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Reducing Disparities in Health Care Access of Refugees and Migrants
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Reducing Disparities in Health Care Access of Refugees and Migrants

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Care Sciences".

Deadline for manuscript submissions: 31 March 2026 | Viewed by 3887

Special Issue Editors

Dr. Ilene Hyman

E-Mail Website
Guest Editor
Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada
Interests: health and social equity; immigrant and refugee health; indigenous health; gender and health; mental health
Dr. Bilkis Vissandjée

E-Mail Website
Guest Editor
1. Faculté des Sciences Infirmières et Centre de Recherche en Santé Publique (CReSP), Université de Montréal, QC H3N 1X9, Canada
2. Institut Universitaire de Recherche SHERPA, Montréal, QC H3N 1Y9, Canada
Interests: women's health; sex, gender and experiences of immigration as social determinants of health and access to health care; global health; challenges related to care in the context of gender-based violence

Special Issue Information

Dear Colleagues,

In the context of unprecedented international migration driven by conflict, persecution, climate change, and economic instability, reducing health disparities for refugees and migrants has become a pressing global challenge. Access to integrated and comprehensive health care is essential in meeting the needs of equity-deserving populations facing multiple and intersecting barriers to health care. Recognizing the diversity within migrant and refugee populations, it is important to note that different aspects of their identities, such as gender, age, migration and socioeconomic status, can intersect and contribute to varying degrees of vulnerability.

This issue aims to highlight innovative, intersectional approaches, policies, and interventions that promote equitable health care access among refugees and migrants, recognizing that the most effective health strategies include health-in-all-policies approaches and the collaboration of partners beyond the health sector. While Canada exemplifies several progressive policies in immigrant integration and inclusion, informational, financial, linguistic, cultural, and systemic barriers persist, with lack of access to inclusive and accessible primary health care being one of our greatest challenges.

We invite submissions that share Canadian and international best practices and lessons for promoting equitable health care access for migrant and refugee populations. Contributions may include critical analyses, reviews, and empirical evidence exploring strategies and policy analyses contributing to this global dialogue.

Dr. Ilene Hyman
Dr. Bilkis Vissandjée
Guest Editors

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 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 thoroughly refereed through a single-blind 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 2500 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

  • health equity
  • refugee health
  • migrant health
  • social determinants of health
  • universal health coverage
  • access to health care

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Published Papers (4 papers)

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Research

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12 pages, 264 KiB  
Article
Factors Impacting COVID-19 Vaccine Uptake and Confidence Among Immigrant and Refugee Populations in Canada
by Ilene Hyman, Ayesha Khan and Iwo Effiong
Int. J. Environ. Res. Public Health 2025, 22(4), 493; https://doi.org/10.3390/ijerph22040493 - 26 Mar 2025
Viewed by 364
Abstract
Objective: This study examines the barriers and facilitators to COVID-19 vaccination among immigrant and refugee populations, with a focus on informing primary healthcare stakeholders on effective strategies to address the health needs of these groups. Although conducted in Canada, the findings are relevant [...] Read more.
Objective: This study examines the barriers and facilitators to COVID-19 vaccination among immigrant and refugee populations, with a focus on informing primary healthcare stakeholders on effective strategies to address the health needs of these groups. Although conducted in Canada, the findings are relevant to countries facing similar challenges in promoting vaccine uptake among migrant communities. Methods: As part of an evaluation of best practices in COVID-19 vaccination promotion and provision, data were collected using in-depth key informant interviews with a cross-section of primary care stakeholders (n = 11). Main findings: Key barriers to vaccine promotion and provision included distrust of health and government services, misinformation, lack of vaccine confidence, and access or systems-level barriers. Effective facilitators were relationship-building and equity-driven approaches, such as community engagement and development, culturally and linguistically effective communication, one-on-one supports, and collaboration with community members as valued partners and staff. These strategies were identified as best practices that enhanced vaccine confidence and uptake. Conclusion: The risk and impacts of COVID-19 are disproportionately distributed worldwide, affecting migrant populations in many countries. Primary healthcare stakeholders must understand the barriers and facilitators to vaccine promotion to effectively address health inequalities. Increasing vaccine uptake and confidence among immigrant and refugee populations requires targeted and tailored approaches that are culturally responsive and equity-informed. These findings provide valuable insights for health systems globally, supporting efforts to reduce health inequities by using inclusive vaccination strategies. Full article
(This article belongs to the Special Issue Reducing Disparities in Health Care Access of Refugees and Migrants)
12 pages, 813 KiB  
Article
Assessing the Risks and Cultural Relativity of Diabetes in Black Individuals of African Caribbean Ancestry (ACB) Aged 18–39 Years in Toronto
by Akm Alamgir, Rhea Raghunauth, Osezua Momoh and Cliff Ledwos
Int. J. Environ. Res. Public Health 2025, 22(1), 85; https://doi.org/10.3390/ijerph22010085 - 10 Jan 2025
Viewed by 1428
Abstract
Context: Diabetes rates are high in Black and some other ethnic communities, often leading to more severe complications. We conducted a study to identify the prevalence and risk of diabetes among African Caribbean Black (ACB) individuals aged 18–39 and to assess the sensitivity [...] Read more.
Context: Diabetes rates are high in Black and some other ethnic communities, often leading to more severe complications. We conducted a study to identify the prevalence and risk of diabetes among African Caribbean Black (ACB) individuals aged 18–39 and to assess the sensitivity of glycated hemoglobin (HbA1c) compared to an oral glucose tolerance test (OGTT) to diagnose diabetes. Methods: In this mixed-methods study, maximum variation sampling was used to recruit 272 ACB participants from fourteen African and five Caribbean countries from Toronto. Participants’ height, weight, waist circumference, HbA1c, OGTT, demographic, and behavioural data were collected. SPSS was used to analyze the quantitative data. This study used descriptive statistics for frequency distribution and cross-tabulation while inferential statistics (regression, ANOVA, factor analysis, etc.) were used for relational analysis. Because of the small sample size, qualitative data were analyzed manually using the charting technique. Results: This study found that 1.5% of participants had diabetes, 9.2% had prediabetes, and 44.9% were at risk of developing diabetes. The mean value of HbA1c, FBS, and 2hPG was 5.5%, 4.8 mmol/L, and 5.7 mmol/L, respectively. The mean BMI was 28.2 kg/m2, and the waist circumference was 85.8 cm. This study found a correlation between glucose intolerance and increasing body mass index (BMI) and waist circumference (WC). Dietary habits, physical inactivity, and mental health challenges were risk factors among the participants. HbA1c was found to be a more sensitive and culturally acceptable screening measure than OGTT in diagnosing diabetes. Conclusions: ACB individuals are at high risk of having diabetes, requiring culturally tailored peer-based health promotion strategies to reduce diabetes prevalence and risk. HbA1c is a culturally acceptable and statistically more capable measure than OGTT in identifying individuals with prediabetes. Further longitudinal research is needed. Full article
(This article belongs to the Special Issue Reducing Disparities in Health Care Access of Refugees and Migrants)
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18 pages, 377 KiB  
Article
Risk Factors for Non-Communicable Diseases in Refugees, Asylum Seekers, and Subsidiary Protection Beneficiaries Resettled or Relocated in Portugal Between 2015 and 2020
by Ana Pinto de Oliveira, Cláudia Conceição and Inês Fronteira
Int. J. Environ. Res. Public Health 2024, 21(11), 1505; https://doi.org/10.3390/ijerph21111505 - 13 Nov 2024
Viewed by 976
Abstract
Non-communicable diseases, previously thought of as a problem of high-income countries, now coexist in low- and middle-income countries, including the countries of origin for many refugees traveling to Europe. We aimed to describe the prevalence of risk factors for non-communicable diseases among refugees, [...] Read more.
Non-communicable diseases, previously thought of as a problem of high-income countries, now coexist in low- and middle-income countries, including the countries of origin for many refugees traveling to Europe. We aimed to describe the prevalence of risk factors for non-communicable diseases among refugees, asylum seekers, and subsidiary protection beneficiaries resettled or relocated in Portugal between 2015 and 2020 and compare these to the prevalence of risk factors in the 12 months before they left their country of origin. A cross-sectional study was conducted between 2019 and 2020 of all refugees, asylum seekers, and subsidiary protection beneficiaries attending a Lisbon, Portugal refugee center. Behavioral and biological risk factors were assessed using the WHO STEPwise modified questionnaire. A descriptive statistical analysis was conducted, which included 80 respondents, mainly men, with an average age of of 30.3 ± 9.8 years. The prevalence of several behavioral risk factors for non-communicable diseases among refugees, asylum seekers, and subsidiary protection beneficiaries was higher at the time of the study than in the 12 months before leaving the country of origin. Differences between men and women were noted in tobacco (49.1% vs. 25.9%) and alcohol use (43.4% vs. 18.5%) in the receiving country. Overweight and obesity also showed differences by gender (7.5% vs. 11.1% and 39.6% vs. 48.1%). The prevalence of suicidal ideation and suicidalplanning was high, and varied from 6.3% and 20% in the country of origin to 16.3% and 38.5% respectively in the receiving country, however the prevalence of suicide attempts was lower in the receiving country (66.7%) compared to the country of origin (100.0%). Information on health and social determinants is critical to identify priorities and increase access to access to gender-specific health and community level interventions, including mental health, to reduce risk factors associated with refugee relocation and resettlement. Full article
(This article belongs to the Special Issue Reducing Disparities in Health Care Access of Refugees and Migrants)

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29 pages, 937 KiB  
Systematic Review
Electronic Personal Health Records for Mobile Populations: A Rapid Systematic Literature Review
by Paulien Tensen, Francisca Gaifém, Simeon Kintu Paul, Frederick Murunga Wekesah, Princess Ruhama Acheampong, Maria Bach Nikolajsen, Ulrik Bak Kirk, Ellis Owusu-Dabo, Per Kallestrup, Charles Agyemang and Steven van de Vijver
Int. J. Environ. Res. Public Health 2025, 22(4), 488; https://doi.org/10.3390/ijerph22040488 - 25 Mar 2025
Viewed by 480
Abstract
Background: Mobile populations, including refugees, asylum seekers, and undocumented migrants, face challenges related to access, continuity, and quality of healthcare, among others, due to the lack of available health records. This study aimed to examine the current landscape of Electronic Personal Health Records [...] Read more.
Background: Mobile populations, including refugees, asylum seekers, and undocumented migrants, face challenges related to access, continuity, and quality of healthcare, among others, due to the lack of available health records. This study aimed to examine the current landscape of Electronic Personal Health Records (EPHRs) developed for and used by mobile populations. Methods: A rapid systematic review was conducted between September 2024 and January 2025, identifying relevant publications through searches in Embase, PubMed, Scopus, and grey literature. Results: The literature search yielded 2303 articles, with 74 remaining after title and abstract screening. After full-text screening, 10 scientific articles and 9 grey literature records were included in a qualitative data synthesis. Six distinct EPHRs were identified, differing in how they centralize health records, in additional functionalities, and the level of patient autonomy granted. Discussion and Conclusions: Limited evidence exists on EPHRs impact on health outcomes or continuity of care, and user adoption remains a critical challenge. Key elements in the development and implementation of EPHRs include ensuring a high level of data security and co-designing easy-to-use EPHRs. The review indicates a need for future research on user experiences of EPHRs and their impact on the health outcomes of mobile populations. Full article
(This article belongs to the Special Issue Reducing Disparities in Health Care Access of Refugees and Migrants)
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