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Factors associated with first-generation immigrant parents’ unwillingness to vaccinate their daughters for HPV 第一代移民父母不愿给女儿接种HPV疫苗的相关因素
IF 4.6 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-01-01 DOI: 10.1016/j.jmh.2023.100161
Yuqi Guo , Omar T. Sims , Qingyi Li , Fan Yang

Purpose

Human papillomavirus (HPV) vaccination rates for children of immigrant parents are substantially lower than US peers. This study aimed (1) to assess the prevalence of immigrant parents’ unwillingness to vaccinate their daughters, (2) to compare by race/ethnicity the prevalence of immigrant parents’ unwillingness to vaccinate their daughters, and (3) to examine predictors of the unwillingness stratified by race/ethnicity.

Method

This study conducted a secondary analysis of data from the Health Information National Trends Survey (HINTS). HPV-related data were extracted and analyzed from first-generation immigrant parents (n = 784) with daughters 11–12 years of age.

Results

The frequency of unwillingness was high for all racial/ethnic groups (43–58%). Non-Hispanic White and Asian parents who were aware of or heard about the HPV vaccine were less likely to be unwilling to vaccinate their daughters. Also, older Hispanic immigrant parents were more likely to be unwilling to vaccinate their daughters for HPV.

Conclusion

To curb future incidences of HPV-related cervical cancers among second-generation immigrant women, efforts are needed to encourage first-generation immigrant parents to presently vaccinate their daughters for HPV.

目的移民儿童的人乳头瘤病毒(HPV)疫苗接种率明显低于美国同龄人。本研究旨在(1)评估移民父母不愿为其女儿接种疫苗的流行程度,(2)按种族/民族比较移民父母不愿为其女儿接种疫苗的流行程度,以及(3)按种族/民族分层检验不愿接种疫苗的预测因素。方法对卫生信息全国趋势调查(hint)数据进行二次分析。从第一代移民父母(n = 784)中提取并分析与hpv相关的数据,他们的女儿年龄在11-12岁之间。结果各种族/民族的不情愿发生率均较高(43% ~ 58%)。知道或听说过HPV疫苗的非西班牙裔白人和亚洲父母不愿意给女儿接种HPV疫苗的可能性较小。此外,年龄较大的西班牙裔移民父母更有可能不愿意给女儿接种HPV疫苗。结论为了遏制第二代移民妇女HPV相关宫颈癌的未来发病率,需要努力鼓励第一代移民父母目前为其女儿接种HPV疫苗。
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引用次数: 0
Screening and routine diagnosis of mental disorders among migrants in primary care: A cross-sectional study 初级保健中移民精神障碍的筛查和常规诊断:一项横断面研究
IF 4.6 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-01-01 DOI: 10.1016/j.jmh.2023.100205
Stella Evangelidou , Angeline Cruz , Yolanda Osorio , Ethel Sequeira-Aymar , Alessandra Queiroga Gonçalves , Laura Camps-Vila , Marta M. Monclús-González , Alba Cuxart-Graell , Elisa M. Revuelta-Muñoz , Núria Busquet-Solé , Susana Sarriegui-Domínguez , Aina Casellas , M. Rosa Dalmau Llorca , Carina Aguilar Martín , Ana Requena-Mendez
<div><h3>Background</h3><p>Migrants in host countries are at risk for the development of mental health conditions. The two aims of the study were to describe routine diagnoses of mental disorders among migrant patients at primary healthcare level and the associated risk factors, and to test the utility of an innovative migrant mental health assessment by evaluating whether the health professionals followed the recommendations proposed by the clinical decision support system (CDSS) tool.</p></div><div><h3>Methods</h3><p>A cross-sectional study was carried out in eight primary care centres (PCCs) in four non-randomly selected health regions of Catalonia, Spain from March to December 2018. Routine health data and mental health diagnoses based on the International Classification of Diseases (10th edition), including mental, behavioural and neuro developmental disorders (F01-F99), symptoms and signs involving emotional state (R45), and sleep disorders (G47), were extracted from the electronic health records. The proportion of mental health conditions was estimated and logistic regression models were used to assess any possible association with mental health disorders. The utility of the mental health assessment was assessed with the proportion of questionnaires performed by health professionals for migrants fulfilling the mental health screening criterion (country of origin with an active conflict in 2017) and the diagnoses given to the screened patients.</p></div><div><h3>Results</h3><p>Of 14,130 migrants that visited any of the PCCs during the study period, 7,358 (52.1 %) were women with a median age of 38.0 years-old. There were 520/14,130 (3.7 %) migrant patients diagnosed with a mental disorder, being more frequent among women (342/7,358; 4.7 %, <em>p</em>-value < 0.001), migrants from Latin-America (177/3,483; 5.1 %, <em>p</em> < 0.001) and those who recently arrived in Spain (170/3,672; 4.6 %, <em>p</em> < 0.001). A lower proportion of mental disorders were reported in migrants coming from conflicted countries in 2017 (116/3,669, 3.2 %, <em>p</em> = 0.053).</p><p>Out of the 547 mental health diagnoses reported in 520 patients, 69/14,130 (0.5 %) were mood disorders, 346/14,130 (2.5 %) anxiety disorders and 127/14,130 (0.9 %) sleeping disorders. Mood disorders were more common in migrants from Eastern Europe (25/2,971; 0.8 %, <em>p</em> < 0.001) and anxiety disorders in migrants from Latin-America (126/3,483; 3.6 %, <em>p</em> < 0.001), while both type of disorders were more often reported in women (<em>p</em> < 0.001).</p><p>In the adjusted model, women (aOR: 1.5, [95 % CI 1.2–1.8, <em>p</em> < 0.001]), migrants with more than one visit to the health center during the study period (aOR: 4.4, [95 %CI 2.8–6.8, <em>p</em> < 0.001]) and who presented an infectious disease (aOR: 2.1, [95 %CI 1.5–3.1, <em>p</em> < 0.001]) had higher odds of having a mental disorder.</p><p>Lastly, out of the 1,840 migrants coming from a confl
东道国的移徙者面临心理健康状况发展的风险。本研究的两个目的是描述移民患者在初级卫生保健水平的常规精神障碍诊断和相关的危险因素,并通过评估卫生专业人员是否遵循临床决策支持系统(CDSS)工具提出的建议来检验创新移民心理健康评估的实用性。方法于2018年3月至12月在西班牙加泰罗尼亚4个非随机选择的卫生区域的8个初级保健中心(PCCs)进行横断面研究。从电子健康记录中提取基于国际疾病分类(第10版)的常规健康数据和精神健康诊断,包括精神、行为和神经发育障碍(F01-F99),涉及情绪状态的症状和体征(R45)和睡眠障碍(G47)。估计心理健康状况的比例,并使用逻辑回归模型来评估与心理健康障碍的任何可能关联。通过卫生专业人员对符合心理健康筛查标准(2017年发生积极冲突的原籍国)的移民进行问卷调查的比例和对筛查患者的诊断,评估了心理健康评估的效用。结果在研究期间访问任何PCCs的14,130名移民中,7,358名(52.1%)是女性,中位年龄为38.0岁。有520/14,130(3.7%)移民患者被诊断为精神障碍,在女性中更为常见(342/7,358;4.7%, p值<0.001),拉丁美洲移民(177/3,483;5.1%, p <0.001)和最近抵达西班牙的人(170/3,672;4.6%, p <0.001)。2017年,来自冲突国家的移民报告的精神障碍比例较低(116/3,669,3.2%,p = 0.053)。在520名患者报告的547项精神健康诊断中,69/14,130(0.5%)为情绪障碍,346/14,130(2.5%)为焦虑症,127/14,130(0.9%)为睡眠障碍。情绪障碍在东欧移民中更为常见(25/ 2971;0.8%, p <0.001)和拉丁美洲移民的焦虑症(126/3,483;3.6%, p <0.001),而这两种类型的疾病在女性中更为常见(p <0.001)。在调整后的模型中,女性(aOR: 1.5, [95% CI 1.2-1.8, p <0.001]),在研究期间多次前往卫生中心的移民(aOR: 4.4, [95% CI 2.8-6.8, p <0.001])和表现为传染病的患者(aOR: 2.1, [95% CI: 1.5-3.1, p <0.001])患精神障碍的几率更高。最后,在2017年来自冲突国家的1840名移民中,有29人(1.6%)在实施了CDSS工具的中心接受了心理健康评估,该工具正确识别了一个人。结论移民的心理健康状况在初级卫生保健中可能被忽视。必须加强这一级护理的干预措施,使其适应移徙者的需要和情况,以确保保健服务的公平性。
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引用次数: 0
Barriers and facilitators to HIV prevention and care for Venezuelan migrant/refugee women and girls in Colombia 哥伦比亚境内委内瑞拉移民/难民妇女和女孩艾滋病毒预防和护理的障碍和促进因素
IF 4.6 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-01-01 DOI: 10.1016/j.jmh.2023.100206
C. Correa-Salazar , J.J. Amon , K. Page , A.K. Groves , U. Bilal , Alejandra Vera , A. Martínez-Donate

Venezuelan migrant and refugee women and girls (VMRWG) face risks of exposure to and infection from HIV and threats of multiple forms of violence (including GBV) during and after migration. Yet, there is a lack of evidence on barriers and facilitators to VMRWGs’ access to HIV prevention and care services this population at all stages of their migration. We addressed this evidence gap by conducting a qualitative study composed of fifty-four semi-structured interviews with practitioners (n = 24) and VMRWG (n = 30) in the two largest receiving cities of migrants in Colombia. We sought to identify perceived barriers and facilitators to HIV prevention and care to inform policies and programmatic efforts. Analysis followed a theory-informed approach using the Socioecological Model. Findings describe multi-level barriers to access to HIV prevention and care related to discrimination, gender-based violence, rigid gender norms, lack of information and system fragmentation. Policies that integrate community-based networks and support intersectoral work are pivotal to breach the gaps between services and communities and develop a gender-sensitive approach that tackles the relationship between gender-based violence and HIV risk.

委内瑞拉移民和难民妇女和女孩(VMRWG)在移民期间和移民后面临接触和感染艾滋病毒的风险以及多种形式暴力(包括性别暴力)的威胁。然而,缺乏证据表明,在移民的各个阶段,这些人群获得艾滋病毒预防和护理服务的障碍和促进因素。我们通过对哥伦比亚两个最大的移民接收城市的从业者(n = 24)和VMRWG (n = 30)进行了54次半结构化访谈的定性研究,解决了这一证据差距。我们试图确定艾滋病毒预防和护理的感知障碍和促进因素,为政策和规划工作提供信息。分析采用了一种基于理论的方法,使用了社会生态学模型。调查结果描述了与歧视、基于性别的暴力、僵化的性别规范、缺乏信息和系统碎片化有关的获得艾滋病毒预防和护理的多层次障碍。整合社区网络和支持部门间工作的政策对于缩小服务与社区之间的差距,制定对性别问题敏感的办法,处理基于性别的暴力与艾滋病毒风险之间的关系至关重要。
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引用次数: 0
Qualitative assessment of the impacts of the COVID-19 pandemic on migration, access to healthcare, and social wellbeing among Venezuelan migrants and refugees in Colombia 对2019冠状病毒病大流行对哥伦比亚境内委内瑞拉移民和难民的移民、获得医疗保健和社会福利的影响进行定性评估
IF 4.6 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-01-01 DOI: 10.1016/j.jmh.2023.100187
Megan Stevenson , José Rafael Guillén , Kristin G. Bevilacqua , Sarah Arciniegas , Jennifer Ortíz , Jhon Jairo López , Jhon Fredy Ramírez , Miguel Barriga Talero , Cindy Quijano , Alejandra Vela , Yessenia Moreno , Francisco Rigual , Kathleen R Page , Paul B Spiegel , Ricardo Luque Núñez , Julián A. Fernández-Niño , Andrea L. Wirtz

Background

Colombia hosts a large number of Venezuelan migrants and refugees who are uniquely vulnerable and have been markedly impacted by the COVID-19 pandemic. It is necessary to understand their experiences to inform future policy decisions both in Colombia and during disease outbreaks in other humanitarian contexts in the future. As part of a larger study focused on HIV among Venezuelans residing in Colombia, qualitative interviews were conducted to understand this population's experiences and access to healthcare.

Methods

Interviews were conducted with Venezuelan migrants and refugees as well as stakeholders such as care providers, humanitarian workers, and government officials. Interviews were recorded, transcribed, and coded using thematic content analysis. Select quotes were translated and edited for length and/or clarity.

Results

Venezuelan migrants and refugees reported high levels of housing instability, job instability, increased barriers to accessing healthcare, and complications in engaging in the HIV care continuum, among other impacts of the COVID-19 pandemic. Stakeholders reported complications in provision of care and obtaining medicines, difficulty maintaining contact with patients, increased discrimination and xenophobia targeting Venezuelan migrants and refugees, increased housing instability among Venezuelan migrants and refugees, and other impacts as a result of the COVID-19 pandemic.

Conclusions

This study demonstrates the unique impacts of the COVID-19 pandemic among Venezuelans residing in Colombia by both compounding extant vulnerabilities and introducing new challenges, such as high rates of eviction. Colombia has enacted increasingly inclusive migration policies for Venezuelan refugees and migrants within the country; findings from this study underscore the necessity for such policies both in and outside of the Colombian context.

哥伦比亚收容了大量委内瑞拉移民和难民,他们特别脆弱,并受到COVID-19大流行的显著影响。有必要了解他们的经验,以便为今后在哥伦比亚和在其他人道主义情况下的疾病暴发期间的政策决定提供信息。作为一项针对居住在哥伦比亚的委内瑞拉人艾滋病毒的大型研究的一部分,进行了定性访谈,以了解这一人口的经历和获得医疗保健的情况。方法对委内瑞拉移民和难民以及护理提供者、人道主义工作者和政府官员等利益相关者进行访谈。使用主题内容分析对访谈进行记录、转录和编码。部分引用经过翻译和编辑,以确保长度和/或清晰度。结果委内瑞拉移民和难民报告说,2019冠状病毒病大流行的影响包括住房不稳定、工作不稳定、获得医疗保健的障碍增加以及参与艾滋病毒连续护理的并发症等。利益攸关方报告说,在提供护理和获取药物方面出现了并发症,难以与患者保持联系,针对委内瑞拉移民和难民的歧视和仇外情绪加剧,委内瑞拉移民和难民的住房不稳定加剧,以及COVID-19大流行造成的其他影响。本研究表明,COVID-19大流行对居住在哥伦比亚的委内瑞拉人产生了独特的影响,既加剧了现有的脆弱性,也带来了新的挑战,如高驱逐率。哥伦比亚为委内瑞拉境内的难民和移民制定了越来越具有包容性的移民政策;这项研究的结果强调了在哥伦比亚境内和境外实施这种政策的必要性。
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引用次数: 2
COVID-19 vaccines, mobility, and pandemic bureaucracies: Undocumented migrants’ perspectives from Italy's Alpine border COVID-19疫苗、流动性和大流行官僚机构:来自意大利阿尔卑斯山边境的无证移民的视角
IF 4.6 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-01-01 DOI: 10.1016/j.jmh.2023.100189
Costanza Torre, Elizabeth Storer

While scholars have noted the deeply unequal effects of the pandemic containment, there has been limited attempt to map the socio-political lives of vaccination policies, particularly from the perspective of undocumented persons moving at state margins. This paper explores how undocumented migrants, who were predominantly male travellers attempting to cross Italy's Alpine borders, encountered Covid-19 vaccines and contemporary legislation. Based on ethnographic observations and qualitative interviews with migrants, doctors, and activists at safehouses both on the Italian and French sides of the Alpine border, we trace how mobility centred decisions to accept or reject vaccines were significantly shaped by exclusionary border regimes. We move beyond the exceptional focus of the Covid-19 pandemic to show how centring visions of health connected to viral risk diverted attention from migrants’ wider struggles to move to obtain safety. Ultimately, we argue for a recognition of how health crises are not merely unequally experienced, but may result in the reconfiguration of violent governance practices at state borders.

虽然学者们已经注意到大流行控制的严重不平等影响,但很少有人尝试绘制疫苗接种政策的社会政治生活地图,特别是从在州边缘移动的无证人员的角度。本文探讨了试图跨越意大利阿尔卑斯山边境的无证移民(主要是男性旅行者)如何遇到Covid-19疫苗和当代立法。根据民族志观察和对阿尔卑斯山边境意大利和法国一侧安全避难所的移民、医生和活动家的定性访谈,我们追踪了以流动性为中心的接受或拒绝疫苗的决定是如何受到排斥性边境制度的重大影响的。我们超越了对Covid-19大流行的特殊关注,展示了将健康与病毒风险联系起来的中心愿景如何转移了人们对移民为获得安全而进行的更广泛斗争的注意力。最后,我们主张认识到卫生危机不仅经历不平等,而且可能导致国家边界暴力治理实践的重新配置。
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引用次数: 0
Turning up the heat: A conceptual model for understanding the migration and health in the context of global climate change 打开暖气:一个理解全球气候变化背景下移民和健康的概念模型
IF 4.6 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-01-01 DOI: 10.1016/j.jmh.2023.100172
Aqsa Khalid , Jabran Ali Babry , Jo Vearey , Dominik Zenner
<div><h3>Background</h3><p>The triangular relationship between climate change-related events, patterns of human migration and their implications for health is an important yet understudied issue. To improve understanding of this complex relationship, a comprehensive, interdisciplinary conceptual model will be useful. This paper investigates relationships between these factors and considers their impacts for affected populations globally.</p></div><div><h3>Methods</h3><p>A desk review of key literature was undertaken. An open-ended questionnaire consisting of 11 items was designed focusing on three themes: predicting population migration by understanding key variables, health implications, and suggestions on policy and research. After using purposive sampling we selected nine experts, reflecting diverse regional and professional backgrounds directly related to our research focus area. All responses were thematically analysed and key themes from the survey were synthesised to construct the conceptual model focusing on describing the relationship between global climate change, migration and health implications and a second model focusing on actionable suggestions for organisations working in the field, academia and policymakers.</p></div><div><h3>Results</h3><p>Key themes which constitute our conceptual model included: a description of migrant populations perceived to be at risk; health characteristics associated with different migratory patterns; health implications for both migrants and host populations; the responsibilities of global and local governance actors; and social and structural determinants of health. Less prominent themes were aspects related to slow-onset migratory patterns, voluntary stay, and voluntary migration. Actionable suggestions include an interdisciplinary and innovative approach to study the phenomenon for academicians, preparedness and globalized training and awareness for field organisations and migrant inclusive and climate sensitive approach for policymakers.</p></div><div><h3>Conclusion</h3><p>Contrary to common narratives, participants framed the impacts of climate change-related events on migration patterns and their health implications as non-linear and indirect, comprising many interrelated individual, social, cultural, demographic, geographical, structural, and political determinants. An understanding of these interactions in various contexts is essential for risk reduction and preventative measures. The way forward broadly includes inclusive and equity-based health services, improved and faster administrative systems, less restrictive (im)migration policies, globally trained staff, efficient and accessible research, and improved emergency response capabilities. The focus should be to increase preventative and adaptation measures in the face of any environmental changes and respond efficiently to different phases of migration to aim for better “health for all and promote universal well-being” (WHO) (<span>World He
气候变化相关事件、人类移徙模式及其对健康的影响之间的三角关系是一个重要但尚未得到充分研究的问题。为了提高对这种复杂关系的理解,一个全面的、跨学科的概念模型将是有用的。本文研究了这些因素之间的关系,并考虑了它们对全球受影响人口的影响。方法对关键文献进行桌面复习。设计了一份包含11个项目的开放式问卷,重点关注三个主题:通过理解关键变量预测人口迁移、健康影响以及对政策和研究的建议。通过有目的的抽样,我们选择了9位专家,他们反映了与我们的研究重点领域直接相关的不同地区和专业背景。对所有答复进行了主题分析,并综合了调查中的关键主题,构建了一个概念模型,重点是描述全球气候变化、移民和健康影响之间的关系,第二个模型侧重于为在该领域工作的组织、学术界和政策制定者提供可操作的建议。结果构成我们概念模型的关键主题包括:对被认为处于危险中的移民人口的描述;与不同移徙模式有关的健康特征;对移徙者和东道国人口的健康影响;全球和地方治理行动者的责任;以及健康的社会和结构决定因素。较不突出的主题是与缓慢开始的移徙模式、自愿停留和自愿移徙有关的方面。可行的建议包括为学者提供跨学科和创新的方法来研究这一现象,为实地组织提供准备和全球化培训和意识,为政策制定者提供包容移民和气候敏感的方法。与常见叙述相反,与会者将气候变化相关事件对移徙模式及其健康影响定义为非线性和间接的,包括许多相互关联的个人、社会、文化、人口、地理、结构和政治决定因素。了解各种情况下的这些相互作用对于减少风险和采取预防措施至关重要。前进的道路包括广泛的包容性和基于公平的卫生服务,改进和更快的行政系统,限制性更少的移民政策,全球培训的工作人员,高效和可获得的研究以及改进的应急响应能力。重点应是在面对任何环境变化时加强预防和适应措施,并对移徙的不同阶段作出有效反应,以实现更好的"人人享有健康和促进普遍福祉"(卫生组织,1999年)。
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引用次数: 0
The role of legal status and uncertainty in the reproductive aspirations of 1.5 and second generation Mexican-origin immigrant young women: An exploratory study 法律地位和不确定性在1.5代和第二代墨西哥裔年轻女性生育愿望中的作用:一项探索性研究
IF 4.6 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-01-01 DOI: 10.1016/j.jmh.2023.100156
Kate Coleman-Minahan , Melissa Villarreal , Goleen Samari

Background

The 1.5 generation, brought to the U.S. prior to age 16, faces barriers that the second generation, U.S.-born to immigrant parents, does not, including only temporary legal protection through the Deferred Action for Childhood Arrivals (DACA) Program. Little is known about how legal status and uncertainty shape cisgender immigrant young women's reproductive aspirations.

Methods

Drawing on the Theory of Conjunctural Action with attention to the immigrant optimism and bargain hypotheses, we conducted an exploratory qualitative study using semi-structured interviews with seven 1.5 generation DACA recipients and eleven second generation Mexican-origin women, 21-33 years old in 2018. Interviews focused on reproductive and life aspirations, migration experiences, and childhood and current economic disadvantage. We conducted a thematic analysis using a deductive and inductive approach.

Results

Data resulted in a conceptual model on the pathways through which uncertainty and legal status shape reproductive aspirations. Participants aspired to complete higher education and have a fulfilling career, financial stability, a stable partnership, and parents’ support prior to considering childbearing. For the 1.5 generation, uncertainty of their legal status makes the thought of parenting feel scary, while for the second generation, the legal status of their parents makes parenting feel scary. Achieving desired stability before childbearing is more challenging and uncertain for the 1.5 generation.

Conclusions

Temporary legal status constrains young women's reproductive aspirations by limiting their ability to achieve desired forms of stability prior to parenting and making the thought of parenting frightening. More research is needed to further develop this novel conceptual model.

在16岁之前被带到美国的1.5代移民面临着第二代移民父母在美国出生的障碍,包括通过“童年入境暂缓遣返计划”(DACA)获得的临时法律保护。对于法律地位和不确定性如何影响顺性别移民年轻女性的生育愿望,人们知之甚少。方法基于联合行动理论,结合移民乐观主义和讨价还价假说,2018年对7名1.5代DACA接受者和11名21-33岁的第二代墨西哥裔女性进行了半结构化访谈,进行了探索性质的研究。访谈的重点是生育和生活愿望、移民经历、童年和目前的经济劣势。我们用演绎和归纳的方法进行了主题分析。结果数据产生了一个关于不确定性和法律地位影响生育愿望的途径的概念模型。参与者希望在考虑生育之前完成高等教育,拥有一份令人满意的职业、稳定的经济状况、稳定的伴侣关系和父母的支持。对于1.5代来说,法律地位的不确定性让育儿的想法变得可怕,而对于2代来说,父母的法律地位让育儿变得可怕。对于第1.5代来说,在生育前实现理想的稳定性更具挑战性和不确定性。结论临时法律地位限制了年轻女性在生育前获得所需稳定形式的能力,并使生育的想法变得可怕,从而限制了她们的生育愿望。需要更多的研究来进一步发展这一新的概念模型。
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引用次数: 0
Are migrants diagnosed with a trauma-related disorder at risk of premature mortality? A register-based cohort study in Denmark 被诊断患有创伤相关疾病的移民是否有过早死亡的风险?丹麦基于登记的队列研究
IF 4.6 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-01-01 DOI: 10.1016/j.jmh.2023.100197
Line Bager , Esben Agerbo , Niels Skipper , Janne Tidselbak Larsen , Thomas Munk Laursen

Background

Mental illness is common among refugees displaced by conflict and war. While evidence points to the relatively good health in terms of longevity of migrants resettled in the destination country, less is known about the mortality of the most vulnerable migrants with a trauma-related diagnosis alone and those with an additional comorbid psychotic disorder. This study aimed to provide an overview of the number and mortality of foreign-born individuals diagnosed with Post-Traumatic Stress Disorder or Enduring Personality Change after a Catastrophic Event (PTSD/EPCACE), a psychotic disorder or both.

Methods

A nationwide register-based cohort study, including residents in Denmark, followed from 1 January 1995 to 31 December 2016. The exposure was PTSD/EPCACE and psychotic disorders as well as region of origin. Relative all-cause mortality was estimated using Cox proportional hazards regression models and calculated for migrants with one or both groups of disorders compared to those from the same region without the disorder.

Results

During the study period, 6,580,000 individuals (50.4% women) were included in the cohort. Of these 1,249,654 (50.5% women) died during follow-up. For men and women from the former Yugoslavia, the Middle East and Northern Africa, a PTSD/EPCACE diagnosis alone or with comorbid psychotic disorder was not associated with increased mortality after adjusting for region of origin. A psychotic disorder alone, however, was associated with an increased mortality rate.

Conclusion

Despite the severity of many refugees’ traumatic experiences, a diagnosis of a trauma-related psychiatric disorder did not appear to increase the mortality rates.

背景精神疾病在因冲突和战争而流离失所的难民中很常见。虽然有证据表明,在目的地国重新安置的移民的健康状况相对较好,但对仅被诊断为创伤相关的最脆弱移民和患有其他共病精神病的移民的死亡率知之甚少。本研究旨在概述外国出生的被诊断为创伤后应激障碍或灾难性事件后持续人格变化(PTSD/EPCACE)、精神病或两者兼有的个体的数量和死亡率。方法1995年1月1日至2016年12月31日,对丹麦居民进行全国性的基于登记的队列研究。暴露是PTSD/EPCACE和精神病性障碍以及起源地区。使用Cox比例风险回归模型估计相对全因死亡率,并计算患有一组或两组疾病的移民与来自同一地区的无疾病移民的相对全因死亡人数。结果在研究期间,6580000人(50.4%的女性)被纳入队列。其中1249654人(50.5%为女性)在随访期间死亡。对于来自前南斯拉夫、中东和北非的男性和女性来说,在调整了原籍地区后,单独诊断PTSD/EPCACE或伴有合并症精神病与死亡率增加无关。然而,单独的精神障碍与死亡率的增加有关。结论尽管许多难民的创伤经历很严重,但对创伤相关精神障碍的诊断似乎并没有增加死亡率。
{"title":"Are migrants diagnosed with a trauma-related disorder at risk of premature mortality? A register-based cohort study in Denmark","authors":"Line Bager ,&nbsp;Esben Agerbo ,&nbsp;Niels Skipper ,&nbsp;Janne Tidselbak Larsen ,&nbsp;Thomas Munk Laursen","doi":"10.1016/j.jmh.2023.100197","DOIUrl":"10.1016/j.jmh.2023.100197","url":null,"abstract":"<div><h3>Background</h3><p>Mental illness is common among refugees displaced by conflict and war. While evidence points to the relatively good health in terms of longevity of migrants resettled in the destination country, less is known about the mortality of the most vulnerable migrants with a trauma-related diagnosis alone and those with an additional comorbid psychotic disorder. This study aimed to provide an overview of the number and mortality of foreign-born individuals diagnosed with Post-Traumatic Stress Disorder or Enduring Personality Change after a Catastrophic Event (PTSD/EPCACE), a psychotic disorder or both.</p></div><div><h3>Methods</h3><p>A nationwide register-based cohort study, including residents in Denmark, followed from 1 January 1995 to 31 December 2016. The exposure was PTSD/EPCACE and psychotic disorders as well as region of origin. Relative all-cause mortality was estimated using Cox proportional hazards regression models and calculated for migrants with one or both groups of disorders compared to those from the same region without the disorder.</p></div><div><h3>Results</h3><p>During the study period, 6,580,000 individuals (50.4% women) were included in the cohort. Of these 1,249,654 (50.5% women) died during follow-up. For men and women from the former Yugoslavia, the Middle East and Northern Africa, a PTSD/EPCACE diagnosis alone or with comorbid psychotic disorder was not associated with increased mortality after adjusting for region of origin. A psychotic disorder alone, however, was associated with an increased mortality rate.</p></div><div><h3>Conclusion</h3><p>Despite the severity of many refugees’ traumatic experiences, a diagnosis of a trauma-related psychiatric disorder did not appear to increase the mortality rates.</p></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"8 ","pages":"Article 100197"},"PeriodicalIF":4.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/76/bd/main.PMC10365948.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9882257","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}
引用次数: 0
Anticipating environmental losses: Effects on place attachment and intentions to move 预期环境损失:对地方依恋和迁移意图的影响
IF 4.6 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-01-01 DOI: 10.1016/j.jmh.2023.100152
Zoe Leviston , Justine Dandy , Pierre Horwitz , Deirdre Drake

Environmental change is often accompanied by non-tangible, non-economic losses, including loss of valued attributes, connection to place, and social cohesion through migration in the face of such changes. Over two studies we sought to test whether imagining the loss of valued environmental characteristics influences intentions to migrate elsewhere and/or engage in place-protective actions, and whether this can be accounted for by changes to place attachment, using the city of Perth, Western Australia as a case study. In Study 1 (N = 148) we found imagined environmental loss significantly increased intentions to move away, and significantly decreased place attachment. There was no influence of imagining loss on place-protective action intentions. We replicated these findings in a representative community sample (Study 2: N = 333). In addition, we found that changes to moving intentions and place attachment related to the type of valued characteristic imagined loss, with characteristics that went beyond the explicitly environmental to encompass social relationships and lifestyle dimensions related to a tendency to stay, and lower reductions to place attachment. The implications of these findings include the inseparability of responses to environmental changes and perceptions of socio-cultural loss.

环境变化往往伴随着无形的、非经济的损失,包括在面对这种变化时因移民而丧失有价值的属性、与地方的联系和社会凝聚力。在两项研究中,我们试图测试想象失去有价值的环境特征是否会影响迁移到其他地方和/或参与地方保护行动的意图,以及这是否可以通过地方依恋的变化来解释,以西澳大利亚州珀斯市为例研究。在研究1 (N = 148)中,我们发现想象中的环境损失显著增加了迁移的意愿,显著降低了地方依恋。想象丧失对地点保护行为意图没有影响。我们在一个有代表性的社区样本中重复了这些发现(研究2:N = 333)。此外,我们发现迁移意图和地点依恋的变化与价值特征想象损失的类型有关,其特征超越了明确的环境,包括与留下来倾向相关的社会关系和生活方式维度,并且降低了对地点依恋的减少。这些发现的含义包括对环境变化的反应和对社会文化损失的看法是不可分割的。
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引用次数: 0
Socio-ecological barriers to access COVID-19 vaccination among Burmese irregular migrant workers in Thailand 在泰国的缅甸非正规移民工人获得新冠肺炎疫苗接种的社会生态障碍
IF 4.6 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-01-01 DOI: 10.1016/j.jmh.2023.100194
Tual Sawn Khai

Thailand is a migration hub in ASEAN (Association of Southeast Asian Nations), with more than 3.9 million migrant workers, accounting for 10% of the country's workforce. The government of Thailand has moved from a pandemic to an endemic state of living with the SAR-CoV2 virus as a new normal since over half of the population has been vaccinated. There is, however, an estimated 1.3 million irregular migrant workers in Thailand who are not covered by Social Security Schemes (SSS) and are likely to have not been vaccinated. This study examines the socio-ecological barriers to accessing vaccination among Burmese irregular migrant workers in Thailand. Qualitative and quantitative data were collected from NGO (Non-Government Organizations) workers and Burmese irregular migrants through an online survey and in-depth interviews. The study reported that over 90% of Burmese irregular migrants were unvaccinated. The main reasons for the low vaccination rate include exclusion from the vaccine distribution program, high cost of the vaccine, perceived low quality of vaccine, language barriers, lack of vaccine information, private and public discrimination against migrants, fear of being detained and deported, and difficulties in finding time and transportation to go to vaccination centres. The Thai government should employ culturally competent interpreters to disseminate vaccine information and potential side effects to encourage vaccinations in order to prevent further casualties and curb the global health crisis. Moreover, it is imperative that the Thai government provide free vaccines to all immigrants regardless of their status and amnesty from deportation and detention during the vaccination period.

泰国是东盟(东南亚国家联盟)的移民中心,有390多万移民工人,占该国劳动力的10%。自从超过一半的人口接种了疫苗以来,泰国政府已经从新冠肺炎疫情转变为严重急性呼吸系统综合征冠状病毒2型的流行状态。然而,据估计,泰国有130万非正规移民工人不在社会保障计划的范围内,他们可能没有接种疫苗。这项研究考察了在泰国的缅甸非正规移民工人获得疫苗接种的社会生态障碍。通过在线调查和深入访谈,从非政府组织工作人员和缅甸非正规移民那里收集了定性和定量数据。该研究报告称,超过90%的缅甸非正规移民未接种疫苗。疫苗接种率低的主要原因包括被排除在疫苗分发计划之外、疫苗成本高、疫苗质量低、语言障碍、缺乏疫苗信息、对移民的私人和公共歧视、担心被拘留和驱逐出境,以及难以找到前往疫苗接种中心的时间和交通工具。泰国政府应雇佣具有文化能力的口译员传播疫苗信息和潜在副作用,鼓励接种疫苗,以防止进一步的伤亡,遏制全球健康危机。此外,泰国政府必须向所有移民提供免费疫苗,无论他们的身份如何,并在疫苗接种期间免于驱逐和拘留。
{"title":"Socio-ecological barriers to access COVID-19 vaccination among Burmese irregular migrant workers in Thailand","authors":"Tual Sawn Khai","doi":"10.1016/j.jmh.2023.100194","DOIUrl":"10.1016/j.jmh.2023.100194","url":null,"abstract":"<div><p>Thailand is a migration hub in ASEAN (Association of Southeast Asian Nations), with more than 3.9 million migrant workers, accounting for 10% of the country's workforce. The government of Thailand has moved from a pandemic to an endemic state of living with the SAR-CoV2 virus as a new normal since over half of the population has been vaccinated. There is, however, an estimated 1.3 million irregular migrant workers in Thailand who are not covered by Social Security Schemes (SSS) and are likely to have not been vaccinated. This study examines the socio-ecological barriers to accessing vaccination among Burmese irregular migrant workers in Thailand. Qualitative and quantitative data were collected from NGO (Non-Government Organizations) workers and Burmese irregular migrants through an online survey and in-depth interviews. The study reported that over 90% of Burmese irregular migrants were unvaccinated. The main reasons for the low vaccination rate include exclusion from the vaccine distribution program, high cost of the vaccine, perceived low quality of vaccine, language barriers, lack of vaccine information, private and public discrimination against migrants, fear of being detained and deported, and difficulties in finding time and transportation to go to vaccination centres. The Thai government should employ culturally competent interpreters to disseminate vaccine information and potential side effects to encourage vaccinations in order to prevent further casualties and curb the global health crisis. Moreover, it is imperative that the Thai government provide free vaccines to all immigrants regardless of their status and amnesty from deportation and detention during the vaccination period.</p></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"8 ","pages":"Article 100194"},"PeriodicalIF":4.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/86/48/main.PMC10292913.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9744792","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}
引用次数: 3
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Journal of Migration and Health
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