BMI) z score. We performed exploratory analyses of the development in BMI z-score within stratified subgroups of children treated in the interventions before investigating potential effect modifications induced by sex, age, family structure, socioeconomic, or immigration status. Results: With a median follow-up of 2.8 years (interquartile range: 1.3; 4.8), 703 children participated in an intervention (445 the Aarhus-intervention; 258 the Randers-intervention) and 2,337 children were not invited to participate (no-intervention). Children in both interventions experienced a comparable reduction in BMI z-scores during the first 6 months compared to the no-intervention group (Aarhus-intervention: −0.12 SD/year and Randers-intervention: −0.25 SD/year). Only children in the Randers-intervention reduced their BMI z-score throughout follow-up (Aarhus-intervention vs. no-intervention: 0.01 SD/year; confidence interval [CI]: −0.01; 0.04; Randers-intervention vs. no-intervention: −0.05 SD/year; CI: −0.08; −0.02). In subgroup comparisons, combining the two interventions, family income below the median (−0.05 SD/year, CI: −0.02; −0.09), immigrant background (0.04 SD/year, CI: 0.00; 0.07), or receiving intervention less than 1 year (0.04 SD/year, CI: 0.00; 0.08) were associated with a yearly increase in BMI z score. In addition, effect modification analyses did not observe any interaction by sex, age, family structure, socioeconomic, or immigration. Conclusions: Although the more dynamic intervention with longer duration obtained and sustained a minor reduction in BMI z score, the clinical impact may only be modest and still not effective enough to induce a long-term beneficial development in BMI in children with obesity.