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Special Issue "Migrant Health 2012"

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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 2012)

Special Issue Editor

Guest Editor
Prof. Dr. Sian Meryl Griffiths (Website)

Professor of Public Health, School of Public Health and Primary Care, The Chinese University of Hong Kong
Interests: health policy; equity and health: migration as a focus; community based health systems; health in student populations

Special Issue Information

Dear Colleagues,

Migration is a significant global challenge for public health in the 21st century. The International Organization on Migration (IOM) estimates that one in thirty-five people in the world are migrants. Reasons for migration are multifarious, involving any kind of movement of populations, with direct implications for the health of migrants and health systems alike. Internal migration such as rural-to-urban migration, cross border migration in increasingly transnational societies, and international migration in an age of a global economy are all distinct areas for public health research.

As a global health issue, at the root of migration is social, political and economic development. This is seen in migrant communities throughout the world, from factory cities in mainland China to new Latino immigrant communities in the United States. From a global perspective migration not only affects how individuals access health services but has implications on a wider scale: health security, infectious disease, health equity, health policy and law, provision of primary care, and the environment. Intergenerational research of migrants ensure that migrant health is long-term and interdisciplinary topic.

This special issue uses different global perspectives to shed light on major challenges of immigrant health and solutions in developing and developed countries alike. Implications for health systems and policy and a wider lens of the global economy will be examined and shared.

Professor Sian M. Griffiths
Guest Editor

Published Papers (12 papers)

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Research

Open AccessArticle Perinatal Outcomes of Uninsured Immigrant, Refugee and Migrant Mothers and Newborns Living in Toronto, Canada
Int. J. Environ. Res. Public Health 2013, 10(6), 2198-2213; doi:10.3390/ijerph10062198
Received: 23 April 2013 / Revised: 22 May 2013 / Accepted: 24 May 2013 / Published: 31 May 2013
Cited by 7 | PDF Full-text (423 KB) | HTML Full-text | XML Full-text
Abstract
Canadian healthcare insurance is not universal for all newcomer populations. New immigrant, refugee claimant, and migrant women face various barriers to healthcare due to the lack of public health insurance coverage. This retrospective study explored the relationships between insurance status and various [...] Read more.
Canadian healthcare insurance is not universal for all newcomer populations. New immigrant, refugee claimant, and migrant women face various barriers to healthcare due to the lack of public health insurance coverage. This retrospective study explored the relationships between insurance status and various perinatal outcomes. Researchers examined and compared perinatal outcomes for 453 uninsured and provincially insured women who delivered at two general hospitals in the Greater Toronto Area between 2007 and 2010. Data on key perinatal health indicators were collected via chart review of hospital medical records. Comparisons were made with regional statistics and professional guidelines where available. Four-in-five uninsured pregnant women received less-than-adequate prenatal care. More than half of them received clearly inadequate prenatal care, and 6.5% received no prenatal care at all. Insurance status was also related to the type of health care provider, reason for caesarean section, neonatal resuscitation rates, and maternal length of hospital stay. Uninsured mothers experienced a higher percentage of caesarian sections due to abnormal fetal heart rates and required more neonatal resuscitations. No significant difference was found for low birth weight, preterm birth, NCIU admissions, postpartum hemorrhage, breast feeding, or intrapartum care provided. Full article
(This article belongs to the Special Issue Migrant Health 2012)
Open AccessArticle The Hispanic Paradox and Older Adults’ Disabilities: Is There a Healthy Migrant Effect?
Int. J. Environ. Res. Public Health 2013, 10(5), 1786-1814; doi:10.3390/ijerph10051786
Received: 15 February 2013 / Accepted: 15 April 2013 / Published: 3 May 2013
Cited by 12 | PDF Full-text (374 KB) | HTML Full-text | XML Full-text
Abstract
The “Hispanic Paradox” suggests that despite rates of poverty similar to African Americans, Hispanics have far better health and mortality outcomes, more comparable to non-Hispanic White Americans. Three prominent possible explanations for the Hispanic Paradox have emerged. The “Healthy Migrant Effect” suggests [...] Read more.
The “Hispanic Paradox” suggests that despite rates of poverty similar to African Americans, Hispanics have far better health and mortality outcomes, more comparable to non-Hispanic White Americans. Three prominent possible explanations for the Hispanic Paradox have emerged. The “Healthy Migrant Effect” suggests a health selection effect due to the demands of migration. The Hispanic lifestyle hypothesis focuses on Hispanics’ strong social ties and better health behaviors. The reverse migration argument suggests that the morbidity profile in the USA is affected when many Hispanic immigrants return to their native countries after developing a serious illness. We analyzed data from respondents aged 55 and over from the nationally representative 2006 American Community Survey including Mexican Americans (13,167 U.S. born; 11,378 immigrants), Cuban Americans (314 U.S. born; 3,730 immigrants), and non-Hispanic White Americans (629,341 U.S. born; 31,164 immigrants). The healthy migrant effect was supported with SES-adjusted disability comparable between Mexican, Cuban and non-Hispanic Whites born in the USA and all immigrants having lower adjusted odds of functional limitations than U.S. born non-Hispanic Whites. The reverse migration hypothesis was partially supported, with citizenship and longer duration in the USA associated with higher rates of SES-adjusted disability for Mexican Americans. The Hispanic healthy life-style explanation had little support in this study. Our findings underline the importance of considering nativity when planning for health interventions to address the needs of the growing Hispanic American older adult population. Full article
(This article belongs to the Special Issue Migrant Health 2012)
Open AccessArticle Social Service Utilization, Sense of Community, Family Functioning and the Mental Health of New Immigrant Women in Hong Kong
Int. J. Environ. Res. Public Health 2013, 10(5), 1735-1746; doi:10.3390/ijerph10051735
Received: 5 March 2013 / Revised: 13 April 2013 / Accepted: 19 April 2013 / Published: 29 April 2013
Cited by 2 | PDF Full-text (182 KB) | HTML Full-text | XML Full-text
Abstract
Drawing upon a sample of 296 new immigrant women in Hong Kong, this study investigated how social service utilization, family functioning, and sense of community influenced the depressive symptoms of new immigrant women. Results of the structural equation modeling suggested that family [...] Read more.
Drawing upon a sample of 296 new immigrant women in Hong Kong, this study investigated how social service utilization, family functioning, and sense of community influenced the depressive symptoms of new immigrant women. Results of the structural equation modeling suggested that family functioning and sense of community were both significantly and negatively associated with the depression of new immigrant women. Utilization of community services also influenced the depression of immigrant women indirectly through the mediating effect of sense of community. Implications of the research findings for mental health intervention were discussed. Full article
(This article belongs to the Special Issue Migrant Health 2012)
Open AccessArticle A First Approach to Differences in Continuity of Care Perceived by Immigrants and Natives in the Catalan Public Healthcare System
Int. J. Environ. Res. Public Health 2013, 10(4), 1474-1488; doi:10.3390/ijerph10041474
Received: 15 February 2013 / Revised: 11 March 2013 / Accepted: 27 March 2013 / Published: 9 April 2013
Cited by 3 | PDF Full-text (239 KB) | HTML Full-text | XML Full-text
Abstract
Objective: To compare immigrants’ and natives’ perceptions of relational, managerial and informational continuity of care and to explore the influence of the length of stay on immigrants’ perceptions of continuity. Methods: Cross-sectional study based on a survey of a random [...] Read more.
Objective: To compare immigrants’ and natives’ perceptions of relational, managerial and informational continuity of care and to explore the influence of the length of stay on immigrants’ perceptions of continuity. Methods: Cross-sectional study based on a survey of a random sample of 1,500 patients, of which 22% (331) were immigrants. The study area was made up by three healthcare areas of the Catalan healthcare system. To collect data, the CCAENA questionnaire was applied. Multivariate logistic regression models were conducted. Results: Like natives, immigrants perceive high levels of managerial continuity (88.5%) and relational continuity with primary and secondary care physicians (86.7 and 81.8%), and lower levels of informational continuity (59.1%). There were no statistically significant differences in managerial and informational continuity between immigrants and natives. However, immigrants perceive a worse relational continuity with primary care physicians in terms of trust, communication and clinical responsibility. Conversely, immigrants perceive higher relational continuity with secondary care physicians in terms of effective communication and clinical responsibility. Discussion: Similar managerial and informational continuity perceptions seem to point towards a similar treatment of patients, regardless of their immigrant status. However, differences in relational continuity highlight the need for improvements in professionals’ skills in treating immigrants’ patients. Full article
(This article belongs to the Special Issue Migrant Health 2012)
Open AccessArticle Men’s Migration, Women’s Personal Networks, and Responses to HIV/AIDS in Mozambique
Int. J. Environ. Res. Public Health 2013, 10(3), 892-912; doi:10.3390/ijerph10030892
Received: 24 December 2012 / Revised: 19 February 2013 / Accepted: 25 February 2013 / Published: 6 March 2013
PDF Full-text (403 KB) | HTML Full-text | XML Full-text
Abstract
This study brings together the literature on social network approaches to social capital and health and on migration and HIV risks to examine how non-migrating wives of labor migrants use their personal networks to cope with perceived risks of HIV infection in [...] Read more.
This study brings together the literature on social network approaches to social capital and health and on migration and HIV risks to examine how non-migrating wives of labor migrants use their personal networks to cope with perceived risks of HIV infection in rural southern Mozambique. Using data from a 2006 survey of 1,680 women and their dyadic interactions, we compare the composition of personal networks, HIV/AIDS communication, and preventive behavior of women married to migrants and those married to non-migrants. Results show that migrants’ wives were more likely than non-migrants’ wives to have other migrants’ wives as personal network members, to engage in HIV/AIDS communication, and to discuss HIV prevention. However, they were no more likely to talk about HIV/AIDS with migrants’ wives than with non-migrants’ wives. They were also no more likely to talk about AIDS and its prevention than non-migrants’ wives who express worry about HIV infection from their spouses. Finally, we detect that network members’ prevention behavior was similar to respondents’, although this did not depend on migration. We contextualize these findings within the literature and discuss their policy implications. Full article
(This article belongs to the Special Issue Migrant Health 2012)
Figures

Open AccessArticle Visibility and Social Recognition as Psychosocial Work Environment Factors among Cleaners in a Multi-Ethnic Workplace Intervention
Int. J. Environ. Res. Public Health 2013, 10(1), 85-106; doi:10.3390/ijerph10010085
Received: 19 July 2012 / Revised: 5 December 2012 / Accepted: 19 December 2012 / Published: 24 December 2012
Cited by 2 | PDF Full-text (390 KB) | HTML Full-text | XML Full-text
Abstract
This article focuses on the psychosocial work environment of immigrant cleaners at a Danish workplace. Today, many cleaners working in Danish cleaning jobs are women from the established immigrant communities, but also labour migrants from the newer EU member states have found [...] Read more.
This article focuses on the psychosocial work environment of immigrant cleaners at a Danish workplace. Today, many cleaners working in Danish cleaning jobs are women from the established immigrant communities, but also labour migrants from the newer EU member states have found their way to the cleaning industry. Studies have drawn attention to immigrants’ low position in the cleaning industry and their increased risk of work injuries. This article is based on a case study of an intervention called “Make a Difference” designed to improve the work environment among cleaners at a multi-ethnic workplace. We used semi-structured interviews, photo logs, observation and participation to investigate how the cleaners experienced their work environment. The cleaners reported an overload of heavy work, related to the concept of a classroom’s “readiness for cleaning”, and they expressed strained social relations and communication in addition to a lack of social recognition and invisibility at the workplace, a school. We analysed these psychosocial work environmental problems by investigating the different forms of social relationships and communication within the group of cleaners, and between the cleaners and the teachers and pupils at the school. Moreover, we discussed why the intervention, based on training of language and cleaning skills and social interaction, only partially improved the cleaners’ psychosocial work environment problems. In this article, we argue that social divisions based on ethnicity between the new and the established group of cleaners, combined with their marginal position and poor work organisation at the school, reinforced the cleaners’ experiences of psychosocial work environment problems. This article suggests that increased effort towards social inclusion at work and improved work organisation, especially for the new labour migrants from newer EU-countries, should be considered. Full article
(This article belongs to the Special Issue Migrant Health 2012)
Figures

Open AccessArticle Occupational Health and Safety Experiences among Self-Identified Immigrant Workers Living or Working in Somerville, MA by Ethnicity, Years in the US, and English Proficiency
Int. J. Environ. Res. Public Health 2012, 9(12), 4452-4469; doi:10.3390/ijerph9124452
Received: 4 September 2012 / Revised: 13 November 2012 / Accepted: 23 November 2012 / Published: 6 December 2012
Cited by 4 | PDF Full-text (216 KB) | HTML Full-text | XML Full-text
Abstract
In this community based research initiative, we employed a survey instrument predominately developed and administered by Teen Educators to assess occupational health risks for Haitian, Salvadoran, and Brazilian immigrants (n = 405) in Somerville, MA, USA. We demonstrate that a combined analysis [...] Read more.
In this community based research initiative, we employed a survey instrument predominately developed and administered by Teen Educators to assess occupational health risks for Haitian, Salvadoran, and Brazilian immigrants (n = 405) in Somerville, MA, USA. We demonstrate that a combined analysis of ethnicity, years in the US, and English proficiency better characterized the occupational experience of immigrant workers than considering these variables individually. While years in the US (negatively) and English proficiency (positively) explained the occurrence of health risks, the country of origin identified the most vulnerable populations in the community. Brazilians, Salvadorans, and other Hispanic, all of whom who have been in the US varying length of time, with varying proficiency in English language had twice the odds of reporting injuries due to work compared to other immigrants. Although this observation was not significant it indicates that years in the US and English proficiency alone do not predict health risks among this population. We recommend the initiation of larger studies employing c community based participatory research methods to confirm these differences and to further explore work and health issues of immigrant populations. This study is one of the small number of research efforts to utilize a contemporaneous assessment of occupational health problems in three distinct immigrant populations at the community level within a specific Environmental Justice context and social milieu. Full article
(This article belongs to the Special Issue Migrant Health 2012)
Open AccessArticle Comparing Sociodemographic Factors Associated with Disability Between Immigrants and the Chilean-Born: Are There Different Stories to Tell?
Int. J. Environ. Res. Public Health 2012, 9(12), 4403-4432; doi:10.3390/ijerph9124403
Received: 29 August 2012 / Revised: 17 October 2012 / Accepted: 6 November 2012 / Published: 4 December 2012
Cited by 2 | PDF Full-text (327 KB) | HTML Full-text | XML Full-text
Abstract
This study explored a range of sociodemographic factors associated with disability among international immigrants in Chile, and compared them to the Chilean-born. Secondary data analysis of the Chilean population-based survey CASEN-2006 was conducted (268,873 participants). Main health outcomes: any disability and six [...] Read more.
This study explored a range of sociodemographic factors associated with disability among international immigrants in Chile, and compared them to the Chilean-born. Secondary data analysis of the Chilean population-based survey CASEN-2006 was conducted (268,873 participants). Main health outcomes: any disability and six different types of disability: visual, hearing, learning, physical, psychiatric and speaking (binary outcomes). Sociodemographic variables: Demographic factors (age, sex, marital status, urban/rural, ethnicity), socioeconomic status (SES: income, education, employment status, and an integrated indicator combining the SES measures through cluster analysis for the immigrant population), material factors (overcrowding, sanitation, housing quality) and migration related (country of origin and length of stay). Immigrants reported a significantly lower prevalence of any disability (3.55%), visual (1.00%) and physical disability (0.38%). Factors associated with any disability among immigrants were age, low SES or over 20 years duration of residence in Chile; while a range of sociodemographic factors were associated with disability in the Chilean-born. Conditional regression models by age group varied between populations, but SES remained significantly associated with disability across immigrants and the Chilean-born. However, there are no similar patterns of factors associated to different types of disability between the populations under study. Factors associated with disability varied between populations under study, but SES showed a consistent association with any disability in immigrants and the Chilean-born. Types of disability showed different patterns of factors associated to them between populations, which suggest the great complexity of underlying mechanisms related to disability in Chile. Full article
(This article belongs to the Special Issue Migrant Health 2012)
Open AccessArticle HIV/AIDS and Associated Conditions among HIV-Infected Refugees in Minnesota, 2000–2007
Int. J. Environ. Res. Public Health 2012, 9(11), 4197-4209; doi:10.3390/ijerph9114197
Received: 9 July 2012 / Revised: 31 October 2012 / Accepted: 9 November 2012 / Published: 16 November 2012
Cited by 3 | PDF Full-text (281 KB) | HTML Full-text | XML Full-text
Abstract
In 2010, the requirement for human immunodeficiency virus (HIV) testing of adult refugees prior to US resettlement was removed, thus leading to a potential for missed diagnosis. We reviewed refugee health assessment data and medical charts to evaluate the health status of [...] Read more.
In 2010, the requirement for human immunodeficiency virus (HIV) testing of adult refugees prior to US resettlement was removed, thus leading to a potential for missed diagnosis. We reviewed refugee health assessment data and medical charts to evaluate the health status of HIV-infected refugees who arrived in Minnesota during 2000–2007, prior to this 2010 policy change. Among 19,292 resettled adults, 174 were HIV-infected; 169 (97%) were African (median age 26.4 (range: 17–76) years). Charts were abstracted for 157 (124 (79%) with ≥1 year of follow-up). At initial presentation, two of 74 (3%) women were pregnant; 27% became pregnant during follow-up. HIV clinical stage varied (59%, asymptomatic; 11%, mild symptoms; 10%, advanced symptoms; 3%, severe symptoms; 17%, unknown); coinfections were common (51 tuberculosis, 13 hepatitis B, 13 parasites, four syphilis). Prior to arrival 4% had received antiretrovirals. Opportunistic infections were diagnosed among 13%; 2% died from AIDS-related causes. Arrival screening may be needed to identify these HIV-infected refugees and prevent HIV-related morbidity and mortality. Full article
(This article belongs to the Special Issue Migrant Health 2012)
Open AccessArticle Experiences of French Speaking Immigrants and Non-immigrants Accessing Health Care Services in a Large Canadian City
Int. J. Environ. Res. Public Health 2012, 9(10), 3755-3768; doi:10.3390/ijerph9103755
Received: 17 September 2012 / Revised: 10 October 2012 / Accepted: 15 October 2012 / Published: 22 October 2012
Cited by 4 | PDF Full-text (168 KB) | HTML Full-text | XML Full-text
Abstract
French speakers residing in predominantly English-speaking communities have been linked to difficulties accessing health care. This study examined health care access experiences of immigrants and non-immigrants who self-identify as Francophone or French speakers in a mainly English speaking province of Canada. We [...] Read more.
French speakers residing in predominantly English-speaking communities have been linked to difficulties accessing health care. This study examined health care access experiences of immigrants and non-immigrants who self-identify as Francophone or French speakers in a mainly English speaking province of Canada. We used semi-structured interviews to gather opinions of recent users of physician and hospital services (N = 26). Language barriers and difficulties finding family doctors were experienced by both French speaking immigrants and non-immigrants alike. This was exacerbated by a general preference for health services in French and less interest in using language interpreters during a medical consultation. Some participants experienced emotional distress, were discontent with care received, often delayed seeking care due to language barriers. Recent immigrants identified lack of insurance coverage for drugs, transportation difficulties and limited knowledge of the healthcare system as major detractors to achieving health. This study provided the groundwork for future research on health issues of official language minorities in Canada. Full article
(This article belongs to the Special Issue Migrant Health 2012)
Open AccessArticle A Study of the Health-Related Quality of Life and Work-Related Stress of White-Collar Migrant Workers
Int. J. Environ. Res. Public Health 2012, 9(10), 3740-3754; doi:10.3390/ijerph9103740
Received: 23 July 2012 / Revised: 26 September 2012 / Accepted: 15 October 2012 / Published: 19 October 2012
Cited by 10 | PDF Full-text (313 KB) | HTML Full-text | XML Full-text
Abstract
Little is known about the health-related quality of life (HRQoL) and work-related stress and its risk factors among white-collar businessmen and management workers that migrate to high-income developing countries. A structural questionnaire survey was administered to 156 white-collar Taiwanese management personnel of [...] Read more.
Little is known about the health-related quality of life (HRQoL) and work-related stress and its risk factors among white-collar businessmen and management workers that migrate to high-income developing countries. A structural questionnaire survey was administered to 156 white-collar Taiwanese management personnel of representative companies of their industries in Taiwan, who were assigned long-term job positions in China. Questionnaire content included demographics and medical history, self-reported physical and mental conditions, personal lifestyle and behavior, Beck Depression Inventory, and information on HRQoL. White-collar migrant workers reported a high prevalence of alcohol consumption (72.4%) and perceived work-related stress (62.2%), and a lower prevalence of regular exercise (12.2%). Workers with higher levels of perceived work-related stress reported more alcohol consumption, a history of hyperlipidemia, and a higher prevalence of self-reported neck pain, poor sleep, and mild/moderate/severe depression. In our primary multivariate risk model to determine lifestyle and work-related stress variables and HRQoL, perceived work-related stress and a feeling of depression negatively impacted both the Physical Component Summary (PCS) and Mental Component Summary (MCS) scores of the SF-36 health survey. Hyperlipidemia and self-reported neck pain were associated with significantly lower PCS scores, whereas cardiovascular disease, gastric ulcer, and poor sleep were associated with statistically lower MCS scores. White-collar migrant workers are generally younger with high socioeconomic status. Perceived work-related stress and a feeling of depression indirectly affect HRQoL. Hyperlipidemia, self-reported neck pain, cardiovascular disease, gastric ulcer, and poor sleep also had a significant negative impact on HRQoL. Full article
(This article belongs to the Special Issue Migrant Health 2012)
Open AccessArticle Older Asian Americans and Pacific Islanders with Activities of Daily Living (ADL) Limitations: Immigration and Other Factors Associated with Institutionalization
Int. J. Environ. Res. Public Health 2012, 9(9), 3264-3279; doi:10.3390/ijerph9093264
Received: 29 June 2012 / Revised: 27 July 2012 / Accepted: 3 September 2012 / Published: 7 September 2012
Cited by 1 | PDF Full-text (80 KB) | HTML Full-text | XML Full-text
Abstract
This study determined the national prevalence and profile of Asian Americans with Activities of Daily Living (ADL) limitations and identified factors associated with institutionalization. Data were obtained from 2006 American Community Survey, which replaced the long-form of the US Census. The data are nationally representative of both institutionalized and community-dwelling older adults. Respondents were Vietnamese (n = 203), Korean (n = 131), Japanese (n = 193), Filipino (n = 309), Asian Indian (n = 169), Chinese (n = 404), Hawaiian/Pacific Islander (n = 54), and non-Hispanic whites (n = 55,040) aged 55 and over who all had ADL limitations. The prevalence of institutionalized among those with ADL limitations varies substantially from 4.7% of Asian Indians to 18.8% of Korean Americans with ADL limitations. Every AAPI group had a lower prevalence of institutionalization than disabled Non-Hispanic whites older adults (23.8%) (p < 0.001). After adjustment for socio-demographic characteristics, Asian Indians, Vietnamese, Japanese, Filipino, and Chinese had significantly lower odds of institutionalization than non-Hispanic whites (OR = 0.29, 0.31, 0.58, 0.51, 0.70, respectively). When the sample was restricted to AAPIs, the odds of institutionalization were higher among those who were older, unmarried, cognitively impaired and those who spoke English at home. This variation suggests that aggregating data across the AAPI groups obscures meaningful differences among these subpopulations and substantial inter-group differences may have important implications in the long-term care setting. Full article
(This article belongs to the Special Issue Migrant Health 2012)

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