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Care and decision-making at the end of life for migrants living in the Netherlands: An intersectional analysis
IF 3.9 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-01-01 DOI: 10.1016/j.jmh.2024.100293
Marieke Torensma , Xanthe de Voogd , Roukayya Oueslati , Irene G.M. van Valkengoed , Dick L. Willems , Bregje D. Onwuteaka-Philipsen , Jeanine L. Suurmond
As migrant populations age, the care system is confronted with the question how to respond to care needs of an increasingly diverse population of older adults. We used qualitative intersectional analysis to examine differential preferences and experiences with care at the end of life of twenty-five patients and their relatives from Suriname, Morocco and Turkey living in The Netherlands. Our analysis focused on the question how – in light of impairment – ethnicity, religion and gender intersect to create differences in social position that shape preferences and experiences related to three main themes: place of care at the end of life; discussing prognosis, advance care, and end-of-life care; and, end-of-life decision-making.
Our findings show that belonging to an ethnic or religious minority brings forth concerns about responsive care. In the nursing home, patients’ minority position and the interplay thereof with gender make it difficult for female patients to request and receive responsive care. Patients with a strong religious affiliation prefer to discuss diagnosis but not prognosis. These preferences are at interplay with factors related to socioeconomic status. The oversight of this variance hampers responsive care for patients and relatives. Preferences for discussion of medical aspects of care are subject to functional impairment and faith. Personal values and goals often remain unexpressed. Lastly, preferences regarding medical end-of-life decisions are foremost subject to religious affiliation and associated moral values. Respondents’ impairment and limited Dutch language proficiency requires their children to be involved in decision-making. Intersecting gendered care roles determine that mostly daughters are involved.
Considering the interplay of aspects of social identity and their effect on social positioning, and pro-active enquiry into values, goals and preferences for end-of-life care of patients and their relatives are paramount to achieve person centred and family-oriented care responsive to the needs of diverse communities.
{"title":"Care and decision-making at the end of life for migrants living in the Netherlands: An intersectional analysis","authors":"Marieke Torensma ,&nbsp;Xanthe de Voogd ,&nbsp;Roukayya Oueslati ,&nbsp;Irene G.M. van Valkengoed ,&nbsp;Dick L. Willems ,&nbsp;Bregje D. Onwuteaka-Philipsen ,&nbsp;Jeanine L. Suurmond","doi":"10.1016/j.jmh.2024.100293","DOIUrl":"10.1016/j.jmh.2024.100293","url":null,"abstract":"<div><div>As migrant populations age, the care system is confronted with the question how to respond to care needs of an increasingly diverse population of older adults. We used qualitative intersectional analysis to examine differential preferences and experiences with care at the end of life of twenty-five patients and their relatives from Suriname, Morocco and Turkey living in The Netherlands. Our analysis focused on the question how – in light of impairment – ethnicity, religion and gender intersect to create differences in social position that shape preferences and experiences related to three main themes: place of care at the end of life; discussing prognosis, advance care, and end-of-life care; and, end-of-life decision-making.</div><div>Our findings show that belonging to an ethnic or religious minority brings forth concerns about responsive care. In the nursing home, patients’ minority position and the interplay thereof with gender make it difficult for female patients to request and receive responsive care. Patients with a strong religious affiliation prefer to discuss diagnosis but not prognosis. These preferences are at interplay with factors related to socioeconomic status. The oversight of this variance hampers responsive care for patients and relatives. Preferences for discussion of medical aspects of care are subject to functional impairment and faith. Personal values and goals often remain unexpressed. Lastly, preferences regarding medical end-of-life decisions are foremost subject to religious affiliation and associated moral values. Respondents’ impairment and limited Dutch language proficiency requires their children to be involved in decision-making. Intersecting gendered care roles determine that mostly daughters are involved.</div><div>Considering the interplay of aspects of social identity and their effect on social positioning, and pro-active enquiry into values, goals and preferences for end-of-life care of patients and their relatives are paramount to achieve person centred and family-oriented care responsive to the needs of diverse communities.</div></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"11 ","pages":"Article 100293"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11780154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068438","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
Syrian refugee and diaspora healthcare professionals: Case studies from the eastern mediterranean and European regions
IF 3.9 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-01-01 DOI: 10.1016/j.jmh.2024.100298
Aula Abbara , Munzer Alkhalil , Kinan Wihba , Omer Abdrabbuh , Diana Rayes , Andrew Ghobrial , Manar Marzouk , Fadi Halabi , Mahmoud Hariri , Abdulkarim Ekzayez
Thousands of Syrian healthcare professionals have been forced to leave Syria since the onset of the uprisings in March 2011 and subsequent descent into conflict. Initially, many stayed in the eastern mediterranean region; however, as the conflict became increasingly protracted and employment policies for Healthcare Professionals (HCPs) became increasingly restrictive, some moved elsewhere, particularly to Germany and the United Kingdom, both of which have aimed to capitalise on both refugee and diaspora HCPs to support human resources gaps in their health systems. Our aim is to explore the different policy practices towards Syrian refugee and diaspora HCPs in the eastern mediterranean and European regions. Methods: We completed a narrative literature review and held a closed, virtual workshop in November 2022 in which 45 participants, most of whom had lived experience in the different refugee hosting contexts, participated. This allowed us to probe the primary themes arising from the literature review and the authors’ observations and present our findings as case studies. Results: We explore through case studies from countries near Syria (Turkey, Lebanon, Jordan, Egypt) and in Europe (Germany, UK) different policies which support or restrict entry into the health workforce. For host countries, those which implement policies that support retraining, accreditation and entry into the workforce have the potential for sustained and cost-effective benefit to their health systems; the impact of this on the HCPs and health system needs further exploration. Without such policies, Syrian HCPs are forced to work in the informal health sector such as in Lebanon or Egypt, leading to potential exploitation and security risks. Discussion: Now is an important opportunity to support Syrian and other refugee HCPs who have been forced to leave their homes to capitalise on their skills to explore the impacts of potentially effective policies and interventions. Such policies that aim to invest in refugee HCPs’ skills, further develop their aptitudes, and potentially establish a connection between them and their homeland in a mutually beneficial manner for both health systems in exile and in their homeland. Nonetheless, this topic still has large research gaps and remains in need of urgent research and data, particularly in view of the fall of the Syrian regime in December 2024 and its potential impacts.
{"title":"Syrian refugee and diaspora healthcare professionals: Case studies from the eastern mediterranean and European regions","authors":"Aula Abbara ,&nbsp;Munzer Alkhalil ,&nbsp;Kinan Wihba ,&nbsp;Omer Abdrabbuh ,&nbsp;Diana Rayes ,&nbsp;Andrew Ghobrial ,&nbsp;Manar Marzouk ,&nbsp;Fadi Halabi ,&nbsp;Mahmoud Hariri ,&nbsp;Abdulkarim Ekzayez","doi":"10.1016/j.jmh.2024.100298","DOIUrl":"10.1016/j.jmh.2024.100298","url":null,"abstract":"<div><div>Thousands of Syrian healthcare professionals have been forced to leave Syria since the onset of the uprisings in March 2011 and subsequent descent into conflict. Initially, many stayed in the eastern mediterranean region; however, as the conflict became increasingly protracted and employment policies for Healthcare Professionals (HCPs) became increasingly restrictive, some moved elsewhere, particularly to Germany and the United Kingdom, both of which have aimed to capitalise on both refugee and diaspora HCPs to support human resources gaps in their health systems. Our aim is to explore the different policy practices towards Syrian refugee and diaspora HCPs in the eastern mediterranean and European regions. Methods: We completed a narrative literature review and held a closed, virtual workshop in November 2022 in which 45 participants, most of whom had lived experience in the different refugee hosting contexts, participated. This allowed us to probe the primary themes arising from the literature review and the authors’ observations and present our findings as case studies. Results: We explore through case studies from countries near Syria (Turkey, Lebanon, Jordan, Egypt) and in Europe (Germany, UK) different policies which support or restrict entry into the health workforce. For host countries, those which implement policies that support retraining, accreditation and entry into the workforce have the potential for sustained and cost-effective benefit to their health systems; the impact of this on the HCPs and health system needs further exploration. Without such policies, Syrian HCPs are forced to work in the informal health sector such as in Lebanon or Egypt, leading to potential exploitation and security risks. Discussion: Now is an important opportunity to support Syrian and other refugee HCPs who have been forced to leave their homes to capitalise on their skills to explore the impacts of potentially effective policies and interventions. Such policies that aim to invest in refugee HCPs’ skills, further develop their aptitudes, and potentially establish a connection between them and their homeland in a mutually beneficial manner for both health systems in exile and in their homeland. Nonetheless, this topic still has large research gaps and remains in need of urgent research and data, particularly in view of the fall of the Syrian regime in December 2024 and its potential impacts.</div></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"11 ","pages":"Article 100298"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143101963","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
Migrant parent-child separation in the first three years of life and mental health problems at preschool age: A cross-sectional study 出生后头三年的移民亲子分离与学龄前的心理健康问题:横断面研究
IF 3.9 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-01-01 DOI: 10.1016/j.jmh.2025.100310
Hailati Akezhuoli , Minghui Tan , Yuyin Ma , Xintian Liu , Jiayao Xu , Jingjing Lu , Xudong Zhou

Background

Parent-child separation is one of the adverse childhood experiences, becoming more common due to economic migration worldwide today. However, there is a lack of understanding of the association between this separation during the critical first three years of life and the development of mental health issues in early childhood. This study aimed to determine the association of parent-child separation in the first three years and its specific patterns with mental health problems that emerged at preschool age.

Methods

We conducted a kindergarten-based parent-reported questionnaire survey in Nanling, Anhui Province, from October 30 to November 3, 2023. Data on parent-child separation in the first three years and its specific patterns concerning parental number, gender, accumulated separation period, and present separation status at preschool age were collected. The parent version of the Strengths and Difficulties Questionnaire (SDQ) was adopted to assess outcomes of interest, including children's total difficulties, internalizing problems, externalizing problems, and pro-social behaviors.

Results

A total of 7487 children from eighty-one kindergartens were included, with a mean (SD) age of 4.2 (0.92) years, and 52.3 % were male. After adjusting for socio-demographic characteristics, compared to non-separation, parent-child separation within the first three years was significantly and positively associated with preschool-aged children's internalizing problems (β = 0.19, [95 % CI, 0.10-0.28]), externalizing problems (β = 0.24, [95 % CI, 0.12- 0.35]), and total difficulties (β = 0.42, [95 % CI, 0.25-0.59]), but not with pro-social behavior. The associations were significant when separated from either one parent or both parents, whether the separation lasted for less than or more than three years in total, and whether the separation occurred previously or persisted into preschool age.

Conclusions

Our findings illustrated the association between early parent-child separation and developing mental health in early childhood, indicating potential opportunities for cost-efficient prevention and intervention for the health and development of vulnerable children separated in the highly mobile society to achieve sustainable development.
{"title":"Migrant parent-child separation in the first three years of life and mental health problems at preschool age: A cross-sectional study","authors":"Hailati Akezhuoli ,&nbsp;Minghui Tan ,&nbsp;Yuyin Ma ,&nbsp;Xintian Liu ,&nbsp;Jiayao Xu ,&nbsp;Jingjing Lu ,&nbsp;Xudong Zhou","doi":"10.1016/j.jmh.2025.100310","DOIUrl":"10.1016/j.jmh.2025.100310","url":null,"abstract":"<div><h3>Background</h3><div>Parent-child separation is one of the adverse childhood experiences, becoming more common due to economic migration worldwide today. However, there is a lack of understanding of the association between this separation during the critical first three years of life and the development of mental health issues in early childhood. This study aimed to determine the association of parent-child separation in the first three years and its specific patterns with mental health problems that emerged at preschool age.</div></div><div><h3>Methods</h3><div>We conducted a kindergarten-based parent-reported questionnaire survey in Nanling, Anhui Province, from October 30 to November 3, 2023. Data on parent-child separation in the first three years and its specific patterns concerning parental number, gender, accumulated separation period, and present separation status at preschool age were collected. The parent version of the Strengths and Difficulties Questionnaire (SDQ) was adopted to assess outcomes of interest, including children's total difficulties, internalizing problems, externalizing problems, and pro-social behaviors.</div></div><div><h3>Results</h3><div>A total of 7487 children from eighty-one kindergartens were included, with a mean (SD) age of 4.2 (0.92) years, and 52.3 % were male. After adjusting for socio-demographic characteristics, compared to non-separation, parent-child separation within the first three years was significantly and positively associated with preschool-aged children's internalizing problems (β = 0.19, [95 % CI, 0.10-0.28]), externalizing problems (β = 0.24, [95 % CI, 0.12- 0.35]), and total difficulties (β = 0.42, [95 % CI, 0.25-0.59]), but not with pro-social behavior. The associations were significant when separated from either one parent or both parents, whether the separation lasted for less than or more than three years in total, and whether the separation occurred previously or persisted into preschool age.</div></div><div><h3>Conclusions</h3><div>Our findings illustrated the association between early parent-child separation and developing mental health in early childhood, indicating potential opportunities for cost-efficient prevention and intervention for the health and development of vulnerable children separated in the highly mobile society to achieve sustainable development.</div></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"11 ","pages":"Article 100310"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143395060","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
Time in the United States and walking for physical activity among Black Californians: Findings from the California Health Interview Survey (2012–2017)
IF 3.9 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-01-01 DOI: 10.1016/j.jmh.2025.100315
Kougang Anne Mbe , Mark Fedyk , Sheryl L. Catz , Christiana Drake , Julie T. Bidwell , Janice F Bell

Background

No studies examine associations between acculturation and physical activity (PA) in California's foreign-born Black population, even though rates of PA are lower in Black populations, lower PA rates are a risk for cardiovascular disease, and this population is growing. Further, despite differences in CVD and PA by sex and mental health status; no studies have examined whether these factors modify associations between acculturation and PA.

Methods

We used the California Health Interview Survey (2012–2017) and fully adjusted, survey-weighted regression models to examine associations between time in the US as a proxy for acculturation (i.e., foreign-born <10 years in the US, foreign-born ≥10 years in the US) and walking for PA [leisure time (LTPA) and transportation-related (TRPA)] among Black Californians (n = 5,952). We also tested effect modification by sex and mental health status.

Results

About 7 % in the sample were foreign-born. In the adjusted model of TRPA, the odds of walking for PA were significantly higher in the foreign-born group living <10 years in the US (OR = 8.63; 95 %CI: 2.49, 29.86; p < 0.01) and no different in the foreign-born group living ≥10 years in the US (OR = 1.05; 95 % CI: 0.62, 1.75; p = 0.85), compared to US-born Black Californians. We found no effect modification of the associations by sex or mental health, except by frequency of feeling depressed.

Conclusion

Some foreign-born Black Californians have higher odds of walking for PA related to transportation than their US-born counterparts. Future research is needed to examine the role of mental health status on PA levels of this immigrant group.
{"title":"Time in the United States and walking for physical activity among Black Californians: Findings from the California Health Interview Survey (2012–2017)","authors":"Kougang Anne Mbe ,&nbsp;Mark Fedyk ,&nbsp;Sheryl L. Catz ,&nbsp;Christiana Drake ,&nbsp;Julie T. Bidwell ,&nbsp;Janice F Bell","doi":"10.1016/j.jmh.2025.100315","DOIUrl":"10.1016/j.jmh.2025.100315","url":null,"abstract":"<div><h3>Background</h3><div>No studies examine associations between acculturation and physical activity (PA) in California's foreign-born Black population, even though rates of PA are lower in Black populations, lower PA rates are a risk for cardiovascular disease, and this population is growing. Further, despite differences in CVD and PA by sex and mental health status; no studies have examined whether these factors modify associations between acculturation and PA.</div></div><div><h3>Methods</h3><div>We used the California Health Interview Survey (2012–2017) and fully adjusted, survey-weighted regression models to examine associations between time in the US as a proxy for acculturation (i.e., foreign-born &lt;10 years in the US, foreign-born ≥10 years in the US) and walking for PA [leisure time (LTPA) and transportation-related (TRPA)] among Black Californians (<em>n</em> = 5,952). We also tested effect modification by sex and mental health status.</div></div><div><h3>Results</h3><div>About 7 % in the sample were foreign-born. In the adjusted model of TRPA, the odds of walking for PA were significantly higher in the foreign-born group living &lt;10 years in the US (OR = 8.63; 95 %CI: 2.49, 29.86; <em>p</em> &lt; 0.01) and no different in the foreign-born group living ≥10 years in the US (OR = 1.05; 95 % CI: 0.62, 1.75; <em>p</em> = 0.85), compared to US-born Black Californians. We found no effect modification of the associations by sex or mental health, except by frequency of feeling depressed.</div></div><div><h3>Conclusion</h3><div>Some foreign-born Black Californians have higher odds of walking for PA related to transportation than their US-born counterparts. Future research is needed to examine the role of mental health status on PA levels of this immigrant group.</div></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"11 ","pages":"Article 100315"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143419152","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
Determinants of HIV viral load suppression rates in Amhara region, Ethiopia with a large number of internally displaced people
IF 3.9 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-01-01 DOI: 10.1016/j.jmh.2025.100304
Gizachew Yismaw , Muluken Azage Yenesew , Tegegn Kebebaw , Leslie Hinyard , Asaminew Gizaw , Alemitu Mequanint , Christian Hendrix , Getahun Abate

Background

The Amhara region in Ethiopia has been affected by a war that led to displacement of millions of people. This study was conducted with the objectives of evaluating HIV viral suppression rates, assessing viral load (VL) testing turnaround time (TAT) and pilot testing of a new webapp to make VL results available in real time while the health system is affected by large numbers of internally displaced people (IDP).

Methods

Data was obtained from 7 HIV VL testing centers that serve 378 anti-retroviral treatment centers. Viral load (VL) suppression rates and VL result turnaround time (TAT) were used as markers of effectiveness of HIV control.

Findings

A total of 98,957 records were analyzed. Patients at three of the seven VL testing sites including Debre-Birehan Referral Hospital (aOR 1.87, 95 CI [1.63–2.14]), Debre-Markos Referral Hospital (aOR 1.76, 95 CI [1.61–1.93]) and University of Gonder (aOR 2.28, 95 CI [2.07–2.51]) had increased risk of virologic failure. TAT between the time VL results were available to the time results were mailed to treatment centers was ≤ 1 week for 61,148 (63.4%) and 2 weeks for 25,172 (26.1%) tests. TAT vary among the 7 VL testing centers.

Interpretation

In a region with large numbers of IDP, virologic failure is more common in older age groups. VL and TAT vary by testing centers which could be reflective of ART default and delay in courier mail driven by internal displacement.
{"title":"Determinants of HIV viral load suppression rates in Amhara region, Ethiopia with a large number of internally displaced people","authors":"Gizachew Yismaw ,&nbsp;Muluken Azage Yenesew ,&nbsp;Tegegn Kebebaw ,&nbsp;Leslie Hinyard ,&nbsp;Asaminew Gizaw ,&nbsp;Alemitu Mequanint ,&nbsp;Christian Hendrix ,&nbsp;Getahun Abate","doi":"10.1016/j.jmh.2025.100304","DOIUrl":"10.1016/j.jmh.2025.100304","url":null,"abstract":"<div><h3>Background</h3><div>The Amhara region in Ethiopia has been affected by a war that led to displacement of millions of people. This study was conducted with the objectives of evaluating HIV viral suppression rates, assessing viral load (VL) testing turnaround time (TAT) and pilot testing of a new webapp to make VL results available in real time while the health system is affected by large numbers of internally displaced people (IDP).</div></div><div><h3>Methods</h3><div>Data was obtained from 7 HIV VL testing centers that serve 378 anti-retroviral treatment centers. Viral load (VL) suppression rates and VL result turnaround time (TAT) were used as markers of effectiveness of HIV control.</div></div><div><h3>Findings</h3><div>A total of 98,957 records were analyzed. Patients at three of the seven VL testing sites including Debre-Birehan Referral Hospital (aOR 1.87, 95 CI [1.63–2.14]), Debre-Markos Referral Hospital (aOR 1.76, 95 CI [1.61–1.93]) and University of Gonder (aOR 2.28, 95 CI [2.07–2.51]) had increased risk of virologic failure. TAT between the time VL results were available to the time results were mailed to treatment centers was ≤ 1 week for 61,148 (63.4%) and 2 weeks for 25,172 (26.1%) tests. TAT vary among the 7 VL testing centers.</div></div><div><h3>Interpretation</h3><div>In a region with large numbers of IDP, virologic failure is more common in older age groups. VL and TAT vary by testing centers which could be reflective of ART default and delay in courier mail driven by internal displacement.</div></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"11 ","pages":"Article 100304"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143419153","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
The role of selected social and psychological factors in violence against Myanmar migrant women in Thailand.
IF 3.9 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-01-01 DOI: 10.1016/j.jmh.2025.100314
Kaung Zaw , Wirin Kittipichai , Kanittha Chamroonsawasdi , Arpaporn Powwattana

Introduction

Violence against women (VAW) is a serious human rights violation with significant implications for public health. VAW affects the well-being of women, children, and families. This cross-sectional study aimed to determine the structural relationship of a set of variables—attitude towards violence (ATT), self-esteem (SE), relationship with residential unit members (RES), social support (SS), and coping strategies (COP)- influencing VAW and to test the model using the empirical data.

Methods

The measurement was deployed to assess violence experienced by 295 Myanmar migrant women residing in Thailand. Data collection involved the use of a self-administered questionnaire consisting of six scales. These scales exhibit Cronbach's alpha coefficients ranging from 0.74 to 0.90. The construct validity was confirmed through confirmatory factor analysis. The structural equation modeling method was employed to test the validity of the model using Mplus Software.

Results

The model provided fitted well with the empirical data (χ2/df =1.74, CFI = 0.93; TLI = 0.91; RMSEA = 0.05; SRMR = 0.06). The VAW accounted for 33 percent of the variance through its set of variables. Among these, ATT, RES, and COP directly impacted VAW, while SS and SE had indirect effects. ATT exhibited the most significant overall influence on VAW, with RES and COP serving as mediators among other antecedents studied in relation to VAW.

Conclusion

The current findings suggest that violence against Myanmar migrant women residing in Thailand is associated with many factors. Understanding these factors can provide valuable insights for policymakers and stakeholders to develop and implement awareness and community-based intervention programs. These findings underscore the importance of targeted strategies to address this issue effectively.
{"title":"The role of selected social and psychological factors in violence against Myanmar migrant women in Thailand.","authors":"Kaung Zaw ,&nbsp;Wirin Kittipichai ,&nbsp;Kanittha Chamroonsawasdi ,&nbsp;Arpaporn Powwattana","doi":"10.1016/j.jmh.2025.100314","DOIUrl":"10.1016/j.jmh.2025.100314","url":null,"abstract":"<div><h3>Introduction</h3><div>Violence against women (VAW) is a serious human rights violation with significant implications for public health. VAW affects the well-being of women, children, and families. This cross-sectional study aimed to determine the structural relationship of a set of variables—attitude towards violence (ATT), self-esteem (SE), relationship with residential unit members (RES), social support (SS), and coping strategies (COP)- influencing VAW and to test the model using the empirical data.</div></div><div><h3>Methods</h3><div>The measurement was deployed to assess violence experienced by 295 Myanmar migrant women residing in Thailand. Data collection involved the use of a self-administered questionnaire consisting of six scales. These scales exhibit Cronbach's alpha coefficients ranging from 0.74 to 0.90. The construct validity was confirmed through confirmatory factor analysis. The structural equation modeling method was employed to test the validity of the model using Mplus Software.</div></div><div><h3>Results</h3><div>The model provided fitted well with the empirical data (χ2/df =1.74, CFI = 0.93; TLI = 0.91; RMSEA = 0.05; SRMR = 0.06). The VAW accounted for 33 percent of the variance through its set of variables. Among these, ATT, RES, and COP directly impacted VAW, while SS and SE had indirect effects. ATT exhibited the most significant overall influence on VAW, with RES and COP serving as mediators among other antecedents studied in relation to VAW.</div></div><div><h3>Conclusion</h3><div>The current findings suggest that violence against Myanmar migrant women residing in Thailand is associated with many factors. Understanding these factors can provide valuable insights for policymakers and stakeholders to develop and implement awareness and community-based intervention programs. These findings underscore the importance of targeted strategies to address this issue effectively.</div></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"11 ","pages":"Article 100314"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143388393","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
Oral health literacy and oral health status of a german adult population with migration background – findings from the MuMi Study
IF 3.9 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-01-01 DOI: 10.1016/j.jmh.2025.100309
Berit Lieske , Christopher Kofahl , Katrin Borof , Kristin Spinler , Anna Poth , Demet Dingoyan , Thomas Beikler , Guido Heydecke , Ghazal Aarabi

Background

People with migration background in Germany demonstrate poorer oral health and different oral health behaviors compared to people without migration background. One crucial factor for achieving and maintaining good oral health is a person's oral health literacy. This article presents results on oral health and oral health literacy from the baseline data of the cluster-randomized controlled MuMi study (Promotion of oral health literacy and oral health of persons with migration background).

Methods

Comparative cross-sectional data on oral health and oral health literacy of patients with and without migration background were examined in 40 dental practices in Hamburg, Germany. Oral examination included a full dental status, the degree of caries restoration, and the approximal plaque index (API). To assess oral health literacy, the Oral Health Literacy Profile (OHLP) was used. Associations between migration status and oral health or oral health literacy were analyzed with linear mixed regression, adjusted for age, sex, education level. The relationship between oral health literacy and oral health was calculated using logistic regression.

Results

Participants with and without migration background differed significantly in oral health literacy and clinical parameters of oral health. The former showed significantly lower oral health literacy (lower OHLP-Scores) and poorer oral health (higher API values as well as a more problem-oriented dental service use). Furthermore, the degree of caries restoration is significantly lower among participants with migration background than those without. Lastly, the logistic regression analysis revealed a significant association between better oral health literacy and lower API values.

Discussion

Migration background appears to be a risk factor in its own right, as the differences in oral health literacy and oral health status remain even after statistically controlling for several confounders. In order to better reflect the diversity within the population with migration background, information on potential access barriers and migration-related factors must be included in further analyses.

Conclusion

Oral health literacy has been found to be a strong predictor for an individual's oral health outcome. Improving the oral health literacy of patients may help in the efforts to improve oral health behaviors and the overall treatment outcomes. Thus, future research should focus on tailored preventive measures for improving oral health literacy, thereby helping to strengthen equal opportunities in oral health in Germany.
{"title":"Oral health literacy and oral health status of a german adult population with migration background – findings from the MuMi Study","authors":"Berit Lieske ,&nbsp;Christopher Kofahl ,&nbsp;Katrin Borof ,&nbsp;Kristin Spinler ,&nbsp;Anna Poth ,&nbsp;Demet Dingoyan ,&nbsp;Thomas Beikler ,&nbsp;Guido Heydecke ,&nbsp;Ghazal Aarabi","doi":"10.1016/j.jmh.2025.100309","DOIUrl":"10.1016/j.jmh.2025.100309","url":null,"abstract":"<div><h3>Background</h3><div>People with migration background in Germany demonstrate poorer oral health and different oral health behaviors compared to people without migration background. One crucial factor for achieving and maintaining good oral health is a person's oral health literacy. This article presents results on oral health and oral health literacy from the baseline data of the cluster-randomized controlled MuMi study (Promotion of oral health literacy and oral health of persons with migration background).</div></div><div><h3>Methods</h3><div>Comparative cross-sectional data on oral health and oral health literacy of patients with and without migration background were examined in 40 dental practices in Hamburg, Germany. Oral examination included a full dental status, the degree of caries restoration, and the approximal plaque index (API). To assess oral health literacy, the Oral Health Literacy Profile (OHLP) was used. Associations between migration status and oral health or oral health literacy were analyzed with linear mixed regression, adjusted for age, sex, education level. The relationship between oral health literacy and oral health was calculated using logistic regression.</div></div><div><h3>Results</h3><div>Participants with and without migration background differed significantly in oral health literacy and clinical parameters of oral health. The former showed significantly lower oral health literacy (lower OHLP-Scores) and poorer oral health (higher API values as well as a more problem-oriented dental service use). Furthermore, the degree of caries restoration is significantly lower among participants with migration background than those without. Lastly, the logistic regression analysis revealed a significant association between better oral health literacy and lower API values.</div></div><div><h3>Discussion</h3><div>Migration background appears to be a risk factor in its own right, as the differences in oral health literacy and oral health status remain even after statistically controlling for several confounders. In order to better reflect the diversity within the population with migration background, information on potential access barriers and migration-related factors must be included in further analyses.</div></div><div><h3>Conclusion</h3><div>Oral health literacy has been found to be a strong predictor for an individual's oral health outcome. Improving the oral health literacy of patients may help in the efforts to improve oral health behaviors and the overall treatment outcomes. Thus, future research should focus on tailored preventive measures for improving oral health literacy, thereby helping to strengthen equal opportunities in oral health in Germany.</div></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"11 ","pages":"Article 100309"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143453387","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
Emptying villages, overflowing glasses: Out-migration and drinking patterns in Rural China
IF 3.9 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-01-01 DOI: 10.1016/j.jmh.2025.100311
Yaxin LAN , Lei JIN

Background

Rural-urban migration is a significant phenomenon in China, resulting in family separation and the emergence of left-behind populations in rural communities. Previous research suggests that migration can influence health behaviors through various pathways. However, limited empirical studies have examined the effects of migration on the drinking behavior of adults left behind. Moreover, the impact of migration at the household and community levels remains unclear.

Methods

This study analyzes the relationship between migration and drinking behavior in rural China with data from the China Health and Nutrition Survey (CHNS 1997–2015) (N = 20,264). Multilevel mixed-effects models are employed to test how household and community levels migration status affects rural residents' weekly alcohol intake.

Results

Weekly alcohol intake would increase by 7.51 g (SE = 2.976, p = 0.012) for men and 0.98 g (SE = 0.419, p = 0.019) for women in families whose members have moved out, while the influence of household migration was no longer significant after controlling for community-level effects. One percentage change in community migration rates would increase men's alcohol intake by 0.6319 g (SE = 26.494, p = 0.017) and women's by 0.0823 g (SE = 2.394, p = 0.001).

Conclusions

Our study emphasizes the importance of considering migration at different levels of analysis. The findings indicate that out-migration is associated with increased alcohol consumption among left-behind adults in rural China. Intervention policies should also consider the unique neighborhood relations in rural China, potentially leveraging social ties within rural communities to spread health awareness and reduce alcohol consumption.
{"title":"Emptying villages, overflowing glasses: Out-migration and drinking patterns in Rural China","authors":"Yaxin LAN ,&nbsp;Lei JIN","doi":"10.1016/j.jmh.2025.100311","DOIUrl":"10.1016/j.jmh.2025.100311","url":null,"abstract":"<div><h3>Background</h3><div>Rural-urban migration is a significant phenomenon in China, resulting in family separation and the emergence of left-behind populations in rural communities. Previous research suggests that migration can influence health behaviors through various pathways. However, limited empirical studies have examined the effects of migration on the drinking behavior of adults left behind. Moreover, the impact of migration at the household and community levels remains unclear.</div></div><div><h3>Methods</h3><div>This study analyzes the relationship between migration and drinking behavior in rural China with data from the China Health and Nutrition Survey (CHNS 1997–2015) (N = 20,264). Multilevel mixed-effects models are employed to test how household and community levels migration status affects rural residents' weekly alcohol intake.</div></div><div><h3>Results</h3><div>Weekly alcohol intake would increase by 7.51 g (SE = 2.976, <em>p</em> = 0.012) for men and 0.98 g (SE = 0.419, <em>p</em> = 0.019) for women in families whose members have moved out, while the influence of household migration was no longer significant after controlling for community-level effects. One percentage change in community migration rates would increase men's alcohol intake by 0.6319 g (SE = 26.494, <em>p</em> = 0.017) and women's by 0.0823 g (SE = 2.394, <em>p</em> = 0.001).</div></div><div><h3>Conclusions</h3><div>Our study emphasizes the importance of considering migration at different levels of analysis. The findings indicate that out-migration is associated with increased alcohol consumption among left-behind adults in rural China. Intervention policies should also consider the unique neighborhood relations in rural China, potentially leveraging social ties within rural communities to spread health awareness and reduce alcohol consumption.</div></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"11 ","pages":"Article 100311"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143395059","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
Emigration and tobacco smoking among those staying behind
IF 3.9 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-01-01 DOI: 10.1016/j.jmh.2025.100305
Artjoms Ivlevs , Roswitha M. King
High or growing rates of smoking tobacco and high rates of emigration are salient features of many low- and middle-income countries, yet the links between migration and smoking remain underexplored. We study the effects of household member emigration on the likelihood of smoking among those staying behind in the countries of former Yugoslavia. Using instrumental variable analysis, we find that the emigration of household members reduces the likelihood of smoking, especially among women and older respondents. These findings support the ‘social remittances’ hypothesis that migration contributes to the transfer of smoking-related norms from destination to source countries. Migration may thus contribute to socioeconomic development of source countries by reducing one of the world's biggest health epidemics: smoking.
{"title":"Emigration and tobacco smoking among those staying behind","authors":"Artjoms Ivlevs ,&nbsp;Roswitha M. King","doi":"10.1016/j.jmh.2025.100305","DOIUrl":"10.1016/j.jmh.2025.100305","url":null,"abstract":"<div><div>High or growing rates of smoking tobacco and high rates of emigration are salient features of many low- and middle-income countries, yet the links between migration and smoking remain underexplored. We study the effects of household member emigration on the likelihood of smoking among those staying behind in the countries of former Yugoslavia. Using instrumental variable analysis, we find that the emigration of household members reduces the likelihood of smoking, especially among women and older respondents. These findings support the ‘social remittances’ hypothesis that migration contributes to the transfer of smoking-related norms from destination to source countries. Migration may thus contribute to socioeconomic development of source countries by reducing one of the world's biggest health epidemics: smoking.</div></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"11 ","pages":"Article 100305"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143101957","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
Improving nutrition for migrant children in Europe through policy: A scoping review
IF 3.9 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-01-01 DOI: 10.1016/j.jmh.2024.100290
Rebecca Lawes, Professor Debbi Marais, Professor Mariza Louw, Ms Beatrice Bennett
Nutrition research concerning migrant populations is abundant, with a surplus of prevalence data related to diverse aspects of malnutrition. However, there is a lack of studies on European country interventions. This gap is more pronounced when examining interventions specific to children. The challenges are clear, but the policy impetus for solving them is not. Examining European interventions on nutrition in refugee and asylum-seeking (RAS) children and families allows for an assessment of the unmet needs in the United Kingdom regarding migration, nutrition, child support, and food security.
This scoping review followed the guidelines in the PRISMA Extension for Scoping Reviews, and 20 documents which covered a mixture of policy interventions were eligible. Meaningful comparisons can be made by assessing the interventions made in migrant nutrition from various European countries with varying political approaches to immigration. This creates a fuller picture of the policy landscape for paediatric migrant nutrition, and in due course, policy decisions can be taken.
This scoping review found a lack of diversity in RAS nutrition policies across Europe and a lack of transparency in those in place, likely rooted in the challenging political landscape of increasing RAS populations in Europe. Improving nutrition interventions requires separating food and health from politics. No interventions focusing on the double burden of malnutrition were found. However, policies addressing the double burden in RAS children should be considered as they may be more politically palatable and financially beneficial to implement.
{"title":"Improving nutrition for migrant children in Europe through policy: A scoping review","authors":"Rebecca Lawes,&nbsp;Professor Debbi Marais,&nbsp;Professor Mariza Louw,&nbsp;Ms Beatrice Bennett","doi":"10.1016/j.jmh.2024.100290","DOIUrl":"10.1016/j.jmh.2024.100290","url":null,"abstract":"<div><div>Nutrition research concerning migrant populations is abundant, with a surplus of prevalence data related to diverse aspects of malnutrition. However, there is a lack of studies on European country interventions. This gap is more pronounced when examining interventions specific to children. The challenges are clear, but the policy impetus for solving them is not. Examining European interventions on nutrition in refugee and asylum-seeking (RAS) children and families allows for an assessment of the unmet needs in the United Kingdom regarding migration, nutrition, child support, and food security.</div><div>This scoping review followed the guidelines in the PRISMA Extension for Scoping Reviews, and 20 documents which covered a mixture of policy interventions were eligible. Meaningful comparisons can be made by assessing the interventions made in migrant nutrition from various European countries with varying political approaches to immigration. This creates a fuller picture of the policy landscape for paediatric migrant nutrition, and in due course, policy decisions can be taken.</div><div>This scoping review found a lack of diversity in RAS nutrition policies across Europe and a lack of transparency in those in place, likely rooted in the challenging political landscape of increasing RAS populations in Europe. Improving nutrition interventions requires separating food and health from politics. No interventions focusing on the double burden of malnutrition were found. However, policies addressing the double burden in RAS children should be considered as they may be more politically palatable and financially beneficial to implement.</div></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"11 ","pages":"Article 100290"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143101959","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
期刊
Journal of Migration and Health
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