Pub Date : 2025-01-01Epub Date: 2025-04-23DOI: 10.1016/j.jmh.2025.100333
Taco Jan Prins , Nunnapus Rueanprasert , Prapatsorn Misa , Anchayarat Puttanusegsan , Jasper Ko Ko Aung , Natasha Herber , Myo Myo , Marcus J Rijken , Michele van Vugt , Chaisiri Angkurawaranon , Rose McGready
Background
Nearly 50 % of women in low- and middle-income countries fail to obtain adequate antenatal care due to barriers in reaching the health facility. A key element of the quality of care is women’s perception of treatment they receive. This study aims to compare the perspectives of urban and rural migrant women from Myanmar in Thailand and the obstacles they face when trying to access care.
Methods
From October-2023 to May-2024, a survey was conducted among migrant women, 74 at Sarapee hospital in Chang Mai Province, and 148 at the clinics of Shoklo Malaria Research Unit (SMRU), Tak Province. Questions based on REPRO-Q were used for scoring satisfaction in several domains using a Likert scale ranging from dissatisfied to satisfied.
Results
The majority of women in Sarapee and SMRU reported pleasant visits, 86.5 % (64/74), 99.3 % (144/145) respectively. Disrespectful behaviour against migrant women was low and mentioned by 14.9 % (11/74) in Sarapee and 1.4 % (2/148) at SMRU. The women attending care at Sarapee reported significantly lower satisfaction 60.8 % (45/74) on being able to refuse examination or treatment compared to women attending care in SMRU 83.0 % (122/147) P < 0.001.
Conclusion
Both urban and rural settings had high rates of perceived pleasant visits and recommending the service to friends, although this could result from hesitancy to give negative feedback. At this critical stage of the life course both institutions can improve, to eliminate experiences of perceived disrespectful behavior.
{"title":"Migrant women’s experience of antenatal care in an urban and rural setting in north and North-West Thailand: A cross sectional survey","authors":"Taco Jan Prins , Nunnapus Rueanprasert , Prapatsorn Misa , Anchayarat Puttanusegsan , Jasper Ko Ko Aung , Natasha Herber , Myo Myo , Marcus J Rijken , Michele van Vugt , Chaisiri Angkurawaranon , Rose McGready","doi":"10.1016/j.jmh.2025.100333","DOIUrl":"10.1016/j.jmh.2025.100333","url":null,"abstract":"<div><h3>Background</h3><div>Nearly 50 % of women in low- and middle-income countries fail to obtain adequate antenatal care due to barriers in reaching the health facility. A key element of the quality of care is women’s perception of treatment they receive. This study aims to compare the perspectives of urban and rural migrant women from Myanmar in Thailand and the obstacles they face when trying to access care.</div></div><div><h3>Methods</h3><div>From October-2023 to May-2024, a survey was conducted among migrant women, 74 at Sarapee hospital in Chang Mai Province, and 148 at the clinics of Shoklo Malaria Research Unit (SMRU), Tak Province. Questions based on REPRO-Q were used for scoring satisfaction in several domains using a Likert scale ranging from dissatisfied to satisfied.</div></div><div><h3>Results</h3><div>The majority of women in Sarapee and SMRU reported pleasant visits, 86.5 % (64/74), 99.3 % (144/145) respectively. Disrespectful behaviour against migrant women was low and mentioned by 14.9 % (11/74) in Sarapee and 1.4 % (2/148) at SMRU. The women attending care at Sarapee reported significantly lower satisfaction 60.8 % (45/74) on being able to refuse examination or treatment compared to women attending care in SMRU 83.0 % (122/147) P < 0.001.</div></div><div><h3>Conclusion</h3><div>Both urban and rural settings had high rates of perceived pleasant visits and recommending the service to friends, although this could result from hesitancy to give negative feedback. At this critical stage of the life course both institutions can improve, to eliminate experiences of perceived disrespectful behavior.</div></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"11 ","pages":"Article 100333"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143890683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01Epub Date: 2025-02-15DOI: 10.1016/j.jmh.2025.100316
Martina Ventura , Alessio Petrelli , Anteo Di Napoli , Sara Leone , Enrico Grande , Marilena Pappagallo , Luisa Frova
Background
A socioeconomic mortality gradient, favourable to the most advantaged social groups, has been documented in high migratory pressure (HMPCs) and highly developed countries, including Italy. However, little is known about how this association differs between natives and immigrants. This study aimed to evaluate the association between education level, occupational class and mortality among Italian and immigrant residents.
Methods
Using a longitudinal design, the 2011 Italian Census population was followed up to 2019. All-cause mortality was retrieved by record linkage with the Causes of Death register. The association between education/occupational class and mortality was evaluated in subjects aged 30–64, separately by sex, citizenship/macro area of origin. Mortality rate ratios (MRR) and 95 % confidence intervals were estimated using negative binomial regression models.
Results
Of the 23,572,516 subjects analysed, 7 % were immigrants from HMPCs; of the 410,746 deaths, 3 % were from HMPCs. Among Italians, a mortality gradient by education was observed (low/high adjMRR: 2.37 [2.16–2.60] males; 1.79 [1.64–1.96] females), whereas a weaker association with no trend was found for HMPC immigrants (adjMRR: 1.12 [1.00–1.25] males; 1.12 [1.00–1.26] females). Regarding occupational class, for immigrants from HMPCs, a higher mortality was observed in male “farmers” and “inactives” compared to “non-manual workers” (adjMRR = 1.31 [1.06–1.61] and adjMRR = 1.67 [1.50–1.85], respectively); and in females for “inactive” subjects (adjMRR = 1.48 [1.35–1.62]).
A higher mortality for the less educated was observed for males from Romania, India and China, and for females from Central-Eastern Europe, Sub-Saharan Africa and Central and South America. A lower mortality was found for the least educated from Morocco.
Conclusions
The higher mortality among less educated subjects was confirmed among Italians, while it was less evident among immigrants from HMPCs. However, differences observed between citizenships, macro-areas of origin and sex highlight the need for social policies accounting for specific risk factors and cultural specificities affecting correct lifestyles and health service access.
{"title":"Socioeconomic inequalities in mortality among Italian and immigrant residents: A longitudinal population-based study","authors":"Martina Ventura , Alessio Petrelli , Anteo Di Napoli , Sara Leone , Enrico Grande , Marilena Pappagallo , Luisa Frova","doi":"10.1016/j.jmh.2025.100316","DOIUrl":"10.1016/j.jmh.2025.100316","url":null,"abstract":"<div><h3>Background</h3><div>A socioeconomic mortality gradient, favourable to the most advantaged social groups, has been documented in high migratory pressure (HMPCs) and highly developed countries, including Italy. However, little is known about how this association differs between natives and immigrants. This study aimed to evaluate the association between education level, occupational class and mortality among Italian and immigrant residents.</div></div><div><h3>Methods</h3><div>Using a longitudinal design, the 2011 Italian Census population was followed up to 2019. All-cause mortality was retrieved by record linkage with the Causes of Death register. The association between education/occupational class and mortality was evaluated in subjects aged 30–64, separately by sex, citizenship/macro area of origin. Mortality rate ratios (MRR) and 95 % confidence intervals were estimated using negative binomial regression models.</div></div><div><h3>Results</h3><div>Of the 23,572,516 subjects analysed, 7 % were immigrants from HMPCs; of the 410,746 deaths, 3 % were from HMPCs. Among Italians, a mortality gradient by education was observed (low/high adjMRR: 2.37 [2.16–2.60] males; 1.79 [1.64–1.96] females), whereas a weaker association with no trend was found for HMPC immigrants (adjMRR: 1.12 [1.00–1.25] males; 1.12 [1.00–1.26] females). Regarding occupational class, for immigrants from HMPCs, a higher mortality was observed in male “farmers” and “inactives” compared to “non-manual workers” (adjMRR = 1.31 [1.06–1.61] and adjMRR = 1.67 [1.50–1.85], respectively); and in females for “inactive” subjects (adjMRR = 1.48 [1.35–1.62]).</div><div>A higher mortality for the less educated was observed for males from Romania, India and China, and for females from Central-Eastern Europe, Sub-Saharan Africa and Central and South America. A lower mortality was found for the least educated from Morocco.</div></div><div><h3>Conclusions</h3><div>The higher mortality among less educated subjects was confirmed among Italians, while it was less evident among immigrants from HMPCs. However, differences observed between citizenships, macro-areas of origin and sex highlight the need for social policies accounting for specific risk factors and cultural specificities affecting correct lifestyles and health service access.</div></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"11 ","pages":"Article 100316"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143563741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01Epub Date: 2025-03-24DOI: 10.1016/j.jmh.2025.100324
Suhaila Halasa , Reema Safadi , Dua' Al-Maharma , Manar Nabolsi , Jennifer Dohrn , Muayyad Ahmad
Breastfeeding initiation and exclusivity are essential in reducing maternal and neonatal mortality and morbidity rates. Employing the Health Belief Model as a framework, this cross-sectional survey aimed to identify influencing factors and barriers to exclusive breastfeeding among 523 eligible Syrian refugee mothers living in Jordan. Of these, 35.8 % practiced exclusive breastfeeding and 36.9 % initiated breastfeeding within the first hour of birth. The logistic regression model showed that prior breastfeeding experience (OR = 5.06, p < 0.001, 95 % CI: 2.17–11.82), maternal satisfaction with feeding method (OR = 3.58, p < 0.001, 95 % CI: 1.89–6.76), medical insurance (OR = 1.74, p = 0.015, 95 % CI: 1.11–2.73), birth method (OR = 1.69, p = 0.034, 95 % CI: 1.04–2.73) and infant gender (OR= 0.64, p = 0.05, 95 % CI: 0.41–0.99) significantly influenced exclusive breastfeeding rates.
The findings revealed that breastfeeding practices do not align with WHO recommendations, emphasizing the crucial role of healthcare providers in supporting breastfeeding mothers during crises. It is essential to consider the unique circumstances and cultural backgrounds of refugees when evaluating their needs for developing breastfeeding programs. International health organizations, like the UNHCR, and host country policymakers should prioritize access to antenatal and postnatal counseling services and health insurance for mothers and children during crises.
母乳喂养的开始和专一性对于降低孕产妇和新生儿死亡率和发病率至关重要。采用健康信念模型作为框架，这项横断面调查旨在确定生活在约旦的523名符合条件的叙利亚难民母亲纯母乳喂养的影响因素和障碍。其中，35.8%实行纯母乳喂养，36.9%在出生后一小时内开始母乳喂养。logistic回归模型显示，既往母乳喂养经历(OR = 5.06, p <；0.001, 95% CI: 2.17-11.82)，产妇对喂养方式的满意度(OR = 3.58, p <；0.001, 95% CI: 1.89-6.76)、医疗保险（OR= 1.74, p = 0.015, 95% CI: 1.11-2.73）、分娩方法（OR= 1.69, p = 0.034, 95% CI: 1.04-2.73）和婴儿性别（OR= 0.64, p = 0.05, 95% CI: 0.41-0.99）显著影响纯母乳喂养率。调查结果显示，母乳喂养做法不符合世卫组织的建议，强调了卫生保健提供者在危机期间支持母乳喂养母亲方面的关键作用。在评估难民制定母乳喂养计划的需求时，必须考虑他们的独特情况和文化背景。难民署等国际卫生组织和东道国决策者应优先考虑在危机期间为母亲和儿童提供产前和产后咨询服务和健康保险。
{"title":"Breastfeeding practices and exclusive breastfeeding among syrian refugee mothers in Jordanian Host Communities","authors":"Suhaila Halasa , Reema Safadi , Dua' Al-Maharma , Manar Nabolsi , Jennifer Dohrn , Muayyad Ahmad","doi":"10.1016/j.jmh.2025.100324","DOIUrl":"10.1016/j.jmh.2025.100324","url":null,"abstract":"<div><div>Breastfeeding initiation and exclusivity are essential in reducing maternal and neonatal mortality and morbidity rates. Employing the Health Belief Model as a framework, this cross-sectional survey aimed to identify influencing factors and barriers to exclusive breastfeeding among 523 eligible Syrian refugee mothers living in Jordan. Of these, 35.8 % practiced exclusive breastfeeding and 36.9 % initiated breastfeeding within the first hour of birth. The logistic regression model showed that prior breastfeeding experience (OR = 5.06, <em>p</em> < 0.001, 95 % CI: 2.17–11.82), maternal satisfaction with feeding method (OR = 3.58, <em>p</em> < 0.001, 95 % CI: 1.89–6.76), medical insurance (OR = 1.74, <em>p</em> = 0.015, 95 % CI: 1.11–2.73), birth method (OR = 1.69, <em>p</em> = 0.034, 95 % CI: 1.04–2.73) and infant gender (OR= 0.64, <em>p</em> = 0.05, 95 % CI: 0.41–0.99) significantly influenced exclusive breastfeeding rates.</div><div>The findings revealed that breastfeeding practices do not align with WHO recommendations, emphasizing the crucial role of healthcare providers in supporting breastfeeding mothers during crises. It is essential to consider the unique circumstances and cultural backgrounds of refugees when evaluating their needs for developing breastfeeding programs. International health organizations, like the UNHCR, and host country policymakers should prioritize access to antenatal and postnatal counseling services and health insurance for mothers and children during crises.</div></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"11 ","pages":"Article 100324"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143768138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01Epub Date: 2025-01-16DOI: 10.1016/j.jmh.2025.100303
Silvia Loi , Peng Li , Mikko Myrskylä
The weathering hypothesis implies that there is an interaction between age and race or ethnicity that results in marginalized groups experiencing a more rapid decline in health than the dominant groups. This hypothesis has been tested mostly focusing on racial and ethnic health inequalities, while less is known about weathering by immigration background. This paper aims at contributing to this strand of research by addressing four research questions: is the health of immigrants declining at a faster pace over the life-course, compared to non-immigrants? Do higher levels of education protect immigrants from accelerated ageing compared to non-immigrants? How do income and marital status affect the health trajectories of immigrants and non-immigrants? How do these patterns vary by sex? We use longitudinal survey data to estimate healthy ageing trajectories of immigrants and non-immigrants over the life-course, in the German context. We examine the roles of education, income, and marital status, separately for men and women. We find that immigrants, and especially immigrant women, have a faster health decline than non-immigrants; that high education is linked to higher levels of health, but does not protect immigrants from ageing in poorer health compared to non-immigrants; and that health disparities between immigrants and non-immigrants persist over the life-course net of the socio-economic controls, which appear to be secondary to other unobserved determinants.
{"title":"Unequal weathering: How immigrants’ health advantage vanishes over the life-course","authors":"Silvia Loi , Peng Li , Mikko Myrskylä","doi":"10.1016/j.jmh.2025.100303","DOIUrl":"10.1016/j.jmh.2025.100303","url":null,"abstract":"<div><div>The weathering hypothesis implies that there is an interaction between age and race or ethnicity that results in marginalized groups experiencing a more rapid decline in health than the dominant groups. This hypothesis has been tested mostly focusing on racial and ethnic health inequalities, while less is known about weathering by immigration background. This paper aims at contributing to this strand of research by addressing four research questions: is the health of immigrants declining at a faster pace over the life-course, compared to non-immigrants? Do higher levels of education protect immigrants from accelerated ageing compared to non-immigrants? How do income and marital status affect the health trajectories of immigrants and non-immigrants? How do these patterns vary by sex? We use longitudinal survey data to estimate healthy ageing trajectories of immigrants and non-immigrants over the life-course, in the German context. We examine the roles of education, income, and marital status, separately for men and women. We find that immigrants, and especially immigrant women, have a faster health decline than non-immigrants; that high education is linked to higher levels of health, but does not protect immigrants from ageing in poorer health compared to non-immigrants; and that health disparities between immigrants and non-immigrants persist over the life-course net of the socio-economic controls, which appear to be secondary to other unobserved determinants.</div></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"11 ","pages":"Article 100303"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143101960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01Epub Date: 2025-09-26DOI: 10.1016/j.jmh.2025.100367
Joshua A.N. van Apeldoorn , Julie S. Jansen , Eva L. Liefhebber , Özgül Uysal-Bozkir , Edanur Sert , Ralf E. Harskamp , Charles Agyemang , Edo Richard , Eric P. Moll van Charante
Objectives
First-generation Turkish migrants in the Netherlands face higher cardiovascular risk and are disproportionately affected by cardiovascular disease (CVD) compared to the Dutch host population. To improve prevention in primary care, we explored their views and preferences on cardiovascular prevention.
Design
We conducted a qualitative study by interviewing first-generation Turkish migrants in The Netherlands. Semi-structured interviews and focus groups, conducted in Dutch or Turkish, were analyzed using thematic analysis.
Results
We conducted 26 individual interviews and two sex-stratified focus group sessions. Participants were aware of CVD risk factors and related health hazards but struggled to adopt a healthy lifestyle, as family obligations, household responsibilities, and work often took precedence over personal health. All participants identified language barriers as a significant challenge, but opinions varied on whether it was necessary for GPs to understand Turkish culture. Some felt this was unnecessary, viewing GPs primarily as medical decision-makers or intermediaries for referrals to other (para)medics, with lifestyle advice outside their professional scope. They emphasized that GPs should ask openly about lifestyle rather than assuming that behaviours associated with a Turkish cultural background play a role.
Conclusions
First-generation Turkish migrants in the Netherlands were aware of CVD risk, but personal responsibilities posed challenges in adopting a healthy lifestyle. Although views on the importance of GPs understanding Turkish culture varied, participants agreed that GPs should ask openly about lifestyle rather than assuming cultural relevance in cardiovascular prevention.
{"title":"First-generation Turkish immigrants' views and preferences on cardiovascular disease prevention in primary care - a qualitative study in the Netherlands","authors":"Joshua A.N. van Apeldoorn , Julie S. Jansen , Eva L. Liefhebber , Özgül Uysal-Bozkir , Edanur Sert , Ralf E. Harskamp , Charles Agyemang , Edo Richard , Eric P. Moll van Charante","doi":"10.1016/j.jmh.2025.100367","DOIUrl":"10.1016/j.jmh.2025.100367","url":null,"abstract":"<div><h3>Objectives</h3><div>First-generation Turkish migrants in the Netherlands face higher cardiovascular risk and are disproportionately affected by cardiovascular disease (CVD) compared to the Dutch host population. To improve prevention in primary care, we explored their views and preferences on cardiovascular prevention.</div></div><div><h3>Design</h3><div>We conducted a qualitative study by interviewing first-generation Turkish migrants in The Netherlands. Semi-structured interviews and focus groups, conducted in Dutch or Turkish, were analyzed using thematic analysis.</div></div><div><h3>Results</h3><div>We conducted 26 individual interviews and two sex-stratified focus group sessions. Participants were aware of CVD risk factors and related health hazards but struggled to adopt a healthy lifestyle, as family obligations, household responsibilities, and work often took precedence over personal health. All participants identified language barriers as a significant challenge, but opinions varied on whether it was necessary for GPs to understand Turkish culture. Some felt this was unnecessary, viewing GPs primarily as medical decision-makers or intermediaries for referrals to other (para)medics, with lifestyle advice outside their professional scope. They emphasized that GPs should ask openly about lifestyle rather than assuming that behaviours associated with a Turkish cultural background play a role.</div></div><div><h3>Conclusions</h3><div>First-generation Turkish migrants in the Netherlands were aware of CVD risk, but personal responsibilities posed challenges in adopting a healthy lifestyle. Although views on the importance of GPs understanding Turkish culture varied, participants agreed that GPs should ask openly about lifestyle rather than assuming cultural relevance in cardiovascular prevention.</div></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"12 ","pages":"Article 100367"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145227176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01Epub Date: 2025-09-20DOI: 10.1016/j.jmh.2025.100357
Yuanyuan Teng , Clive E. Sabel , Tomoya Hanibuchi , Tomoki Nakaya
Studies have shown that migrants and ethnic minority groups were disproportionately affected by the COVID-19 pandemic, yet the role of the social environment in shaping their vulnerabilities remains underexplored in Japan. This study explored the experiences of migrants in Japan during the COVID-19 pandemic and examined the association between social environmental factors (i.e., population density, neighborhood deprivation, ethnic density, and social networks) and both COVID-19 infections and vaccination uptake. Two nationwide online surveys were conducted in 2021 and 2023 to capture migrants' experiences and analyze these associations during the middle and waning stages of the pandemic. Modified Poisson regressions with robust standard errors were applied for the analysis. The findings revealed the complex and evolving influence of social environmental factors on infections and vaccination uptake as the pandemic progressed. Larger neighborhood ties with co-nationals were associated with a higher risk of infection in 2021, while neighborhood population density, neighborhood deprivation, and ethnic density showed no significant association with infection in both surveys. Regarding COVID-19 vaccination, more social contacts with Japanese natives were negatively associated with vaccine hesitancy in 2021 and incomplete vaccination in 2023. Additionally, neighborhood deprivation was positively associated with vaccine hesitancy and incomplete vaccination in 2021 before adjusting for other variables. In anticipation of future pandemics, customized programs should be developed to address the unique healthcare needs of migrants and tailored to different stages of the pandemic.
{"title":"Examining the role of social environment on COVID-19 infections and vaccine uptake among migrants in Japan: Findings from nationwide surveys in 2021 and 2023","authors":"Yuanyuan Teng , Clive E. Sabel , Tomoya Hanibuchi , Tomoki Nakaya","doi":"10.1016/j.jmh.2025.100357","DOIUrl":"10.1016/j.jmh.2025.100357","url":null,"abstract":"<div><div>Studies have shown that migrants and ethnic minority groups were disproportionately affected by the COVID-19 pandemic, yet the role of the social environment in shaping their vulnerabilities remains underexplored in Japan. This study explored the experiences of migrants in Japan during the COVID-19 pandemic and examined the association between social environmental factors (i.e., population density, neighborhood deprivation, ethnic density, and social networks) and both COVID-19 infections and vaccination uptake. Two nationwide online surveys were conducted in 2021 and 2023 to capture migrants' experiences and analyze these associations during the middle and waning stages of the pandemic. Modified Poisson regressions with robust standard errors were applied for the analysis. The findings revealed the complex and evolving influence of social environmental factors on infections and vaccination uptake as the pandemic progressed. Larger neighborhood ties with co-nationals were associated with a higher risk of infection in 2021, while neighborhood population density, neighborhood deprivation, and ethnic density showed no significant association with infection in both surveys. Regarding COVID-19 vaccination, more social contacts with Japanese natives were negatively associated with vaccine hesitancy in 2021 and incomplete vaccination in 2023. Additionally, neighborhood deprivation was positively associated with vaccine hesitancy and incomplete vaccination in 2021 before adjusting for other variables. In anticipation of future pandemics, customized programs should be developed to address the unique healthcare needs of migrants and tailored to different stages of the pandemic.</div></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"12 ","pages":"Article 100357"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145227183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01Epub Date: 2025-06-27DOI: 10.1016/j.jmh.2025.100341
Neila Gross , Maia C. Tarnas , Rashmina J. Sayeeda , Carly Ching , David Flynn , Muhammad H Zaman
Background
Infectious disease research is essential for disease prevention and management within refugee camps and informal settlements. The objective of this study is to identify the characteristics of existing infectious disease research in these settings and to assess stated research challenges, ethical considerations, and studied interventions within these studies.
Methods
This is a systematic review of forty primary studies focused on infectious disease research conducted among displaced populations. Included studies are published in English between 1995 and 2023. Three databases were searched, PubMed, Embase, and Web of Science, and this review was registered with PROSPERO (CRD42023461567). The risk of bias of the studies was assessed using the Mixed Methods Appraisal Tool.
Results
85 % of studies (n = 34) researched an intervention for infectious disease prevention or control and 70 % of studies (n = 28) were randomized controlled trials. 75 % of studies were located in Bangladesh (n = 15) or Pakistan (n = 15). 40 % of studies focused on diarrheal diseases (n = 16) and 28 % on malaria (n = 11). Common identified research challenges included population mobility, limited external validity, and low recruitment. No studies included the community in the initial study conception or investigated the research impact on the community. Community involvement was often through community health workers (45 %). Of the 18 studies that studied a resource-based intervention, 20 % explicitly noted that the intervention was unsustainable.
Discussion
While guidelines for conducting research in displaced settings exist, there are gaps in their utilization. We identified a disconnect between where displaced individuals reside and where research is conducted, as well as a prioritization of particular infectious diseases. Researchers identified numerous challenges in conducting research in these settings, though the community was rarely involved in the research. Context-specific considerations and community involvement are vital in research with displaced communities.
{"title":"Infectious disease research in forcibly displaced populations: A systematic review in low- and middle-income host countries","authors":"Neila Gross , Maia C. Tarnas , Rashmina J. Sayeeda , Carly Ching , David Flynn , Muhammad H Zaman","doi":"10.1016/j.jmh.2025.100341","DOIUrl":"10.1016/j.jmh.2025.100341","url":null,"abstract":"<div><h3>Background</h3><div>Infectious disease research is essential for disease prevention and management within refugee camps and informal settlements. The objective of this study is to identify the characteristics of existing infectious disease research in these settings and to assess stated research challenges, ethical considerations, and studied interventions within these studies.</div></div><div><h3>Methods</h3><div>This is a systematic review of forty primary studies focused on infectious disease research conducted among displaced populations. Included studies are published in English between 1995 and 2023. Three databases were searched, PubMed, Embase, and Web of Science, and this review was registered with PROSPERO (CRD42023461567). The risk of bias of the studies was assessed using the Mixed Methods Appraisal Tool.</div></div><div><h3>Results</h3><div>85 % of studies (<em>n</em> = 34) researched an intervention for infectious disease prevention or control and 70 % of studies (<em>n</em> = 28) were randomized controlled trials. 75 % of studies were located in Bangladesh (<em>n</em> = 15) or Pakistan (<em>n</em> = 15). 40 % of studies focused on diarrheal diseases (<em>n</em> = 16) and 28 % on malaria (<em>n</em> = 11). Common identified research challenges included population mobility, limited external validity, and low recruitment. No studies included the community in the initial study conception or investigated the research impact on the community. Community involvement was often through community health workers (45 %). Of the 18 studies that studied a resource-based intervention, 20 % explicitly noted that the intervention was unsustainable.</div></div><div><h3>Discussion</h3><div>While guidelines for conducting research in displaced settings exist, there are gaps in their utilization. We identified a disconnect between where displaced individuals reside and where research is conducted, as well as a prioritization of particular infectious diseases. Researchers identified numerous challenges in conducting research in these settings, though the community was rarely involved in the research. Context-specific considerations and community involvement are vital in research with displaced communities.</div></div><div><h3>Funding</h3><div>Wellcome Trust (Contract Number C-010,656).</div></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"12 ","pages":"Article 100341"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144534638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01Epub Date: 2025-04-25DOI: 10.1016/j.jmh.2025.100334
Akindele Abimibayo Adeoya
Objective
Health literacy (HL) is the ability to access, understand, evaluate, and apply health information for well-being. However, comparisons between domestic and international students remain limited. This study aims to investigate HL among Japanese and international university students in Japan and explore the factors that influence it.
Methods
This cross-sectional study used both the English and Japanese versions of the 47-item European Health Literacy Survey Questionnaire (HLS-EU-Q47). Using convenience sampling, a total of 1366 university students across six regions in Japan who provided informed consent participated in this self-administered, online-based survey. Descriptive statistics, t-tests, ANOVA and multiple regression were conducted as appropriate at a 0.05 alpha level using JMP statistical software (version 17.0.0)
Results
The results revealed that 60 % and 32 % of participants had inadequate and problematic HL, respectively, indicating that 92 % of all students had limited HL. International students exhibited better HL than Japanese university students (p < 0.0001), a difference that remained after adjusting for sociodemographic and educational factors (β = 3.39, 95 % confidence interval = 2.83 – 3.95, p < 0.0001). The competency of “appraising” within the healthcare domain presented the greatest challenge for international students, whereas “understanding” within the disease prevention domain was most difficult for Japanese students. Furthermore, the results indicated a strong association between HL and sociodemographic factors such as age, level of study, marital status, and religious affiliation. In contrast, health literacy showed an inverse association with economic status, program of study and parental education level. There was an observable trend between improved Japanese language proficiency and improved HL among international students.
Conclusion
International students in Japan demonstrated better HL than Japanese university students. Educational institutions must take a more proactive role in fostering HL for all students through general health education and peer-to-peer programs to create a more informed, healthy, and productive student community.
{"title":"Exploring health literacy among Japanese and international university students in Japan: A comparative cross-sectional study","authors":"Akindele Abimibayo Adeoya","doi":"10.1016/j.jmh.2025.100334","DOIUrl":"10.1016/j.jmh.2025.100334","url":null,"abstract":"<div><h3>Objective</h3><div>Health literacy (HL) is the ability to access, understand, evaluate, and apply health information for well-being. However, comparisons between domestic and international students remain limited. This study aims to investigate HL among Japanese and international university students in Japan and explore the factors that influence it.</div></div><div><h3>Methods</h3><div>This cross-sectional study used both the English and Japanese versions of the 47-item European Health Literacy Survey Questionnaire (HLS-EU-Q47). Using convenience sampling, a total of 1366 university students across six regions in Japan who provided informed consent participated in this self-administered, online-based survey. Descriptive statistics, <em>t</em>-tests, ANOVA and multiple regression were conducted as appropriate at a 0.05 alpha level using JMP statistical software (version 17.0.0)</div></div><div><h3>Results</h3><div>The results revealed that 60 % and 32 % of participants had inadequate and problematic HL, respectively, indicating that 92 % of all students had limited HL. International students exhibited better HL than Japanese university students (<em>p</em> < 0.0001), a difference that remained after adjusting for sociodemographic and educational factors (β = 3.39, 95 % confidence interval = 2.83 – 3.95, <em>p</em> < 0.0001). The competency of “appraising” within the healthcare domain presented the greatest challenge for international students, whereas “understanding” within the disease prevention domain was most difficult for Japanese students. Furthermore, the results indicated a strong association between HL and sociodemographic factors such as age, level of study, marital status, and religious affiliation. In contrast, health literacy showed an inverse association with economic status, program of study and parental education level. There was an observable trend between improved Japanese language proficiency and improved HL among international students.</div></div><div><h3>Conclusion</h3><div>International students in Japan demonstrated better HL than Japanese university students. Educational institutions must take a more proactive role in fostering HL for all students through general health education and peer-to-peer programs to create a more informed, healthy, and productive student community.</div></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"11 ","pages":"Article 100334"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143894949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01Epub Date: 2025-10-17DOI: 10.1016/j.jmh.2025.100368
Franziska Reinhardt, Imad Maatouk
While research has established links between migration and health outcomes, the role of cultural and social factors in mediating this relationship remains understudied. This study examines how family relationships, value orientations, and life satisfaction interact with migration status to influence health outcomes in Germany.
Using data from the Family Demographic Panel (FReDA), a representative German study on family relationships, we conducted multiple linear and multivariate regression analyses (n = 8939). The study employs a comprehensive set of health indicators, including both objective measures and self-reported health status.
The analyses reveal that migration status alone is not a significant predictor of health outcomes when controlling for social and cultural factors. Instead, life satisfaction and family relationships showed substantial effects on health. Both traditional and modern family values were linked to better health outcomes, showing that stable values, regardless of whether they are traditional or modern, can support health.
These findings challenge simplified assumptions about migration-health relationships and emphasize the importance of recognizing cultural values, social support systems, and psychosocial well-being as relevant factors in addressing health disparities. They also underscore the need for healthcare systems to adopt culturally sensitive approaches that consider the diverse social realities of individuals.
{"title":"Beyond individual integration: Family systems, social support networks and living environment as health determinants among migrants in Germany","authors":"Franziska Reinhardt, Imad Maatouk","doi":"10.1016/j.jmh.2025.100368","DOIUrl":"10.1016/j.jmh.2025.100368","url":null,"abstract":"<div><div>While research has established links between migration and health outcomes, the role of cultural and social factors in mediating this relationship remains understudied. This study examines how family relationships, value orientations, and life satisfaction interact with migration status to influence health outcomes in Germany.</div><div>Using data from the Family Demographic Panel (FReDA), a representative German study on family relationships, we conducted multiple linear and multivariate regression analyses (<em>n</em> = 8939). The study employs a comprehensive set of health indicators, including both objective measures and self-reported health status.</div><div>The analyses reveal that migration status alone is not a significant predictor of health outcomes when controlling for social and cultural factors. Instead, life satisfaction and family relationships showed substantial effects on health. Both traditional and modern family values were linked to better health outcomes, showing that stable values, regardless of whether they are traditional or modern, can support health.</div><div>These findings challenge simplified assumptions about migration-health relationships and emphasize the importance of recognizing cultural values, social support systems, and psychosocial well-being as relevant factors in addressing health disparities. They also underscore the need for healthcare systems to adopt culturally sensitive approaches that consider the diverse social realities of individuals.</div></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"12 ","pages":"Article 100368"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145473343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01Epub Date: 2025-10-31DOI: 10.1016/j.jmh.2025.100374
Oscar Espinosa , Paul Rodríguez , Valeria Bejarano , Santiago León , José Luis Ortiz
Introduction
From 2021 to 2023, Colombia implemented a national policy to expand health insurance coverage for over 1.4 million Venezuelan migrants through its subsidized health insurance system, which provides universal health coverage to low-income Colombian populations. This study evaluates the cost-utility of the intervention, focusing on its health and economic returns.
Methods
We conducted a cost-utility analysis by translating government expenditure per enrolled migrant into health outcomes (QALYs/YLLs) using Colombia-specific cost-effectiveness thresholds. Health benefits were measured in quality-adjusted life years (QALYs) gained and years of life lost (YLLs) averted. Colombia-specific cost-effectiveness thresholds (CETs) were used to estimate outcomes, and an internal rate of return (IRR) analysis assessed the program's social profitability.
Results
The intervention generated an estimated 10,259 QALYs gained or 11,843 YLLs averted between 2021 and 2023. The IRR reached 27.5% when QALYs were valued at 100% of Gross Domestic Product per capita, indicating strong social returns. Women and adults aged 19–44 showed the greatest health gains, with urban areas receiving the highest benefits. This evidence demonstrates that even health policies can yield high social returns, providing a model for other countries navigating large-scale migration.
Discussion
Expanding subsidized health insurance to migrants proves to be a highly cost-effective policy. This analysis supports Colombia’s approach as a scalable and impactful model for inclusive public health aligned with universal health coverage goals.
{"title":"Health for all? A cost-utility evaluation of Colombia's policy to enroll Venezuelan migrants (2021–2023)","authors":"Oscar Espinosa , Paul Rodríguez , Valeria Bejarano , Santiago León , José Luis Ortiz","doi":"10.1016/j.jmh.2025.100374","DOIUrl":"10.1016/j.jmh.2025.100374","url":null,"abstract":"<div><h3>Introduction</h3><div>From 2021 to 2023, Colombia implemented a national policy to expand health insurance coverage for over 1.4 million Venezuelan migrants through its subsidized health insurance system, which provides universal health coverage to low-income Colombian populations. This study evaluates the cost-utility of the intervention, focusing on its health and economic returns.</div></div><div><h3>Methods</h3><div>We conducted a cost-utility analysis by translating government expenditure per enrolled migrant into health outcomes (QALYs/YLLs) using Colombia-specific cost-effectiveness thresholds. Health benefits were measured in quality-adjusted life years (QALYs) gained and years of life lost (YLLs) averted. Colombia-specific cost-effectiveness thresholds (CETs) were used to estimate outcomes, and an internal rate of return (IRR) analysis assessed the program's social profitability.</div></div><div><h3>Results</h3><div>The intervention generated an estimated 10,259 QALYs gained or 11,843 YLLs averted between 2021 and 2023. The IRR reached 27.5% when QALYs were valued at 100% of Gross Domestic Product per capita, indicating strong social returns. Women and adults aged 19–44 showed the greatest health gains, with urban areas receiving the highest benefits. This evidence demonstrates that even health policies can yield high social returns, providing a model for other countries navigating large-scale migration.</div></div><div><h3>Discussion</h3><div>Expanding subsidized health insurance to migrants proves to be a highly cost-effective policy. This analysis supports Colombia’s approach as a scalable and impactful model for inclusive public health aligned with universal health coverage goals.</div></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"12 ","pages":"Article 100374"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145525558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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