Search Results (357)

This study examines the perceived mental health of Ukrainian female forced migrants in Ireland through the lens of the socio-ecological model (SEM). Using binomial logistic regression on a 2023 online survey dataset (N = 656), it explores multi-level predictors across individual, relationship, community, and societal domains. Results indicate that individual-level factors explain the largest proportion of variance in perceived mental health (Nagelkerke R² = 0.399). Employment status, self-rated physical health, and coping strategies were key determinants: part-time employment and good physical health were associated with higher odds of good perceived mental health. In contrast, avoidant coping and worsening health were associated with poorer outcomes. Relationship-level factors (R² = 0.194) also contributed significantly; lack of social support and deteriorating family or friendship ties were linked to poorer mental health, whereas participation in refugee meetings was strongly protective. Community-level factors (R² = 0.123) revealed that unstable housing, living with strangers, and declining neighbourhood relationships were associated with reduced mental well-being. At the societal level (R² = 0.168), insufficient access to psychological support and excessive exposure to Ukrainian news were associated with poorer outcomes, while moderate news engagement was protective. The findings highlight the multifaceted nature of refugees’ perceived mental health, emphasising the interdependence of personal resilience, social connectedness, and systemic support. Full article

The dual Hukou system, originating in China’s planned economy period, structured Chinese society into separate urban and rural segments, thereby generating distinct sets of rights and benefits for agricultural and non-agricultural residents regarding land, social security, education, and healthcare. Urban home purchase is a pivotal indicator of social integration for rural–urban migrants in destination cities. While the literature has extensively examined migrants’ residential conditions in China, the institutional impact of the agricultural hukou system—a core constraint—on their urban homeownership, along with its underlying mechanisms and heterogeneity, remains underexplored. To address this gap, this study adopts a twofold approach: theoretically, it employs the separating equilibrium model in housing markets with incomplete information to verify that agricultural hukou acts as an institutional barrier to migrants’ local home purchases; empirically, it uses data from the China Migrants Dynamic Survey (CMDS) and applies the Fairlie decomposition method to quantify the constraint effect. The empirical results suggest that agricultural hukou exerts a 29.72% suppressive effect on migrants’ urban home purchase behavior. This effect operates indirectly by weakening migrants’ long-term settlement intention, which serves as a mediating variable. Moreover, the hindrance of agricultural hukou varies heterogeneously across groups, differing in education level, generational cohort, and regional distribution. To advance the fair and sustainable development of the real estate market, we advocate accelerating hukou reform by decoupling public services from residence status, fostering inclusive urbanization, and ensuring equitable development of housing markets. Full article

Background/Objectives: Iran carries a significant burden of mental health disorders. This study aimed to describe the status of mental health and mental health care in Iran between 2012 and 2023, addressing inequalities and mapping existing challenges in the mental health care system. Methods: A systematic literature review was conducted. Databases including Medline, CINAHL, APA PsycINFO, Scopus, Web of Science, and the Cochrane Library, as well as local databases such as SID, Magiran, and Noormags, were searched to identify studies related to mental health care in Iran. A total of 59 studies met the inclusion criteria. An inductive approach and thematic analysis were used to synthesize themes from the data. Results: Lower socioeconomic status (SES) was associated with higher rates of mental disorders due to poverty-related stressors and limited access to quality care. Gender disparities revealed that women are more vulnerable to mental health problems, exacerbated by perceived gender inequality. Ethnic minorities and undocumented migrant populations faced inadequate healthcare services, resulting in poorer mental health outcomes. Children and older adults also experienced mental health challenges influenced by sociodemographic factors. The main challenge for mental health care is establishing mechanisms to ensure more equitable access for all citizens. Additional challenges include limited awareness among policymakers, insufficient budget allocation, weak prevention programs, and poor intra- and inter-sectoral coordination and collaboration. A shortage of mental health care providers, as well as deficiencies in structure, system processes, and resources, further hinder progress. Conclusions: Socioeconomic factors exacerbate the challenges of Iran’s under-resourced mental health system. To address these issues, equity considerations must be integrated into mental health policies. Key interventions include the routine monitoring of mental health indicators, expanding insurance coverage for mental health services, and establishing dedicated services for children. Full article

Background: Vaccine hesitancy and refusal are growing public health challenges, reflecting individual decisions and social inequalities. The COVID-19 pandemic reshaped vaccine perceptions and may have amplified pre-existing differences. This study analyzed the evolution of vaccine hesitancy and refusal among adults in the Community of Madrid (Spain) between 2019 and 2024. We also explored the associated sociodemographic profiles. Methods: A retrospective observational study was conducted using data from the Non-communicable Disease Risk-Factor Surveillance System through a computer-assisted telephone interview (CATI) survey, targeting adults aged 18–64 years. Four waves (2019, 2020, 2021, 2024) were analyzed. Prevalence rates with 95% confidence intervals (95%CI) were calculated. The associations with sociodemographic variables (sex, age, country of birth, education, and employment status) were assessed using Poisson regression models to obtain crude and adjusted prevalence ratios (aPR). Results: A total of 7978 participants were included (49.1% men; mean age 41.97 years). Vaccine hesitancy increased from 3.8% (95% CI: 3.0–4.7) in 2019 to 18.5% (95% CI: 16.8–20.2) in 2024; vaccine refusal increased from 2.1% (95% CI: 1.6–2.8) to 8.0% (95% CI: 6.9–9.3). Vaccine hesitancy and refusal adjusted for socioeconomic variables increased in 2024 compared to 2019 (PRa: 5.04; 95% CI: 3.96–6.41 and aPR: 4.00; 95% CI: 2.86–5.59, respectively). Hesitancy was associated with female sex and middle age in 2019, to middle age in 2020, to intermediate education and migrant origin in 2021, and to education and migrant status in 2024. Vaccine refusal showed a similar pattern to that of vaccine hesitancy, highlighting the association with socioeconomic vulnerability. Conclusion: Between 2019 and 2024, vaccine hesitancy and refusal increased, and the association with socioeconomic vulnerability has also increased. Equity-based vaccination strategies are needed in order to strengthen institutional trust and reduce structural barriers to vaccine acceptance. Full article

Background/Objectives: The nutrition and lifestyle choices made during pregnancy significantly impact the long-term health of both mother and child. This observational study, conducted at the Jersey Maternity Unit, investigated how maternal diet and weight influence delivery outcomes and newborn feeding methods among 81 pregnant women. The aim of the study was to assess whether maternal diet, weight changes, and infant feeding practices vary according to ethnicity and duration of residence in Jersey, in order to inform culturally sensitive health improvement strategies. Methods: The FFQ was used to characterise the diet before and during pregnancy. Diet quality was assessed by the 9-item aMED score. Data on anthropometric measurements (including gestational weight gain, GWG), socioeconomic characteristics, and infant feeding methods (including breastfeeding rates) were collected. Results: The statistical analyses evaluate differences and distribution of data in the groups of women based on the ethnicity and period the mothers had lived on the island. For all the women, there were significant changes in the weight gained at week 28 compared to weeks 8 and 12 (+8.0 (4.0; 12.1) kg, p ≤ 0.001), as well as the period before pregnancy until the 34th week of gestation (+11.9 (8.0; 12.1) kg, p ≤ 0.001). The intake of low-fat dairy, whole grains, and fruit changed through the gestation period and differed between pregnant women with different periods of island residence. There were no changes in the aMED score and adherence. Conclusions: Maternal weight gain followed a consistent pattern during pregnancy, whereas dietary behaviours—particularly the consumption of key food groups—varied by cultural background and length of residence. These findings emphasise the need for culturally sensitive antenatal care and tailored nutrition strategies to improve maternal outcomes, support breastfeeding, and reduce long-term health risks for mothers and children in Jersey’s multicultural population. Full article

Food insecurity (FI) is a major public health problem that disproportionately affects women, especially if they are migrants. In Chile, there is limited data on how gender and migration status intersect to explain vulnerability to FI. A cross-sectional analytical study was conducted among 2124 women of childbearing age (1062 Chilean and 1062 immigrants) residing in south-central Chile. Biosociodemographic variables were collected through a structured questionnaire, and FI was assessed using the Household Food Insecurity Access Scale (HFIAS). Multivariate logistic regression models were applied to estimate risk factors using odds ratios (OR). Overall, 39.2% of women experienced some degree of FI, with prevalence significantly higher among immigrants (49%) compared to Chileans (29%). Severe FI was twice as frequent in immigrant women (18.1% vs. 9.2%). The risk factor of FI in the total sample included immigrant status (OR = 2.61; 95% CI: 2.15–3.17), low socioeconomic status (OR = 2.25; 1.77–2.87), having children (OR = 1.82; 1.49–2.23), being head of household (OR = 1.53; 1.25–1.87), not having a job (OR = 1.27; 1.02–1.58), and suffering from depression (OR = 2.11; 1.66–2.67). Subgroup analyses confirmed similar determinants in both groups, with not having a job being relevant mainly for immigrants and age acting as a protective factor among Chileans. FI is highly prevalent among women in south-central Chile, particularly among immigrants. Structural determinants such as socioeconomic status, having children, being the head of the household, and depression increase vulnerability. Policies must integrate gender and migration perspectives, promoting access to adequate food, employment, childcare, and mental health support. Full article

The objective of the study is to describe the health status and use of public healthcare services by undocumented migrant sex workers (UMSWs) attended in Catalonia between 2013 and 2018. This study utilized a descriptive observational research design. Non-parametric tests were applied to estimate differences in the use of public healthcare services, and incidence and prevalence of selected sexually transmitted diseases (STDs) according to gender and region of origin. Out of 1464 women and 199 men UMSWs, 855 (51.4%) contacted primary care services once or more, and 378 (22.7%) used emergency services. Differences between regions of origin were found in the use of primary care services (Sub-Saharan Africa had 65.9% while Europe and Central Asia 43.0%, p < 0.001). Facilitating early diagnosis and improving access to healthcare resources among key populations such as men who have sex with men or transgender women can be achieved through interventions such as community-led point-of-care testing, which increases the frequency of HIV and STD screening and may also prove effective among UMSWs. Full article

Background/Objectives: The aim of this study was to evaluate the oral health status of socially vulnerable children and adolescents in Seville and to examine its associations with behavioral and sociodemographic determinants. We hypothesized that greater social vulnerability and suboptimal behaviors would be associated with higher caries experience. Methods: A cross-sectional analytical study was conducted on 250 participants aged 2 to 17 years attending the Luis Séiquer Social Dentistry Foundation between January and March 2025. Clinical examinations followed the WHO Oral Health Surveys: Basic Methods (5th edition, 2013) and were performed by a calibrated dentist. Variables included dental caries indices (dft, DMFT), pulpal treatment needs, and oral hygiene practices. Statistical analyses included Kruskal–Wallis, Mann–Whitney U, Fisher’s exact tests, and multivariate regression models (significance level p < 0.05). Results: Caries prevalence was high across all age groups, particularly in primary dentition (mean dft = 3.05 ± 3.80; DMFT = 2.99 ± 3.66; p < 0.001). Pulp therapy needs were significantly higher among preschoolers (mean = 2.22 ± 2.31). Factors such as low parental education, migrant background, insufficient toothbrushing frequency, and frequent sugar intake were strongly associated with poorer oral health outcomes. Although fluoridated toothpaste use was widespread (>94%), dental floss use remained limited (34.8%). Multivariate analyses confirmed a strong association between social inequalities and oral disease burden. Conclusions: Children and adolescents from vulnerable groups in Seville experience a high prevalence of dental caries and substantial unmet treatment needs. Findings highlight marked oral health disparities linked to socioeconomic status, emphasizing the urgent need for early preventive programs, culturally adapted oral health education, and equitable access to dental care. Full article

Background: People experiencing homelessness (PEH) face significant health disparities and systemic barriers to healthcare, elevating their risk for cancer and other chronic diseases. To tackle PEHs’ challenges in accessing cancer preventive care, the CANCERLESS project implemented the Health Navigator Model (HNM)—a person-centered intervention that utilizes trained Health Navigators to provide tailored support and facilitate service access. Recognizing housing as a key determinant of health, this analysis assessed changes in housing status associated with participation in the HNM among CANCERLESS participants in Austria, Greece, Spain, and the UK. Methods: This was a secondary analysis of cross-national data collected during a single-arm interventional study. Of 652 enrolled PEH, 277 (42.5%) completed the HNM intervention follow-up and were included in the analysis. Changes in housing status from baseline to follow-up were categorized using the European Typology of Homelessness and Housing Exclusion (ETHOS) and treated as an ordered outcome. Descriptive statistics were complemented by a cumulative link mixed model with a participant random intercept to estimate the association between time (follow-up vs. baseline) and housing transitions among completers, adjusting for age, residence/legal status, and daily smoking. Results: Participants had a mean age of 47.4 (SD 13.8), primarily identified as male (64.1%), reported upper secondary education (33.9%), and were from Western European countries (39.7%), with varying housing situations. Among intervention completers, time (follow-up vs. baseline) was associated with higher odds of being in a higher ETHOS category (OR = 1.49, 95% CI = 1.02–2.20, p = 0.042), consistent with a modest improvement in housing status. Larger estimates were observed among migrants without legal documents (OR = 24.13, 95% CI = 6.41–90.89, p < 0.001), while daily smoking was associated with lower odds (OR = 0.33, 95% CI = 0.11–0.96, p = 0.041); other residence status categories were not statistically significant. Conclusions: Suggesting that tailored, navigation-based models, such as the HNM, may be linked to improved housing stability for PEH, these findings can inform piloting and context-aligned integration of the HNM within public health strategies as an alternative approach to address the complex, interconnected health and social needs of PEH. However, the lack of a comparison group and high attrition limit the results’ conclusiveness, and future evaluations should aim to include assessments of housing-associated contextual factors. Full article

Public cooperation is crucial for the police to successfully perform their duties. Yet marginalised and vulnerable groups facing uncertainty about their societal status often significantly mistrust the police. Migrant populations experiencing forced labour are marginalised and uncertain groups that face significant challenges for police in gaining trust and cooperation, especially since many have escaped conflict or authoritarian regimes, or experienced trauma and exploitation prior to encountering police in democratic contexts. This paper examines the potential role of policing agencies in Anglophone countries in addressing forced labour in migrant communities. Whilst recognising that police are not ideal first responders to this issue, the paper acknowledges that they often represent the first visible state response with the legal authority to support or detain individuals. This paper reviews the literature on forced labour and migration and presents a conceptual argument, applying procedural justice as a theoretical framework to assess its potential for improving the policing of forced labour, particularly among newly arrived migrants still establishing social relationships, bonds, and capital. The paper concludes by arguing that procedural justice may help police earn the trust and confidence of migrant populations experiencing forced labour and help address labour exploitation, although this trust-building remains hampered by the concomitant harms caused by crimmigration systems. Full article

Labour migration from Central and Eastern Europe plays a significant role in the labour market of the European Union, yet few studies examine the direction and extent of occupational mobility triggered by migration. This study introduces a new analytical tool, the Career Benefit Index, which measures the direction of change in occupational status between the labour markets of the country of origin and the host country. The tool also enables the assessment of sociological factors that explain these changes. The index was developed using data from Hungarian workers living in Austria and Germany. The analysis revealed that educational attainment has no significant impact on career mobility. In contrast, demographic factors such as gender, age, and particularly very high-level German language proficiency strongly influence career trajectories. The index demonstrates that labour market capacities play a limited role in shaping migrants’ career paths, as the host labour markets tend to “evaluate” migrant workers primarily based on their linguistic and demographic attributes. The index and the findings contribute to a deeper understanding of labour market integration among Central and Eastern European migrants and may offer new directions for migration and employment policy analysis. Full article

Background: Migrant populations are commonly under-immunised relative to general populations in host countries. The evidence base on routine vaccination among migrant children suggests that higher priority is given to infants and younger children compared to adolescents. Though migrants are often classified as a homogenous group, different sub-populations of migrants exist, including voluntary migrants who choose to move and involuntary migrants forcibly displaced by humanitarian crises. The human papillomavirus (HPV) vaccine, a relatively recent addition to global routine immunisation schedules for adolescents, is a useful proxy for understanding vaccine equity for this under-prioritised group. This qualitative systematic review explores health system determinants of delivery and uptake of HPV vaccination services among involuntary migrants. Methods: A literature search was conducted across ten electronic databases. An analytical framework tailored to the migrant context aided in capturing the complexity and magnitude of systemic factors that determine vaccine delivery and uptake among involuntary migrants. Of the 676 records retrieved, 27 studies were included in this review. Results: Key determinants of vaccine delivery include adaptation of immunisation policies for migrant inclusiveness, implementation of migrant-targeted interventions, health provider recommendations, electronic health records, and free vaccines. Uptake determinants include access dependent on legal status, awareness-related determinants akin to culturally appropriate health messaging, and acceptance-related determinants associated with sociocultural beliefs, misinformation, and distrust. Conclusions: Prioritising vaccination programmes linked with non-outbreak-related diseases is challenging in the disruptive context of humanitarian crises given fragile health systems, limited resources, loss of health infrastructure and deployment of health personnel to emergency care. We strongly advocate for global actors at all health systems levels to actively reform national HPV vaccination programmes to enhance inclusivity of adolescent girls in crises settings or resettled in host countries. Full article

Background/Objectives: Migrant youth often experience multiple, intersecting systems of oppression (e.g., racism, poverty, and discrimination) that may contribute to disparities in pediatric pain prevalence, severity, and management. However, pain in migrant youth remains poorly understood. This rapid scoping review will examine the nature and extent of the existing literature on pain among migrant youth. Methods: This protocol has been preregistered on the Open Science Framework. The review will follow guidelines for conducting and reporting rapid and scoping reviews, and will be guided by PCC (population, concept, context) and PROGRESS-Plus methodological frameworks. Electronic searches will be conducted in MEDLINE, CINAHL, and Scopus for primary research studies published since 2015 that describe and examine pain among migrant youth (age < 18 years). Two reviewers will independently screen titles, abstracts, and full texts, with disagreements resolved by consensus or a third reviewer. Data charting will be piloted on 5–10 studies, then independently conducted by two reviewers. Extracted data will include study characteristics (authors, year, purpose, methodology); participant sociodemographic information (e.g., racial and/or ethnic identity, age, sex, gender identity, sexual orientation, socioeconomic position); migration status; countries of origin and destination; definition and characteristics of pain; and measures of systemic factors (e.g., racism). Results: Findings will be synthesized descriptively and interpreted within sociocultural and geopolitical contexts to better understand pain among migrant youth. Conclusions: This review will aim to provide critical insights into the intersections between migration and pediatric pain, offering guidance for future research, clinical practice, and policy to improve pain management and outcomes for migrant youth. Full article

Tuberculosis (TB) remains a critical public health issue in Johannesburg, South Africa, driven by a complex interplay of individual, social, and structural factors. This study assessed the syndemic relationship between these determinants to understand their collective impact on TB burden and treatment outcomes. A cross-sectional survey was conducted among TB patients attending selected clinics, examining behavioural risks (e.g., smoking, alcohol use, HIV co-infection), social conditions (poverty, overcrowding, stigma), and structural challenges (access to healthcare, migration status). The results revealed a significant co-occurrence of TB and HIV (56.1%), alongside high rates of smoking (33.1%) and alcohol use (45.2%). Unemployment (50.2%), inadequate housing, and limited healthcare access, particularly for undocumented migrants (26.2%), were also prominent. Factor analysis demonstrated a syndemic interaction between behavioural and social determinants, underscoring the compounded vulnerability of affected populations. The findings highlight the necessity of integrating medical interventions with social and structural reforms. Recommendations include TB-HIV co-management, substance abuse programmes, improved housing, and inclusive healthcare access. A multisectoral approach addressing both health and socioeconomic inequalities is critical for comprehensive TB control in urban South African contexts. Full article

Despite the growing number of older adults engaging in voluntary migration, there is a lack of knowledge about their psychological well-being in cross-cultural contexts. This cross-sectional study investigated factors associated with psychological well-being among older Chinese migrants residing in Chiang Mai, Thailand. Between December 2024 and February 2025, 204 Chinese migrants aged 60 and above who had resided in Chiang Mai for at least six months participated in a survey in Chinese. The survey measured sociodemographic and psychosocial factors including perceived health, income, marital status, number of co-residing family members, social support, acculturative stress, sense of mastery, and loneliness. Multiple regression analysis showed that gender (female) (p = 0.006), better perceived health status (p = 0.021), higher income (p = 0.007), more co-residing family members (p = 0.037), a greater sense of mastery (p = 0.009), and lower levels of loneliness (p < 0.001) were each independently associated with better psychological well-being. In contrast, neither general family support nor acculturative stress was a statistically significant predictor. These findings highlight the significant roles of financial security, family co-residence, personal empowerment, and social connectedness in shaping overall well-being. Strategies to improve psychological well-being in this population should focus on strengthening emotional connectedness, supporting the development of meaningful family and social relationships, and supporting economic stability. Full article