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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: closed (30 November 2015)

Special Issue Editor

Guest Editor
Prof. Dr. Sloane Burke Winkelman

Public Health Programs Health Sciences, Department California State University, Northridge Jacaranda Hall (JD), 2501 Northridge, CA 91330, USA
Website | E-Mail
Interests: Migrant Health

Special Issue Information

Dear Colleagues,

According to the World Health Organization (WHO) and International Organization on Migration, there are an estimated 1 billion migrants in the world today. To place this in perspective, it is estimated that one out of every thirty-five people in the world today is a migrant (2013). Migrants comprise various populations, including workers, displaced persons, students, undocumented individuals and others. Each migrant population has unique needs and experiences in addition to varying degrees of environmental, social, economic, and psychological risk factors due to displacement. The public health needs of this growing population are considerable, particularly for developing countries.

From a global perspective, migration—voluntary or forced—is pervasive due to skilled worker shortages, demographic imbalances, climate change, economic and political turmoil, and natural and man-made disasters. The health of migrants and health issues associated with migrant populations are crucial public health challenges faced by governments, the public health system, non-governmental organization and societies (WHO, 2013). This population experiences unique public health challenges magnified by the social determinants of health, including: access to health services, health literacy, environmental and occupational health, infectious and chronic diseases, psychosocial health, health policy, advocacy, and administration—all of which are important areas for research dissemination.

This special issue in IJERPH aims to advance the field of migrant health. This issue focuses on public health challenges and recommended solutions, with the goal of sharing scientific knowledge and informing public health practitioners as to how we can reduce health disparities and improve health outcomes for migrant populations. Qualitative, quantitative, and review paper submissions are welcome. Submissions focused on assessment, evaluation and measurement, intervention, and recommended strategies for program implementation are encouraged.

The special issue on Migrant Health will cover topics in:

  • Health issues or social determinants of health related to migrants
  • Strategies for improving the health of migrants
  • Assessment, evaluation and measurement
  • Intervention and program implementation
  • Qualitative and quantitative research methods

Prof. Dr. Sloane Burke Winkelman
Guest Editor

Submission

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. Papers will be published continuously (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are refereed through a peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed Open Access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1600 CHF (Swiss Francs).

Published Papers (29 papers)

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Research

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Open AccessArticle Lower Prevalence of Atopic Dermatitis and Allergic Sensitization among Children and Adolescents with a Two-Sided Migrant Background
Int. J. Environ. Res. Public Health 2016, 13(3), 265; doi:10.3390/ijerph13030265
Received: 30 November 2015 / Revised: 19 February 2016 / Accepted: 23 February 2016 / Published: 26 February 2016
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Abstract
In industrialized countries atopic diseases have been reported to be less likely in children and adolescents with a migrant background compared to non-migrants. This paper aimed at both examining and comparing prevalence of asthma, allergic rhinoconjunctivitis and atopic dermatitis and allergic sensitization to
[...] Read more.
In industrialized countries atopic diseases have been reported to be less likely in children and adolescents with a migrant background compared to non-migrants. This paper aimed at both examining and comparing prevalence of asthma, allergic rhinoconjunctivitis and atopic dermatitis and allergic sensitization to specific IgE antibodies in children and adolescents with and without a migrant background. Using data of the population-based German Health Interview and Examination Survey for children and adolescents (KiGGS;n = 17,450; 0–17 years), lifetime and 12-month prevalence of atopic diseases and point prevalence of 20 common allergic sensitizations were investigated among migrants compared to non-migrants. Multiple regression models were used to estimate the association of atopic disease and allergic sensitization with migrant background. In multivariate analyses with substantial adjustment we found atopic dermatitis about one-third less often (OR 0.73, 0.57–0.93) in participants with a two-sided migrant background. Statistically significant associations between allergic sensitizations and a two-sided migrant background remained for birch (OR 0.73, 0.58–0.90), soybean (OR 0.72, 0.54–0.96), peanut (OR 0.69, 0.53–0.90), rice (OR 0.64, 0.48–0.87), potato (OR 0.64, 0.48–0.85), and horse dander (OR 0.58, 0.40–0.85). Environmental factors and living conditions might be responsible for the observed differences. Full article
(This article belongs to the Special Issue Migrant Health)
Open AccessArticle What Effect Does International Migration Have on the Nutritional Status and Child Care Practices of Children Left Behind?
Int. J. Environ. Res. Public Health 2016, 13(2), 218; doi:10.3390/ijerph13020218
Received: 7 November 2015 / Revised: 25 January 2016 / Accepted: 4 February 2016 / Published: 15 February 2016
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Abstract
Despite an increasing trend in labour migration and economic dependence on foreign migrant workers in Sri Lanka, very little is known about the child care and nutritional status of “children left behind”. The aim of this study was to examine the factors influencing
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Despite an increasing trend in labour migration and economic dependence on foreign migrant workers in Sri Lanka, very little is known about the child care and nutritional status of “children left behind”. The aim of this study was to examine the factors influencing the nutritional status and care practices of children left behind. A sample of 321 children, 6–59 months old of international migrant workers from a cross-sectional nationally represented study were included. Care practices were assessed using ten caregiving behaviours on personal hygiene, feeding, and use of health services. Results revealed the prevalence of stunting, wasting and underweight to be 11.6, 18.2 and 24.0 percent, respectively. Father being a migrant worker has a positive effect on childcare practices and birthweight of the child. This study indicates that undernutrition remains a major concern, particularly in the poorest households where the mother is a migrant worker, also each additional 100 g increase in the birthweight of a child in a migrant household, decreases the probability of being wasted, stunted and underweight by 6%, 8% and 23% respectively. In depth study is needed to understand how labour migration affects household level outcomes related to child nutrition and childcare in order to build skills and capacities of migrant families. Full article
(This article belongs to the Special Issue Migrant Health)
Open AccessArticle Using a Household Food Inventory to Assess the Availability of Traditional Vegetables among Resettled African Refugees
Int. J. Environ. Res. Public Health 2016, 13(1), 137; doi:10.3390/ijerph13010137
Received: 26 October 2015 / Revised: 30 November 2015 / Accepted: 5 January 2016 / Published: 18 January 2016
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Abstract
A cross-sectional sequential explanatory mixed methods study was conducted among household food preparers to examine the association between home availability and consumption of traditional vegetables among resettled African refugees living in Queensland, Australia. Home availability of traditional African vegetables was associated with age,
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A cross-sectional sequential explanatory mixed methods study was conducted among household food preparers to examine the association between home availability and consumption of traditional vegetables among resettled African refugees living in Queensland, Australia. Home availability of traditional African vegetables was associated with age, having a vegetable garden, employment status, and having a supermarket in the local neighborhood. Food preparers from homes with low vegetable availability were less likely to consume the recommended number of vegetable servings. Barriers faced in the food environment included language, lack of availability of traditional vegetables and lack of transport. All of these aspects contributed to the study findings that both individual and food environment characteristics may play a role in access to and availability of food and vegetable consumption of resettled refugees. Consumption of traditional foods among the resettled refugees continues post resettlement. Full article
(This article belongs to the Special Issue Migrant Health)
Open AccessArticle Screening for Infectious Diseases among Newly Arrived Migrants: Experiences and Practices in Non-EU Countries of the Mediterranean Basin and Black Sea
Int. J. Environ. Res. Public Health 2015, 12(12), 15550-15558; doi:10.3390/ijerph121215002
Received: 22 September 2015 / Revised: 27 October 2015 / Accepted: 30 November 2015 / Published: 8 December 2015
Cited by 3 | PDF Full-text (590 KB) | HTML Full-text | XML Full-text
Abstract
Changing migration dynamics in the Mediterranean Sea and differences in infectious diseases (ID) burden between the countries of origin have raised questions whether public health actions are needed to avoid the transmission of ID. Screening newly arrived migrants for ID is one health
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Changing migration dynamics in the Mediterranean Sea and differences in infectious diseases (ID) burden between the countries of origin have raised questions whether public health actions are needed to avoid the transmission of ID. Screening newly arrived migrants for ID is one health monitoring option, offering opportunities for prevention, early detection and treatment. The authors conducted a survey among country experts in non-European Union countries of the Mediterranean and Black Sea, in order to explore current ID screening practices and policies for newly arrived migrants. The association between the existence of guidelines and the proportion of refugees in the population was also estimated. Eighteen country experts responded (90%) out of the 20 invited. Eleven countries (61%) implemented screening programmes and six (38%) had national guidelines. Screening was performed most often for tuberculosis at the holding level. A higher proportion of refugees in the population was associated with the existence of guidelines for screening (p = 0.05). Fourteen experts (88%) considered screening among migrants useful. The results show that screening for ID in newly arrived migrants is relevant for non-EU countries of the Mediterranean and Black Sea. Common guidelines could be promoted focusing on both individual and public health benefits of screening programmes. Full article
(This article belongs to the Special Issue Migrant Health)
Open AccessArticle Assessing the Acceptability and Usability of an Internet-Based Intelligent Health Assistant Developed for Use among Turkish Migrants: Results of a Study Conducted in Bremen, Germany
Int. J. Environ. Res. Public Health 2015, 12(12), 15339-15351; doi:10.3390/ijerph121214987
Received: 18 September 2015 / Revised: 24 November 2015 / Accepted: 26 November 2015 / Published: 3 December 2015
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Abstract
The Internet offers a new chance for health professionals to reach population groups not usually reached through traditional information channels, for example, migrants. Criticism has, however, been raised that most health information on the Internet is not easy to read and lacks cultural
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The Internet offers a new chance for health professionals to reach population groups not usually reached through traditional information channels, for example, migrants. Criticism has, however, been raised that most health information on the Internet is not easy to read and lacks cultural sensitivity. We developed an Internet-based bilingual health assistant especially for Turkish migrants in Germany, tested its acceptance, and evaluated its usability in a participatory research design with families with and without Turkish migrant background. The interactive health assistant covered the following: nutrition, physical activity, overweight, diabetes, as well as pregnancy and pregnancy support. The idea of an Internet-based health assistant was generally accepted by all participants of the evaluation study, as long as it would be incorporated in existing appliances, such as smartphones. The bilingual nature of the assistant was welcomed especially by first generation migrants, but migrant participants also indicated that not all health information needed to be made available in a culture-specific way. The participants were least satisfied with the nutrition component, which they felt should include recipes and ingredients from the culture of origin, as well as specific aspects of food preparation. Full article
(This article belongs to the Special Issue Migrant Health)
Open AccessArticle Return Migration among Elderly, Chronically Ill Bosnian Refugees: Does Health Matter?
Int. J. Environ. Res. Public Health 2015, 12(10), 12643-12661; doi:10.3390/ijerph121012643
Received: 18 August 2015 / Revised: 22 September 2015 / Accepted: 30 September 2015 / Published: 12 October 2015
Cited by 3 | PDF Full-text (685 KB) | HTML Full-text | XML Full-text
Abstract
Elderly migrants constitute a considerable share of global return migration; nevertheless, literature on the health aspects of the return migration among these migrants is still scarce. This study explores the significance of return migration among elderly, chronically ill Bosnian refugees from Denmark and
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Elderly migrants constitute a considerable share of global return migration; nevertheless, literature on the health aspects of the return migration among these migrants is still scarce. This study explores the significance of return migration among elderly, chronically ill Bosnian refugees from Denmark and the role of health issues in their decision to return. It is based on semi-structured interviews with 33 elderly, chronically ill Bosnian refugees who have moved back to Bosnia and Herzegovina, and 10 elderly, chronically ill Bosnian refugees who have remained in Denmark. The interviews show that physical health, in the sense of the absence of illness and easy access to necessary health-care services and medicines, was not highly prioritized when the decision was made whether or not to return. However, if health is regarded more broadly as involving more than mere physical health and the absence of illness, health did matter. Viewed as physical, social and mental well-being in line with WHO’s definition of health, health was indeed one of the most important factors when the decision to return was made. Full article
(This article belongs to the Special Issue Migrant Health)
Open AccessArticle Towards a European Framework to Monitor Infectious Diseases among Migrant Populations: Design and Applicability
Int. J. Environ. Res. Public Health 2015, 12(9), 11640-11661; doi:10.3390/ijerph120911640
Received: 3 August 2015 / Revised: 6 September 2015 / Accepted: 9 September 2015 / Published: 17 September 2015
Cited by 6 | PDF Full-text (1039 KB) | HTML Full-text | XML Full-text
Abstract
There are limitations in our capacity to interpret point estimates and trends of infectious diseases occurring among diverse migrant populations living in the European Union/European Economic Area (EU/EEA). The aim of this study was to design a data collection framework that could capture
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There are limitations in our capacity to interpret point estimates and trends of infectious diseases occurring among diverse migrant populations living in the European Union/European Economic Area (EU/EEA). The aim of this study was to design a data collection framework that could capture information on factors associated with increased risk to infectious diseases in migrant populations in the EU/EEA. The authors defined factors associated with increased risk according to a multi-dimensional framework and performed a systematic literature review in order to identify whether those factors well reflected the reported risk factors for infectious disease in these populations. Following this, the feasibility of applying this framework to relevant available EU/EEA data sources was assessed. The proposed multidimensional framework is well suited to capture the complexity and concurrence of these risk factors and in principle applicable in the EU/EEA. The authors conclude that adopting a multi-dimensional framework to monitor infectious diseases could favor the disaggregated collection and analysis of migrant health data. Full article
(This article belongs to the Special Issue Migrant Health)
Open AccessArticle Perceived Discrimination and Health among Immigrants in Europe According to National Integration Policies
Int. J. Environ. Res. Public Health 2015, 12(9), 10687-10699; doi:10.3390/ijerph120910687
Received: 22 July 2015 / Revised: 19 August 2015 / Accepted: 25 August 2015 / Published: 31 August 2015
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Abstract
Background: Discrimination harms immigrants’ health. The objective of this study was to analyze the association between perceived discrimination and health outcomes among first and second generation immigrants from low-income countries living in Europe, while accounting for sex and the national policy on
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Background: Discrimination harms immigrants’ health. The objective of this study was to analyze the association between perceived discrimination and health outcomes among first and second generation immigrants from low-income countries living in Europe, while accounting for sex and the national policy on immigration. Methods: Cross-sectional study including immigrants from low-income countries aged ≥15 years in 18 European countries (European Social Survey, 2012) (sample of 1271 men and 1335 women). The dependent variables were self-reported health, symptoms of depression, and limitation of activity. The independent variables were perceived group discrimination, immigrant background and national immigrant integration policy. We tested for association between perceived group discrimination and health outcomes by fitting robust Poisson regression models. Results: We only observed significant associations between perceived group discrimination and health outcomes in first generation immigrants. For example, depression was associated with discrimination among both men and women (Prevalence Ratio-, 1.55 (95% CI: 1.16–2.07) and 1.47 (95% CI: 1.15–1.89) in the multivariate model, respectively), and mainly in countries with assimilationist immigrant integration policies. Conclusion: Perceived group discrimination is associated with poor health outcomes in first generation immigrants from low-income countries who live in European countries, but not among their descendants. These associations are more important in assimilationist countries. Full article
(This article belongs to the Special Issue Migrant Health)
Open AccessArticle Depression, Help-Seeking and Self-Recognition of Depression among Dominican, Ecuadorian and Colombian Immigrant Primary Care Patients in the Northeastern United States
Int. J. Environ. Res. Public Health 2015, 12(9), 10450-10474; doi:10.3390/ijerph120910450
Received: 18 June 2015 / Revised: 7 August 2015 / Accepted: 19 August 2015 / Published: 27 August 2015
Cited by 1 | PDF Full-text (731 KB) | HTML Full-text | XML Full-text
Abstract
Latinos, the largest minority group in the United States, experience mental health disparities, which include decreased access to care, lower quality of care and diminished treatment engagement. The purpose of this cross-sectional study of 177 Latino immigrants in primary care is to identify
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Latinos, the largest minority group in the United States, experience mental health disparities, which include decreased access to care, lower quality of care and diminished treatment engagement. The purpose of this cross-sectional study of 177 Latino immigrants in primary care is to identify demographic factors, attitudes and beliefs, such as stigma, perceived stress, and ethnic identity that are associated with depression, help-seeking and self-recognition of depression. Results indicated that 45 participants (25%) had depression by Patient Health Questionnaire (PHQ-9) criteria. Factors most likely to be associated with depression were: poverty; difficulty in functioning; greater somatic symptoms, perceived stress and stigma; number of chronic illnesses; and poor or fair self-rated mental health. Fifty-four people endorsed help-seeking. Factors associated with help-seeking were: female gender, difficulty in functioning, greater somatic symptoms, severity of depression, having someone else tell you that you have an emotional problem, and poor or fair self-rated mental health. Factors most likely to be associated with self-recognition were the same, but also included greater perceived stress. This manuscript contributes to the literature by examining attitudinal factors that may be associated with depression, help-seeking and self-recognition among subethnic groups of Latinos that are underrepresented in research studies. Full article
(This article belongs to the Special Issue Migrant Health)
Open AccessArticle Predictors for Using a HIV Self-Test Among Migrant and Seasonal Farmworkers in North Carolina
Int. J. Environ. Res. Public Health 2015, 12(7), 8348-8358; doi:10.3390/ijerph120708348
Received: 6 June 2015 / Revised: 11 July 2015 / Accepted: 15 July 2015 / Published: 17 July 2015
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Abstract
Background: Approximately, two million migrant and seasonal farmworkers (MSF) work in the United States annually. Several factors, such as lack of access to healthcare services and health behaviors, contribute to risk of HIV transmission. Relatively few studies have explored MSF knowledge of HIV
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Background: Approximately, two million migrant and seasonal farmworkers (MSF) work in the United States annually. Several factors, such as lack of access to healthcare services and health behaviors, contribute to risk of HIV transmission. Relatively few studies have explored MSF knowledge of HIV transmission and testing options. Methods: A 12-question, self-administered survey of farmworkers (n = 178) from 19 migrant camps was conducted. The survey assessed knowledge of factors related to HIV transmission, testing, and intention to use a HIV home-test kit. Results: Participants with knowledge of treatment for HIV (p = 0.03) and that condom use protects against HIV (p = 0.04) were more willing to express intent to use a home test kit than those with less knowledge. Concern among farmworkers that HIV was a very or somewhat serious problem in their community was associated with expressing intent to use a home test kit (OR = 2.3, 95% CI = 0.92–5.5). Respondents with less knowledge were less likely to use a home test kit. Conclusions: MSF were concerned about HIV in their community and would be willing to use to a home test kit. This pilot study provides a basis for additional research related to HIV testing within the MSF community. Full article
(This article belongs to the Special Issue Migrant Health)
Open AccessArticle Migration, Acculturation and Environment: Determinants of Obesity among Iranian Migrants in Australia
Int. J. Environ. Res. Public Health 2015, 12(2), 1083-1098; doi:10.3390/ijerph120201083
Received: 18 June 2014 / Revised: 23 December 2014 / Accepted: 13 January 2015 / Published: 22 January 2015
Cited by 3 | PDF Full-text (755 KB) | HTML Full-text | XML Full-text
Abstract
While migration from low- to high-income countries is typically associated with weight gain, the obesity risks of migration from middle-income countries are less certain. In addition to changes in behaviours and cultural orientation upon migration, analyses of changes in environments are needed to
[...] Read more.
While migration from low- to high-income countries is typically associated with weight gain, the obesity risks of migration from middle-income countries are less certain. In addition to changes in behaviours and cultural orientation upon migration, analyses of changes in environments are needed to explain post-migration risks for obesity. The present study examines the interaction between obesity-related environmental factors and the pattern of migrant acculturation in a sample of 152 Iranian immigrants in Victoria, Australia. Weight measurements, demographics, physical activity levels and diet habits were also surveyed. The pattern of acculturation (relative integration, assimilation, separation or marginalization) was not related to body mass index, diet, or physical activity behaviours. Three relevant aspects of participants’ perception of the Australian environment (physically active environments, social pressure to be fit, unhealthy food environments) varied considerably by demographic characteristics, but only one (physically active environments) was related to a pattern of acculturation (assimilation). Overall, this research highlighted a number of key relationships between acculturation and obesity-related environments and behaviours for our study sample. Theoretical models on migration, culture and obesity need to include environmental factors. Full article
(This article belongs to the Special Issue Migrant Health)
Open AccessArticle Screening for Infectious Diseases among Newly Arrived Migrants in EU/EEA Countries—Varying Practices but Consensus on the Utility of Screening
Int. J. Environ. Res. Public Health 2014, 11(10), 11004-11014; doi:10.3390/ijerph111011004
Received: 2 September 2014 / Revised: 29 September 2014 / Accepted: 15 October 2014 / Published: 21 October 2014
Cited by 8 | PDF Full-text (363 KB) | HTML Full-text | XML Full-text
Abstract
Screening is one possible tool for monitoring infectious diseases among migrants. However, there is limited information on screening programmes targeted for newly arrived migrants in EU/EEA countries. Our aim was to investigate the implementation, practices and usefulness of these programmes. We conducted a
[...] Read more.
Screening is one possible tool for monitoring infectious diseases among migrants. However, there is limited information on screening programmes targeted for newly arrived migrants in EU/EEA countries. Our aim was to investigate the implementation, practices and usefulness of these programmes. We conducted a survey among country experts from EU/EEA countries and Switzerland, asking whether their countries had implemented screening programmes. We also estimated the association between the implementation of these programmes and the rate of asylum-seekers in the population. Of the countries, 16 (59%) had implemented screening programmes and 15 (56%) had national guidelines. The rate of asylum-seekers was associated with implementation of screening programmes (p = 0.014). Screening was performed most often for tuberculosis; most commonly on holding level, and was targeted to specific migrant groups in over half of the countries performing screening. Twenty-five of all the country experts (96%) considered screening among migrants useful, and 24 (92%) would welcome EU level guidelines for screening. The implementation of screening programmes varied, and the practices were different among countries. Our survey suggests, that establishing EU level guidelines for screening would be useful, although they would have to take into account differences between individual countries. Full article
(This article belongs to the Special Issue Migrant Health)
Open AccessArticle Lifestyle Course as an Investment in Perceived Improved Health among Newly Arrived Women from Countries outside Europe
Int. J. Environ. Res. Public Health 2014, 11(10), 10622-10640; doi:10.3390/ijerph111010622
Received: 15 July 2014 / Revised: 23 September 2014 / Accepted: 10 October 2014 / Published: 15 October 2014
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Abstract
Family reunification was the most common reason (34%) for resettlement in Sweden in 2013. About one-fifth of the population is foreign-born. This study used mixed methods to evaluate a culturally tailored clinical health-promotion intervention. The intervention was conducted by licensed clinicians and a
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Family reunification was the most common reason (34%) for resettlement in Sweden in 2013. About one-fifth of the population is foreign-born. This study used mixed methods to evaluate a culturally tailored clinical health-promotion intervention. The intervention was conducted by licensed clinicians and a local coordinator. Sessions were five-weeks long, two hours a week. The quantitative data cover results from 54 participants, mainly Arabic and Somali-speaking, who participated in 10 groups. The participants’ perceived health improved significantly over the three measures. They also shared that their health significantly improved according to moderate effect size. The qualitative data, analyzed using revised content analysis, reflected one general theme: “the intervention is an investment in perceived improved health”, and four categories: “perceived increased health literacy”, “strength, empowerment and security”, “finding a new lifestyle”, and “the key to entry into Swedish society is language”. An intervention focusing on the prevention of ill-health, on health as a human right, and on empowerment, and aimed at female newcomers, has practical implications. Full article
(This article belongs to the Special Issue Migrant Health)
Open AccessArticle Changes in Access to Health Services of the Immigrant and Native-Born Population in Spain in the Context of Economic Crisis
Int. J. Environ. Res. Public Health 2014, 11(10), 10182-10201; doi:10.3390/ijerph111010182
Received: 13 August 2014 / Revised: 17 September 2014 / Accepted: 18 September 2014 / Published: 30 September 2014
Cited by 7 | PDF Full-text (686 KB) | HTML Full-text | XML Full-text
Abstract
Aim: To analyze changes in access to health care and its determinants in the immigrant and native-born populations in Spain, before and during the economic crisis. Methods: Comparative analysis of two iterations of the Spanish National Health Survey (2006 and 2012). Outcome variables
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Aim: To analyze changes in access to health care and its determinants in the immigrant and native-born populations in Spain, before and during the economic crisis. Methods: Comparative analysis of two iterations of the Spanish National Health Survey (2006 and 2012). Outcome variables were: unmet need and use of different healthcare levels; explanatory variables: need, predisposing and enabling factors. Multivariate models were performed (1) to compare outcome variables in each group between years, (2) to compare outcome variables between both groups within each year, and (3) to determine the factors associated with health service use for each group and year. Results: unmet healthcare needs decreased in 2012 compared to 2006; the use of health services remained constant, with some changes worth highlighting, such as the decline in general practitioner visits among autochthons and a narrowed gap in specialist visits between the two populations. The factors associated with health service use in 2006 remained constant in 2012. Conclusion: Access to healthcare did not worsen, possibly due to the fact that, until 2012, the national health system may have cushioned the deterioration of social determinants as a consequence of the financial crisis. Further studies are necessary to evaluate the effects of health policy responses to the crisis after 2012. Full article
(This article belongs to the Special Issue Migrant Health)
Open AccessCommunication Can Migration Health Assessments Become a Mechanism for Global Public Health Good?
Int. J. Environ. Res. Public Health 2014, 11(10), 9954-9963; doi:10.3390/ijerph111009954
Received: 1 July 2014 / Revised: 9 September 2014 / Accepted: 18 September 2014 / Published: 26 September 2014
Cited by 8 | PDF Full-text (498 KB) | HTML Full-text | XML Full-text
Abstract
Migrant health assessments (HAs) consist of a medical examination to assess a migrant’s health status and to provide medical clearance for work or residency based on conditions defined by the destination country and/or employer. We argue that better linkages between health systems and
[...] Read more.
Migrant health assessments (HAs) consist of a medical examination to assess a migrant’s health status and to provide medical clearance for work or residency based on conditions defined by the destination country and/or employer. We argue that better linkages between health systems and migrant HA processors at the country level are needed to shift these from being limited as an instrument of determining non-admissibility for purposes of visa issuance, to a process that may enhance public health. The importance of providing appropriate care and follow-up of migrants who “fail” their HA and the need for global efforts to enable data-collection and research on HAs are also highlighted. Full article
(This article belongs to the Special Issue Migrant Health)
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Open AccessArticle Benefit and Adherence of the Disease Management Program “Diabetes 2”: A Comparison of Turkish Immigrants and German Natives with Diabetes
Int. J. Environ. Res. Public Health 2014, 11(9), 9723-9738; doi:10.3390/ijerph110909723
Received: 30 June 2014 / Revised: 22 August 2014 / Accepted: 4 September 2014 / Published: 17 September 2014
PDF Full-text (412 KB) | HTML Full-text | XML Full-text
Abstract
There is an ongoing debate about equity and equality in health care, and whether immigrants benefit equally from services as the non-immigrant population. The study focuses on benefits from and adherence to the diabetes mellitus type 2 (DM 2) disease management program (DMP)
[...] Read more.
There is an ongoing debate about equity and equality in health care, and whether immigrants benefit equally from services as the non-immigrant population. The study focuses on benefits from and adherence to the diabetes mellitus type 2 (DM 2) disease management program (DMP) among Turkish immigrants in Germany. So far, it has not been researched whether this group benefits from enrollment in the DMP as well as diabetics from the non-immigrant population. Data on the non-immigrant sample (N = 702) stem from a survey among members of a German health insurance, the Turkish immigrant sample (N = 102) was recruited in the area of Hamburg. Identical questions in both surveys enable comparing major components. Regarding process quality, Turkish diabetics do not differ from the non-immigrant sample; moreover, they have significantly more often received documentation and diabetes training. In terms of outcome quality however, results display a greater benefit on behalf of the non-immigrant sample (e.g., blood parameters and body mass index), and they also met more of the DMP criteria. This underlines the need of diabetics with Turkish background for further education and information in order to become the empowered patient as is intended by the DMP as well as to prevent comorbidities. Full article
(This article belongs to the Special Issue Migrant Health)
Open AccessArticle Patient Experienced Continuity of Care in the Psychiatric Healthcare System—A Study Including Immigrants, Refugees and Ethnic Danes
Int. J. Environ. Res. Public Health 2014, 11(9), 9739-9759; doi:10.3390/ijerph110909739
Received: 25 April 2014 / Revised: 29 August 2014 / Accepted: 10 September 2014 / Published: 17 September 2014
PDF Full-text (517 KB) | HTML Full-text | XML Full-text
Abstract
Aim: The purpose of this study was to investigate continuity of care in the psychiatric healthcare system from the perspective of patients, including vulnerable groups such as immigrants and refugees. Method: The study is based on 19 narrative interviews conducted with 15
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Aim: The purpose of this study was to investigate continuity of care in the psychiatric healthcare system from the perspective of patients, including vulnerable groups such as immigrants and refugees. Method: The study is based on 19 narrative interviews conducted with 15 patients with diverse migration backgrounds (immigrants, descendents, refugees, and ethnic Danes). Patients were recruited from a community psychiatric centre situated in an area with a high proportion of immigrants and refugees. Data were analysed through the lens of a theoretical framework of continuity of care in psychiatry, developed in 2004 by Joyce et al., which encompasses four domains: accessibility, individualised care, relationship base and service delivery. Results: Investigating continuity of care, we found issues of specific concern to immigrants and refugees, but also commonalities across the groups. For accessibility, areas pertinent to immigrants and refugees include lack of knowledge concerning mental illness and obligations towards children. In terms of individualised care, trauma, additional vulnerability, and taboo concerning mental illness were of specific concern. In the domain of service delivery, social services included assistance with immigration papers for immigrants and refugees. In the relationship base domain, no differences were identified. Implications for priority area: The treatment courses of patients in the psychiatric field are complex and diverse and the patient perspective of continuity of care provides important insight into the delivery of care. The study highlights the importance of person-centred care irrespective of migration background though it may be beneficial to have an awareness of areas that may be of more specific concern to immigrants and refugees. Conclusions: The study sheds light on concerns specific to immigrants and refugees in a framework of continuity of care, but also commonalities across the patient groups. Full article
(This article belongs to the Special Issue Migrant Health)
Open AccessArticle Acculturation and Depressive Symptoms among Turkish Immigrants in Germany
Int. J. Environ. Res. Public Health 2014, 11(9), 9503-9521; doi:10.3390/ijerph110909503
Received: 24 June 2014 / Revised: 25 August 2014 / Accepted: 4 September 2014 / Published: 12 September 2014
Cited by 5 | PDF Full-text (546 KB) | HTML Full-text | XML Full-text
Abstract
The present study explores the impact of acculturation on depressive symptoms among Turkish immigrants in Germany, taking into account different dimensions of cultural orientation. A total of 471 patients from two selected samples (254 primary care patients and 217 outpatients of a psychosomatic
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The present study explores the impact of acculturation on depressive symptoms among Turkish immigrants in Germany, taking into account different dimensions of cultural orientation. A total of 471 patients from two selected samples (254 primary care patients and 217 outpatients of a psychosomatic department) participated. Levels of acculturation were measured as orientation towards culture of origin (CO), and orientation towards the host culture (HC). Acculturation strategies (integration, assimilation, separation, and marginalization) were also assessed as well as their association with depressive symptoms (BDI). Furthermore, gender- and migration-related differences in terms of acculturation and levels of depressive symptomatology were analyzed. Integration was the acculturation strategy associated with the lowest level of depressive symptoms (M = 14.6, SD = 11.9), while marginalization was associated with the highest (M = 23.5, SD = 14.7). Gender was not found to have a significant impact on acculturation but influenced depressive symptoms, with women (M = 21.8, SD = 13.3) reporting higher levels of depressive symptomatology than men (M = 15.1, SD = 14.0; p < 0.001). In first generation immigrants, significantly higher CO (M = 46.6, SD = 8.3; p < 0.001), lower HC (M = 31.0, SD = 9.6; p < 0.001), and higher levels of depressive symptoms (M = 20.2, SD = 14.1; p < 0.001) were found in comparison to second generation immigrants (CO: M = 41.3, SD = 7.4; HC: M = 36.2, SD = 8.8; depressive symptoms: M = 14.0, SD = 12.9). Our results suggest that orientation towards both the heritage and the host culture has a positive effect on the mental health status of immigrants. Future research needs to include representative samples of migrants from different cultures to further explore the association between acculturation and mental health. Full article
(This article belongs to the Special Issue Migrant Health)
Open AccessArticle Effectiveness of the Relaxation Response-Based Group Intervention for Treating Depressed Chinese American Immigrants: A Pilot Study
Int. J. Environ. Res. Public Health 2014, 11(9), 9186-9201; doi:10.3390/ijerph110909186
Received: 5 June 2014 / Revised: 15 August 2014 / Accepted: 1 September 2014 / Published: 5 September 2014
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Abstract
Background: This study examined the feasibility, safety and efficacy of an 8-week Relaxation Response (RR)-based group. Methods: Twenty-two depressed Chinese American immigrants were recruited. Outcomes measures were response and remission rates, the Hamilton Rating Scale for Depression, Clinical Global Impressions Scale,
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Background: This study examined the feasibility, safety and efficacy of an 8-week Relaxation Response (RR)-based group. Methods: Twenty-two depressed Chinese American immigrants were recruited. Outcomes measures were response and remission rates, the Hamilton Rating Scale for Depression, Clinical Global Impressions Scale, Quality of Life Enjoyment and Satisfaction Questionnaire, and the Multidimensional Scale of Perceived Social Support Scale. Results: Participants (N = 22) were 82% female, mean age was 53 (±12). After intervention, completers (N = 15) showed a 40% response rate and a 27% remission rate, and statistically significant improvement in most outcome measures. Discussion: The RR-based group is feasible and safe in treating Chinese American immigrants with depression. Full article
(This article belongs to the Special Issue Migrant Health)
Open AccessArticle Refugees Connecting with a New Country through Community Food Gardening
Int. J. Environ. Res. Public Health 2014, 11(9), 9202-9216; doi:10.3390/ijerph110909202
Received: 11 June 2014 / Revised: 15 August 2014 / Accepted: 22 August 2014 / Published: 5 September 2014
Cited by 5 | PDF Full-text (500 KB) | HTML Full-text | XML Full-text
Abstract
Refugees are a particularly vulnerable population who undergo nutrition transition as a result of forced migration. This paper explores how involvement in a community food garden supports African humanitarian migrant connectedness with their new country. A cross-sectional study of a purposive sample of
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Refugees are a particularly vulnerable population who undergo nutrition transition as a result of forced migration. This paper explores how involvement in a community food garden supports African humanitarian migrant connectedness with their new country. A cross-sectional study of a purposive sample of African refugees participating in a campus-based community food garden was conducted. Semi-structured interviews were undertaken with twelve African humanitarian migrants who tended established garden plots within the garden. Interview data were thematically analysed revealing three factors which participants identified as important benefits in relation to community garden participation: land tenure, reconnecting with agri-culture, and community belonging. Community food gardens offer a tangible means for African refugees, and other vulnerable or marginalised populations, to build community and community connections. This is significant given the increasing recognition of the importance of social connectedness for wellbeing. Full article
(This article belongs to the Special Issue Migrant Health)
Open AccessArticle Heat-Related Illness among Oregon Farmworkers
Int. J. Environ. Res. Public Health 2014, 11(9), 9273-9285; doi:10.3390/ijerph110909273
Received: 17 June 2014 / Revised: 15 August 2014 / Accepted: 22 August 2014 / Published: 5 September 2014
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Abstract
Farmworkers are particularly vulnerable to climate-sensitive health outcomes such as heat-related illness (HRI) given their tasks involve heavy exertion in an outdoor setting. The objectives of the study were to: (1) describe symptoms of HRI experienced by farmworkers and (2) explore factors associated
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Farmworkers are particularly vulnerable to climate-sensitive health outcomes such as heat-related illness (HRI) given their tasks involve heavy exertion in an outdoor setting. The objectives of the study were to: (1) describe symptoms of HRI experienced by farmworkers and (2) explore factors associated with heat knowledge, level of concern regarding HRI, and comfort level taking breaks at work. Bilingual research staff conducted personal interviews of 100 farmworkers during July and August 2013. Data collected included demographics, work history and current work practices, trainings received, HRI symptoms experienced, health status, and health behaviors. Nearly 30% of participants reported experiencing ≥2 HRI symptoms during the previous work. Few participants had high level of heat knowledge (21.0%) and 15.6% of participants reported being “very concerned” about the health effects of working in hot conditions. Participants who were paid by the piece were more likely to have a high heat knowledge score and be “very concerned” about HRI but less likely to be “very comfortable” taking a break compared to workers paid by the hour than those who had not received HRI training. Results suggest several areas in which employers and agencies conducting outreach and education to the workers about HRI can change their practices including providing cooling measures and HRI training about risk factors for HRI. Full article
(This article belongs to the Special Issue Migrant Health)
Open AccessArticle An Early Warning System Based on Syndromic Surveillance to Detect Potential Health Emergencies among Migrants: Results of a Two-Year Experience in Italy
Int. J. Environ. Res. Public Health 2014, 11(8), 8529-8541; doi:10.3390/ijerph110808529
Received: 26 June 2014 / Revised: 29 July 2014 / Accepted: 8 August 2014 / Published: 20 August 2014
Cited by 7 | PDF Full-text (308 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
Profound geopolitical changes have impacted the southern and eastern Mediterranean since 2010 and defined a context of instability that is still affecting several countries today. Insecurity combined with the reduction of border controls has led to major population movements in the region and
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Profound geopolitical changes have impacted the southern and eastern Mediterranean since 2010 and defined a context of instability that is still affecting several countries today. Insecurity combined with the reduction of border controls has led to major population movements in the region and to migration surges from affected countries to southern Europe, especially to Italy. To respond to the humanitarian emergency triggered by this migration surge, Italy implemented a syndromic surveillance system in order to rapidly detect potential public health emergencies in immigrant reception centres. This system was discontinued after two years. This paper presents the results of this experience detailing its strengths and weaknesses in order to document the applicability and usefulness of syndromic surveillance in this specific context. Full article
(This article belongs to the Special Issue Migrant Health)
Open AccessArticle HIV Risky Sexual Behaviors and HIV Infection Among Immigrants: A Cross-Sectional Study in Lisbon, Portugal
Int. J. Environ. Res. Public Health 2014, 11(8), 8552-8566; doi:10.3390/ijerph110808552
Received: 1 July 2014 / Revised: 23 July 2014 / Accepted: 12 August 2014 / Published: 20 August 2014
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Abstract
This study aimed to examine risky sexual behavior, its associated factors and HIV infection among immigrants. A participatory cross-sectional survey was conducted with 1187 immigrants at the National Immigrant Support Centre, in Lisbon (52.2% female; 34.0% Africans, 33.8% Brazilians, 32.2% Eastern Europeans). About
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This study aimed to examine risky sexual behavior, its associated factors and HIV infection among immigrants. A participatory cross-sectional survey was conducted with 1187 immigrants at the National Immigrant Support Centre, in Lisbon (52.2% female; 34.0% Africans, 33.8% Brazilians, 32.2% Eastern Europeans). About 38% of participants reported ≥2 sexual partners in the previous year, 16.2% both regular and occasional sexual partners (last 12 months), 33.1% inconsistent condom use with occasional partners, and 64% no condom use in the last sexual intercourse. Unprotected sex in the last sexual intercourse was more likely among women, Africans, those older, with elementary education, those married and those who didn’t receive free condoms in the previous year. No condom use was less likely among those having only occasional sexual partners and both regular and occasional sexual partners. One third of participants had never been tested for HIV. Those never tested reported more frequently inconsistent condom use than those ever tested. Overall, 2.0% reported being HIV positive (2.5% of men; 4.4% of Africans); 4.3% admitted having a STI in previous year. HIV-positive immigrants reported high-risk sexual behaviors. Tailored interventions to promote awareness of HIV serostatus among immigrants as well as culturally adapted risk reduction strategies should be strengthened. Full article
(This article belongs to the Special Issue Migrant Health)
Open AccessArticle Cancer Screening among Immigrants Living in Urban and Regional Australia: Results from the 45 and Up Study
Int. J. Environ. Res. Public Health 2014, 11(8), 8251-8266; doi:10.3390/ijerph110808251
Received: 24 June 2014 / Revised: 30 July 2014 / Accepted: 6 August 2014 / Published: 14 August 2014
Cited by 2 | PDF Full-text (356 KB) | HTML Full-text | XML Full-text
Abstract
Over 25% of the Australian population are immigrants, and are less active participants in cancer screening programmes. Most immigrants live in urban areas of Australia, but a significant proportion (~20%), live in regional areas. This study explored differences in cancer screening participation by
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Over 25% of the Australian population are immigrants, and are less active participants in cancer screening programmes. Most immigrants live in urban areas of Australia, but a significant proportion (~20%), live in regional areas. This study explored differences in cancer screening participation by place of birth and residence. Self-reported use of mammogram, faecal occult blood test (FOBT), and/or prostate specific antigen (PSA) tests was obtained from 48,642 immigrants and 141,275 Australian-born participants aged 50 years or older in the 45 and Up Study (New South Wales, Australia 2006–2010). Poisson regression was used to estimate relative risks of test use, adjusting for key socio-demographic characteristics. Overall, immigrants from Asia and Europe were less likely to have had any of the tests in the previous two years than Australian-born participants. Regional Australian-born participants were more likely to have had any of the tests than those living in urban areas. Regional immigrant participants were more likely to have had an FOBT or PSA test than those living in urban areas, but there were no differences in mammograms. This report identifies key immigrant groups in urban and regional areas that policymakers and healthcare providers should target with culturally appropriate information to promote cancer screening. Full article
(This article belongs to the Special Issue Migrant Health)
Open AccessArticle Immigrants’ Access to Health Insurance: No Equality without Awareness
Int. J. Environ. Res. Public Health 2014, 11(7), 7144-7153; doi:10.3390/ijerph110707144
Received: 29 April 2014 / Revised: 10 June 2014 / Accepted: 25 June 2014 / Published: 14 July 2014
PDF Full-text (206 KB) | HTML Full-text | XML Full-text
Abstract
The Czech government has identified commercial health insurance as one of the major problems for migrants’ access to health care. Non-EU immigrants are eligible for public health insurance only if they have employee status or permanent residency. The present study examined migrants’ access
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The Czech government has identified commercial health insurance as one of the major problems for migrants’ access to health care. Non-EU immigrants are eligible for public health insurance only if they have employee status or permanent residency. The present study examined migrants’ access to the public health insurance system in Czechia. A cross-sectional survey of 909 immigrants from Ukraine and Vietnam was conducted in March and May 2013, and binary logistic regression was applied in data analysis. Among immigrants entitled to Czech public health insurance due to permanent residency/asylum, 30% were out of the public health insurance system, and of those entitled by their employment status, 50% were out of the system. Migrants with a poor knowledge of the Czech language are more likely to remain excluded from the system of public health insurance. Instead, they either remain in the commercial health insurance system or they simultaneously pay for both commercial and public health insurance, which is highly disadvantageous. Since there are no reasonable grounds to stay outside the public health insurance, it is concluded that it is lack of awareness that keeps eligible immigrants from entering the system. It is suggested that no equal access to health care exists without sufficient awareness about health care system. Full article
(This article belongs to the Special Issue Migrant Health)
Open AccessArticle Socio-Demographic and Dietary Factors Associated with Excess Body Weight and Abdominal Obesity among Resettled Bhutanese Refugee Women in Northeast Ohio, United States
Int. J. Environ. Res. Public Health 2014, 11(7), 6639-6652; doi:10.3390/ijerph110706639
Received: 6 April 2014 / Revised: 12 June 2014 / Accepted: 18 June 2014 / Published: 25 June 2014
Cited by 3 | PDF Full-text (220 KB) | HTML Full-text | XML Full-text
Abstract
Studies of obesity and related health conditions among the Bhutanese, one of the largest refugee groups resettled in the United States in the past five years, are limited. This study examined the factors associated with excess body weight (body mass index ≥ 23
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Studies of obesity and related health conditions among the Bhutanese, one of the largest refugee groups resettled in the United States in the past five years, are limited. This study examined the factors associated with excess body weight (body mass index ≥ 23 kg/m2) and abdominal obesity (waist circumference > 80 cm) in a community-based sample of 18–65 year old Bhutanese refugee women in Northeast Ohio. A Nepali-language questionnaire was used to measure socio-demographic and dietary factors. Height, weight, and waist circumference were measured to define excess body weight and abdominal obesity. The mean (±standard deviation) age of the 108 participants was 36.5 (±12.2) years and length of time in the U.S. was 19.4 (±11.9) months. Overall, 64.8% and 69.4% of the women had excess body weight and abdominal obesity, respectively. Age was significantly associated with both excess body weight (odds ratio: 1.10; 95% confidence interval: 1.05–1.16) and abdominal obesity (1.09; 1.04–1.14). Consuming meat (4.01; 1.14–14.60) was significantly associated with excess body weight but not abdominal obesity. These findings suggest the need for lifestyle and dietary change education programs among this new and vulnerable group to reduce the prevalence of excess body weight and abdominal obesity and their health consequences. Full article
(This article belongs to the Special Issue Migrant Health)
Open AccessArticle Association Between Health-Related Quality of Life and Being an Immigrant Among Adolescents, and the Role of Socioeconomic and Health-Related Difficulties
Int. J. Environ. Res. Public Health 2014, 11(2), 1694-1714; doi:10.3390/ijerph110201694
Received: 28 November 2013 / Revised: 20 January 2014 / Accepted: 22 January 2014 / Published: 30 January 2014
Cited by 3 | PDF Full-text (405 KB) | HTML Full-text | XML Full-text
Abstract
To develop satisfactorily, adolescents require good health-related quality of life (QOL, including physical health, psychological health, social relationships and living environment). However, for poorly understood reasons, it is often lacking, especially among immigrants with lower family and socioeconomic resources. This study assessed health-related
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To develop satisfactorily, adolescents require good health-related quality of life (QOL, including physical health, psychological health, social relationships and living environment). However, for poorly understood reasons, it is often lacking, especially among immigrants with lower family and socioeconomic resources. This study assessed health-related QOL of European and non-European immigrant adolescents and the contributions of socioeconomic difficulties, unhealthy behaviors, and violence. It included 1,559 middle-school adolescents from north-eastern France (mean age 13.5, SD 1.3; 1,451 French adolescents, 54 European immigrants and 54 non-European immigrants), who completed a self-administered questionnaire including sex, age, socioeconomic characteristics (family structure, parents’ education, occupation, and income), unhealthy behaviors (uses of tobacco/alcohol/cannabis/hard drugs, obesity, and involvement in violence), having sustained violence, sexual abuse, and the four QOL domains measured with the World Health Organization’s WHOQOL-BREF (poor: score < 25PthP percentile). Data were analyzed using logistic regression models. Poor physical health, psychological health, social relationships, and living environment affected more European immigrants (26% to 35%) and non-European immigrants (43% to 54%) than French adolescents (21% to 26%). European immigrants had a higher risk of poor physical health and living environment (gender-age-adjusted odds ratio 2.00 and 1.88, respectively) while non-European immigrants had a higher risk for all poor physical health, psychological health, social relationships, and living environment (3.41, 2.07, 3.25, and 3.79, respectively). Between 20% and 58% of these risks were explained by socioeconomic difficulties, parts of which overlapped with unhealthy behaviors and violence. The associations between the two sets of covariates greatly differed among French adolescents and immigrants. Poor QOL was more common among European and non-European immigrants due to socioeconomic difficulties and associated unhealthy behaviors and violence. The different risk patterns observed between French adolescents and immigrants may help prevention. Full article
(This article belongs to the Special Issue Migrant Health)

Review

Jump to: Research

Open AccessReview Immigrant Mental Health, A Public Health Issue: Looking Back and Moving Forward
Int. J. Environ. Res. Public Health 2015, 12(10), 13624-13648; doi:10.3390/ijerph121013624
Received: 22 July 2015 / Revised: 24 September 2015 / Accepted: 20 October 2015 / Published: 27 October 2015
Cited by 1 | PDF Full-text (259 KB) | HTML Full-text | XML Full-text
Abstract
The Mental Health Commission of Canada’s (MHCC) strategy calls for promoting the health and wellbeing of all Canadians and to improve mental health outcomes. Each year, one in every five Canadians experiences one or more mental health problems, creating a significant cost to
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The Mental Health Commission of Canada’s (MHCC) strategy calls for promoting the health and wellbeing of all Canadians and to improve mental health outcomes. Each year, one in every five Canadians experiences one or more mental health problems, creating a significant cost to the health system. Mental health is pivotal to holistic health and wellbeing. This paper presents the key findings of a comprehensive literature review of Canadian research on the relationship between settlement experiences and the mental health and well-being of immigrants and refugees. A scoping review was conducted following a framework provided by Arskey and O’Malley (Int J Soc Res Methodol 8:19–32, 2005). Over two decades of relevant literature on immigrants’ health in Canada was searched. These included English language peer-reviewed publications from relevant online databases Medline, Embase, PsycInfo, Healthstar, ERIC and CINAHL between 1990 and 2015. The findings revealed three important ways in which settlement affects the mental health of immigrants and refugees: through acculturation related stressors, economic uncertainty and ethnic discrimination. The recommendations for public health practice and policy are discussed. Full article
(This article belongs to the Special Issue Migrant Health)
Open AccessReview The Longer You Stay, the Worse Your Health? A Critical Review of the Negative Acculturation Theory among Asian Immigrants
Int. J. Environ. Res. Public Health 2014, 11(8), 8038-8057; doi:10.3390/ijerph110808038
Received: 24 April 2014 / Revised: 18 June 2014 / Accepted: 23 July 2014 / Published: 8 August 2014
Cited by 6 | PDF Full-text (659 KB) | HTML Full-text | XML Full-text
Abstract
Researchers have become increasingly interested in the health patterns of immigrants with longer residence in the United States, as this reveals the health consequences of integration processes. The negative acculturation effect has been the dominant interpretation of duration patterns, despite empirical and theoretical
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Researchers have become increasingly interested in the health patterns of immigrants with longer residence in the United States, as this reveals the health consequences of integration processes. The negative acculturation effect has been the dominant interpretation of duration patterns, despite empirical and theoretical uncertainties about this assumption. This theory assumes that immigrant health declines with longer residence in the United States because of poorer health behaviors and health risks that reflect Americanized lifestyles. This paper reviews the empirical support for the negative acculturation theory among Asian immigrants to determine if and when it is an appropriate interpretation for duration patterns. I conclude that empirical inconsistencies and methodological issues limit the negative acculturation theory as the primary interpretation for duration patterns. First, there is no consistent evidence that health behaviors decline with time. There is also substantial group heterogeneity in duration patterns as well as heterogeneity across health outcomes. The literature has not adequately addressed methodological shortcomings, such as confounding by cohort effects or non-linear duration patterns. Length of residence in the United States is still an important aspect of Asian immigrant health, but the mechanisms of this relationship are still understudied. I propose alternative frameworks between duration and health that consider environmental influences and end with future research directions to explore research gaps. Full article
(This article belongs to the Special Issue Migrant Health)

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