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Healthcare for Migrants and Minorities
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Healthcare for Migrants and Minorities

A special issue of Healthcare (ISSN 2227-9032).

Deadline for manuscript submissions: 7 April 2027 | Viewed by 13659

Editors

Dr. Hideomi Yamada

E-Mail Website
Guest Editor
International Clinic, The University of Tokyo, Tokyo 113-8655, Japan
Interests: internal medicine; clinical medicine; renal medicine; divine internal medicine
Dr. Soichiro Saeki

E-Mail Website
Guest Editor Assistant
Center Hospital of the National Center for Global Health and Medicine, Tokyo 162-8655, Japan
Interests: medical education; health communication

Special Issue Information

Dear Colleagues,

The health of immigrants and underrepresented populations has increasingly garnered attention across various dimensions. The COVID-19 pandemic has disproportionately impacted racial and ethnic minority groups in terms of infection, hospitalization, and mortality rates, highlighting the critical importance of understanding and addressing the social determinants of health that drive these disparities, including poverty and limited access to quality healthcare. Migrants and underrepresented ethnic groups often face a multitude of unique health challenges, such as restricted healthcare access, linguistic barriers, cultural differences, and discrimination.

This Special Issue aims to examine the current landscape of healthcare provision for migrants and underrepresented populations, explore the specific health challenges these groups encounter, and identify innovative solutions and best practices to address these issues. The collection of papers will cover a broad range of topics, including healthcare accessibility, cultural competency, language barriers, mental health, and racial and ethnic disparities in the management of chronic diseases. Additionally, this Special Issue will investigate the impact of social determinants of health and their influence on healthcare outcomes within these populations.

Dr. Hideomi Yamada
Guest Editors

Dr. Soichiro Saeki
Guest Editor Assistant

Manuscript Submission Information

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. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly 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 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • language barriers
  • emigrants and immigrants
  • migrant health
  • minority health
  • global health
  • non-national patients
  • foreigners
  • social determinants of health
  • health equity
  • racial disparities

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Published Papers (7 papers)

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Research

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16 pages, 384 KB  
Article
Awareness of and Satisfaction with Governmental COVID-19 Support Among Foreign Residents in Japan: A Cross-Sectional Study
by Shizuko Arima, Rie Ogasawara and Daisuke Onozuka
Healthcare 2026, 14(10), 1279; https://doi.org/10.3390/healthcare14101279 - 8 May 2026
Viewed by 372
Abstract
Background: Foreign residents in Japan faced various barriers that hindered their access to governmental COVID-19 (Coronavirus Disease 2019) support, which may have influenced their satisfaction with available services and overall well-being. However, limited evidence exists on how awareness of such support relates [...] Read more.
Background: Foreign residents in Japan faced various barriers that hindered their access to governmental COVID-19 (Coronavirus Disease 2019) support, which may have influenced their satisfaction with available services and overall well-being. However, limited evidence exists on how awareness of such support relates to satisfaction. This study examined the association between awareness of governmental COVID-19 support and satisfaction among foreign residents living in Japan. Methods: A cross-sectional online survey was conducted between September and November 2023 using a commercial online survey panel of foreign residents in Japan. Satisfaction with governmental support was assessed using a 10-point scale and dichotomized at the median. Signal detection analysis was applied to identify factors associated with higher satisfaction. Results: Among 427 respondents, 400 (93.7%) reported receiving COVID-19 vaccination. Satisfaction with government support was assessed using a 10-point scale, with a mean score of 5.8. Awareness of support was the strongest predictor of satisfaction, and length of residence was an additional determinant among those aware of support. Distinct demographic and socioeconomic patterns were observed across awareness and residence groups. Conclusions: Awareness of governmental COVID-19 support played a key role in shaping satisfaction among foreign residents, regardless of service use. Tailored, group-specific approaches considering length of residence and individual characteristics may improve access to support and enhance well-being. Full article
(This article belongs to the Special Issue Healthcare for Migrants and Minorities)
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13 pages, 715 KB  
Article
Unmet Medical Needs Among Immigrants in Korea Before and During COVID-19
by Min Young Park and Joonho Ahn
Healthcare 2026, 14(9), 1226; https://doi.org/10.3390/healthcare14091226 - 2 May 2026
Viewed by 457
Abstract
Background/Objectives: This study aimed to investigate how the disparities in unmet medical needs between immigrants to South Korea and native-born populations evolved during the COVID-19 pandemic. Methods: Using nationally representative cross-sectional data from the 2018 and 2020 Surveys on Immigrants’ Living Conditions and [...] Read more.
Background/Objectives: This study aimed to investigate how the disparities in unmet medical needs between immigrants to South Korea and native-born populations evolved during the COVID-19 pandemic. Methods: Using nationally representative cross-sectional data from the 2018 and 2020 Surveys on Immigrants’ Living Conditions and Labor Force in South Korea, we compared unmet medical needs among immigrants at two time points (N = 12,227 in 2018; N = 18,530 in 2020). Standardized prevalence ratios (SPRs) were calculated. Analyses were stratified according to work status, gender, Korean language proficiency, education level, and duration of stay. Results: Working immigrants had lower SPRs for unmet medical needs than Korean nationals (2018: 0.879; 2020: 0.745) but non-workers had consistently higher SPRs (2018: 1.117; 2020: 1.128). The SPRs for male and female non-workers increased and decreased, respectively. The SPRs were persistently higher among individuals with poorer Korean language proficiency, lower education, and shorter duration of stay. Conclusions: Systemic disruptions, such as the COVID-19 pandemic, may exacerbate pre-existing healthcare inequalities among immigrant populations. The persistence and widening of these disparities call for targeted policies that address structural barriers and ensure equitable healthcare access during future public health crises. Full article
(This article belongs to the Special Issue Healthcare for Migrants and Minorities)
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19 pages, 301 KB  
Article
Exploring the Immigrant Health Paradox Among the Vietnamese Population in the United States
by Tran Nguyen, Gia-Thien Nguyen, Raymond Chong and Yoon-Ho Seol
Healthcare 2026, 14(3), 354; https://doi.org/10.3390/healthcare14030354 - 30 Jan 2026
Viewed by 1072
Abstract
Background: The term immigrant health paradox describes how immigrants often have better health outcomes than their American-born counterparts. While existing literature treats this phenomenon as broadly generalizable, emerging research indicates that its expression varies across cultural and migration contexts. Understanding how the [...] Read more.
Background: The term immigrant health paradox describes how immigrants often have better health outcomes than their American-born counterparts. While existing literature treats this phenomenon as broadly generalizable, emerging research indicates that its expression varies across cultural and migration contexts. Understanding how the immigrant health paradox may appear across specific ethnic groups requires research that maps variation rather than assumes uniformity. Objectives: This study seeks to describe patterns, explore variation by nativity, and identify factors associated with well-being among the Vietnamese population in the United States (US). By focusing on descriptive trends and contextual influences, the study aims to generate new insights into how the paradox may manifest—or diverge—in the Vietnamese context. Methods: We conducted an online survey asking participants about their depressive disorders, physical and mental health status, demographics, socioeconomic status, social networks, and experiences with daily discrimination. Descriptive statistics were used to describe the study sample. Linear regression and ordinal logistic regression were performed to explore the relationships. Results: In this exploratory analysis, we did not observe indications of the Vietnamese immigrant health paradox. Material factors, especially perceptions of financial needs, as well as psychological factors, were somewhat associated with how Vietnamese people living in the US assess their health. Conclusions: The absence of the Vietnamese immigrant health paradox in the US underscores the need for nuanced health models that reflect diversity within immigrant groups. Their experiences reveal how migration histories, structural barriers, and racialization shape health outcomes in ways that differ from expectations. Full article
(This article belongs to the Special Issue Healthcare for Migrants and Minorities)
10 pages, 210 KB  
Article
Determinants of Unpaid Hospital Charges Among Non-Resident Foreign Patients: A Retrospective Single-Center Study in Tokyo, Japan
by Soichiro Saeki, Yukiko Nakamura, Nanako Miki, Yasuyo Osanai, Mayumi Horikawa and Chihaya Hinohara
Healthcare 2025, 13(22), 2893; https://doi.org/10.3390/healthcare13222893 - 13 Nov 2025
Viewed by 1696
Abstract
Background/Objectives: Unpaid medical expenses incurred by foreign nationals represent a growing concern for healthcare systems amid increasing international mobility. Japan, which lacks mandatory public insurance coverage for non-resident visitors, faces particular vulnerability in terms of uncompensated hospital care. This study aims to [...] Read more.
Background/Objectives: Unpaid medical expenses incurred by foreign nationals represent a growing concern for healthcare systems amid increasing international mobility. Japan, which lacks mandatory public insurance coverage for non-resident visitors, faces particular vulnerability in terms of uncompensated hospital care. This study aims to identify factors contributing to unpaid medical charges among uninsured, non-resident foreign patients hospitalized at a tertiary care facility in Tokyo. Methods: This retrospective observational analysis was conducted using medical and administrative data from patients admitted between January 2023 and February 2025. Patients who received elective medical tourism care were excluded. Data on demographics, length of hospital stay, care intensity, payment status, and third-party financial assistance were analyzed. Logistic regression models were applied to assess predictors of nonpayment. Results: Among 153 eligible cases, 9 patients (5.9%) had outstanding hospital bills upon discharge. Compared with those with completed payments, the unpaid group experienced longer admissions, more intensive care utilization, and higher total charges. Notably, the absence of third-party financial support (primarily travel insurance) was significantly associated with unpaid charges. Multivariate analysis identified this factor as the main independent predictor (adjusted odds ratio [OR]: 0.12; 95% confidence interval [CI]: 0.02–0.915; p = 0.040). Total amount of billing was also statistically significant (adjusted odds ratio [OR]: 1.01; 95% confidence interval [CI]: 1.00–1.01; p = 0.039). Conclusions: These findings highlight the importance of private insurance in mitigating financial risk in hospitals. Implementing policy measures to promote or require insurance enrollment, along with streamlined reimbursement systems, may contribute to sustainable care delivery for international patients. Full article
(This article belongs to the Special Issue Healthcare for Migrants and Minorities)
20 pages, 284 KB  
Article
A Comparison of Chinese and Korean Older Adult Immigrants’ Transnational Healthcare Practices in Toronto, Canada: A Mixed-Methods Study
by Leah Czukar, Lu Wang, Sepali Guruge, Janet Lum and Meira Greenbaum
Healthcare 2025, 13(19), 2493; https://doi.org/10.3390/healthcare13192493 - 1 Oct 2025
Cited by 2 | Viewed by 1739
Abstract
Background/Objectives: While immigrants represent 21% of Canada’s total population, they represent 30% of the country’s older population. Sociocultural and economic barriers to the Canadian healthcare system have been frequently reported among older adult immigrants. These barriers are intricately linked to a vastly understudied [...] Read more.
Background/Objectives: While immigrants represent 21% of Canada’s total population, they represent 30% of the country’s older population. Sociocultural and economic barriers to the Canadian healthcare system have been frequently reported among older adult immigrants. These barriers are intricately linked to a vastly understudied phenomenon-transnational health practices (THP), which may involve travelling to home countries for healthcare, accessing medicine and health-related information and resources linked to home countries. This study aimed to explore the relationships among local healthcare experiences in Canada, individual characteristics and use of THP among older adult immigrants. Methods: A mixed-methods approach was used combining statistical, spatial and qualitative methods to analyze group patterns of THP and its influencing factors. Primary data was collected through surveys and focus groups of older Mainland Chinese and older South Korean immigrants residing in Toronto. They are the two largest East Asian groups in Canada, with documented transnational ties with their home country. Results: The study found that THP were sought by both groups but were more prevalent among older Chinese immigrants. By integrating quantitative and qualitative analyses, the study revealed complex relationships between THP and barriers in local healthcare access relating to wait times, cost, language, availability, spatial accessibility and quality of care, for different types of care including primary, specialist, eye and dental care. Conclusions: The study generates new knowledge on THP in Canada and adds to the growing body of literature on transnational healthcare practices and behaviours among migrants across different countries and regions. It provides implications to inform health policy and deliver care for older adult immigrants as their populations continue to increase. Full article
(This article belongs to the Special Issue Healthcare for Migrants and Minorities)
10 pages, 257 KB  
Article
Primary Care Service Provision Scale for Evaluating the Right to Health Among International Migrant Populations
by Consuelo Cruz-Riveros, Alfonso Urzúa, Carolina Lagos and Evelyn Parada
Healthcare 2025, 13(16), 2068; https://doi.org/10.3390/healthcare13162068 - 21 Aug 2025
Viewed by 4711
Abstract
Introduction: This study was conducted from July 2021 to December 2022. We propose a scale to measure the right to health among international migrants in primary care settings. The scale aims to highlight and objectively assess the elements integrated into the delivery of [...] Read more.
Introduction: This study was conducted from July 2021 to December 2022. We propose a scale to measure the right to health among international migrants in primary care settings. The scale aims to highlight and objectively assess the elements integrated into the delivery of healthcare services by health personnel. Objective: Our aim was to develop and evaluate the psychometric properties of a measurement scale assessing the right to health in primary care for migrant populations in Chile, from the perspective of healthcare workers. Methods: An instrumental psychometric study was conducted. The sample comprised 339 primary healthcare workers from the Antofagasta, Biobío, and Metropolitan regions of Chile. The stages of the process included a theoretical review, conceptual definition, item construction, initial qualitative evaluation, and scale administration. Results: The initial 55-item model exhibited unsatisfactory fit indices (χ2 = 2608.693; df = 1271; p < 0.001; RMSEA = 0.056; CFI = 0.931; TLI = 0.919; SRMR = 0.054), whereas the refined 19-item model achieved satisfactory fit (χ2 = 441.72, df = 146, p < 0.001; RMSEA = 0.07; CFI = 0.95; TLI = 0.94; SRMR = 0.05). Conclusions: The scale demonstrates robust internal consistency and offers a valuable tool for evaluating primary healthcare delivery to international migrants based on the right to health framework. Full article
(This article belongs to the Special Issue Healthcare for Migrants and Minorities)

Review

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15 pages, 250 KB  
Review
Bridging the Language Gap in Healthcare: A Narrative Review of Interpretation Services and Access to Care for Immigrants and Refugees in Greece and Europe
by Athina Pitta, Maria Tzitiridou-Chatzopoulou, Arsenios Tsiotsias and Serafeim Savvidis
Healthcare 2026, 14(2), 215; https://doi.org/10.3390/healthcare14020215 - 15 Jan 2026
Cited by 1 | Viewed by 1985
Abstract
Background: Language barriers remain a major obstacle to equitable healthcare access for immigrants and refugees across Europe. Greece, as both a transit and host country, faces persistent challenges in providing linguistically and culturally appropriate care. Methods: This study presents a narrative [...] Read more.
Background: Language barriers remain a major obstacle to equitable healthcare access for immigrants and refugees across Europe. Greece, as both a transit and host country, faces persistent challenges in providing linguistically and culturally appropriate care. Methods: This study presents a narrative literature review synthesizing international, European, and Greek evidence on the effects of limited language proficiency, professional interpretation, and intercultural mediation on healthcare access, patient safety, satisfaction, and clinical outcomes. Peer-reviewed studies and selected grey literature were identified through searches of PubMed, Scopus, Web of Science, and CINAHL. Results: The evidence consistently demonstrates that the absence of professional interpretation is associated with substantially higher rates of clinically significant communication errors, longer hospital stays, increased readmissions, and higher healthcare costs. In contrast, the use of trained medical interpreters and intercultural mediators improves comprehension, shared decision-making, patient satisfaction, and clinical outcomes. Comparative European data from Italy, Spain, Germany, and Sweden show that institutionalized interpretation systems outperform Greece’s fragmented, NGO-dependent approach. Greek studies further reveal that limited proficiency in Greek is associated with reduced service utilization, longer waiting times, and lower patient satisfaction. Conclusions: This narrative review highlights the urgent need for Greece to adopt a coordinated, professionally staffed interpretation and intercultural mediation framework. Strengthening linguistic support within the healthcare system is essential for improving patient safety, equity, efficiency, and the integration of migrant and refugee populations. Full article
(This article belongs to the Special Issue Healthcare for Migrants and Minorities)
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