Pub Date : 2025-01-01Epub Date: 2025-09-04DOI: 10.1016/j.jmh.2025.100354
Jose Manuel Ruiz Giardin , Nieves Mesa Plaza , Almudena Escribá Bárcena , Juan Victor SanMartín López , Sonia Gonzalo Pascua , Luis Antonio Lechuga Suárez , Santiago Prieto Menchero , Maria Jesús Domínguez García , Sergio Serrano Villar , Santiago Moreno Guillén , on behalf FUENCOVID group
Background
During the SARS-CoV-2 pandemic, the differential impact on ethnic groups has been widely debated. This study examines the immigrant population of Fuenlabrada, Spain, analyzing their infection, hospitalization, ICU admission, and mortality rates compared with the Spanish population.
Methods
This ambispective observational study (March 2020–January 2023) analyzed infection rates, hospitalizations, ICU admissions, and deaths among 215,000 inhabitants (10 % immigrants). Propensity score analysis was conducted to ensure comparability between groups.
Findings
Among 14,688 patients with 18,724 infections, 4102 (21·9 %) infections occurred in immigrants. Of 5429 hospitalized infections, 989 (19·2 %) involved immigrants. Immigrants had more than double the hospitalization rates of Spaniards (fourfold among Latin Americans). Spaniards were older (by 16 years), had higher comorbidities, longer hospital stays, and higher one-month mortality (4·9 % vs. 1 %). Vaccination rates were lower among immigrants (Spaniards 77 %, Latin Americans 70 %, other immigrants ∼50 %). Adjusted analyses revealed no significant differences in mortality between groups.
Interpretation
Elevated infection rates in immigrants, particularly Latin Americans, likely explain their higher hospitalization and ICU admission rates. Mortality, adjusted for demographics and clinical factors, did not differ significantly. Future research should explore the socio-demographic and genetic contributors to these disparities.
在SARS-CoV-2大流行期间，对族裔群体的不同影响一直存在广泛争论。本研究调查了西班牙富恩拉布拉达的移民人口，分析了他们的感染率、住院率、ICU入院率和死亡率与西班牙人口的比较。方法本双视角观察研究（2020年3月- 2023年1月）分析了215,000名居民（10%的移民）的感染率、住院率、ICU入院率和死亡率。进行倾向评分分析以确保组间可比性。结果14688例患者中，18724例感染中，移民感染4102例（21.9%）。在5429例住院感染中，989例（19.2%）涉及移民。移民的住院率是西班牙人的两倍多（拉丁美洲人的四倍）。西班牙人年龄较大（16岁），合并症较高，住院时间较长，一个月死亡率较高（4.9% vs. 1%）。移民的疫苗接种率较低（西班牙人77%，拉丁美洲人70%，其他移民~ 50%）。调整后的分析显示，两组之间的死亡率没有显著差异。移民，特别是拉丁美洲人的感染率升高可能解释了他们较高的住院率和ICU入院率。经人口统计学和临床因素调整后的死亡率没有显著差异。未来的研究应该探索这些差异的社会人口和遗传因素。
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Pub Date : 2025-01-01Epub Date: 2025-03-27DOI: 10.1016/j.jmh.2025.100329
Kenta Okuyama , Sara Larsson Lönn , Ardavan M. Khoshnood , Jan Sundquist , Kristina Sundquist
Introduction
Immigrant children are often challenged at school. School performance is an important predictor of future socioeconomic position and mental and physical health. While studies have investigated parental mental disorders as a potential factor for poor school performance, no studies have investigated this among children with foreign-born parents, i.e., second-generation immigrant children. We aimed to examine whether parental depressive, anxiety, and personality disorders, affect school performance among non-immigrant children and second-generation immigrant children in Sweden.
Methods
Multiple nationwide population register data in Sweden were used. Non-immigrant children, i.e., children born to two Swedish-born parents (n = 593,515), and second-generation immigrant children with two foreign-born parents from non-Western regions (n = 71,721) were included. School grades in the final compulsory school year were used as outcome. Parental mental disorders were measured in the inpatient and outpatient registers. While adjusting for potential confounders, the association between parental mental disorders and school grades was assessed by a linear mixed model. Interaction terms were included to examine whether the association between parental mental disorders and school grades differed by children's immigration status.
Results
Parental mental disorder was associated with lower school grades for both non-immigrant and second-generation immigrant children and in both males and females. The school grades were lower among second-generation immigrant children but the effect of parental mental disorder was smaller among second-generation immigrant children than among non-immigrant children.
Conclusion
Parental mental disorders affected the school performance of all children negatively. Future studies could examine what type of support at school for both second-generation immigrant children and non-immigrant children of parents with mental disorders are most beneficial.
{"title":"Parental mental disorders and school performance among non-immigrant and second-generation immigrant children in Sweden","authors":"Kenta Okuyama , Sara Larsson Lönn , Ardavan M. Khoshnood , Jan Sundquist , Kristina Sundquist","doi":"10.1016/j.jmh.2025.100329","DOIUrl":"10.1016/j.jmh.2025.100329","url":null,"abstract":"<div><h3>Introduction</h3><div>Immigrant children are often challenged at school. School performance is an important predictor of future socioeconomic position and mental and physical health. While studies have investigated parental mental disorders as a potential factor for poor school performance, no studies have investigated this among children with foreign-born parents, i.e., second-generation immigrant children. We aimed to examine whether parental depressive, anxiety, and personality disorders, affect school performance among non-immigrant children and second-generation immigrant children in Sweden.</div></div><div><h3>Methods</h3><div>Multiple nationwide population register data in Sweden were used. Non-immigrant children, i.e., children born to two Swedish-born parents (<em>n</em> = 593,515), and second-generation immigrant children with two foreign-born parents from non-Western regions (<em>n</em> = 71,721) were included. School grades in the final compulsory school year were used as outcome. Parental mental disorders were measured in the inpatient and outpatient registers. While adjusting for potential confounders, the association between parental mental disorders and school grades was assessed by a linear mixed model. Interaction terms were included to examine whether the association between parental mental disorders and school grades differed by children's immigration status.</div></div><div><h3>Results</h3><div>Parental mental disorder was associated with lower school grades for both non-immigrant and second-generation immigrant children and in both males and females. The school grades were lower among second-generation immigrant children but the effect of parental mental disorder was smaller among second-generation immigrant children than among non-immigrant children.</div></div><div><h3>Conclusion</h3><div>Parental mental disorders affected the school performance of all children negatively. Future studies could examine what type of support at school for both second-generation immigrant children and non-immigrant children of parents with mental disorders are most beneficial.</div></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"11 ","pages":"Article 100329"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143738953","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: 2023-12-28DOI: 10.1016/j.jmh.2023.100210
Denise L. Spitzer , Anne-Sophie Jung , Sally Hargreaves
The COVID-19 pandemic has exposed—and exacerbated—major health inequities around the globe including amongst many persons framed as ‘migrants whose lives are shaped by discursive legal, political, and social meanings and legal statuses that situate them within local, national, and global hierarchies. This special issue is dedicated to critical analyses of the roll-out of COVID-19 vaccinations in relation to migrants and other minorities associated with migration, and how migrant groups have been considered and neglected by national and global COVID-19 responses. Drawing from work with asylum seekers, internal and international migrants—both documented and undocumented—in countries ranging from Greece, Japan, and India to Thailand and Canada, authors in this special issue apply critical political economic, feminist, and intersectional lenses to examinations of migrants, migration, and COVID-19 vaccinations.
{"title":"Critical perspectives on migrants, migration, and COVID-19 vaccination editorial for special issue","authors":"Denise L. Spitzer , Anne-Sophie Jung , Sally Hargreaves","doi":"10.1016/j.jmh.2023.100210","DOIUrl":"10.1016/j.jmh.2023.100210","url":null,"abstract":"<div><div>The COVID-19 pandemic has exposed—and exacerbated—major health inequities around the globe including amongst many persons framed as ‘migrants whose lives are shaped by discursive legal, political, and social meanings and legal statuses that situate them within local, national, and global hierarchies. This special issue is dedicated to critical analyses of the roll-out of COVID-19 vaccinations in relation to migrants and other minorities associated with migration, and how migrant groups have been considered and neglected by national and global COVID-19 responses. Drawing from work with asylum seekers, internal and international migrants—both documented and undocumented—in countries ranging from Greece, Japan, and India to Thailand and Canada, authors in this special issue apply critical political economic, feminist, and intersectional lenses to examinations of migrants, migration, and COVID-19 vaccinations.</div></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"11 ","pages":"Article 100210"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139188199","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: 2025-09-05DOI: 10.1016/j.jmh.2025.100355
Sigiriya Aebischer Perone , Kinda Khamasmie , Ranim Doukki , Claudine Dauby , Catherine Savoy , François Chappuis , Nicolas Perone , David Beran
Background
Proper management of persons living with chronic diseases including diabetes requires collaboration between different health care providers. Yet in humanitarian settings, care is essentially provided by health services organised in silos, without coordination and inclusion of people living with various conditions. Interprofessional teamwork could be a means to address this, but this approach is rarely implemented in such contexts.
Methods
Semi-structured interviews were conducted with a purposive sample of 12 health care professionals from the International Committee of the Red Cross in Syria and in headquarters Switzerland, to explore their perceptions and experiences of factors influencing the work across professional teams. Qualitative analysis was conducted using an inductive and deductive thematic approach.
Main findings
The perspectives of humanitarian actors on interprofessional care for persons living with diabetes in a humanitarian setting identified four key factors that influence interprofessional collaboration: i) person focused inclusive leadership to overcome competing demands and competition between health teams, ii) reorganisation of health services with a clear structure, appropriate resources and processes for interprofessional collaboration, iii) commitment and openness of the individual health professional to work collaboratively and iv) the key role and capacities of people with diabetes, who need to be included as team members. These four elements interact and need to come together to ensure successful interprofessional care.
Implications
The findings advocate for an inclusive leadership of the interprofessional team, reorganisation of work, empowerment of all team members, and inclusion of people with a chronic condition in the team. Health care providers are thus encouraged to support interprofessional care to address the needs of people living with a chronic condition in a humanitarian context.
{"title":"Perspectives of humanitarian actors on interprofessional care for persons living with diabetes: Lessons from Aleppo, Syria","authors":"Sigiriya Aebischer Perone , Kinda Khamasmie , Ranim Doukki , Claudine Dauby , Catherine Savoy , François Chappuis , Nicolas Perone , David Beran","doi":"10.1016/j.jmh.2025.100355","DOIUrl":"10.1016/j.jmh.2025.100355","url":null,"abstract":"<div><h3>Background</h3><div>Proper management of persons living with chronic diseases including diabetes requires collaboration between different health care providers. Yet in humanitarian settings, care is essentially provided by health services organised in silos, without coordination and inclusion of people living with various conditions. Interprofessional teamwork could be a means to address this, but this approach is rarely implemented in such contexts.</div></div><div><h3>Methods</h3><div>Semi-structured interviews were conducted with a purposive sample of 12 health care professionals from the International Committee of the Red Cross in Syria and in headquarters Switzerland, to explore their perceptions and experiences of factors influencing the work across professional teams. Qualitative analysis was conducted using an inductive and deductive thematic approach.</div></div><div><h3>Main findings</h3><div>The perspectives of humanitarian actors on interprofessional care for persons living with diabetes in a humanitarian setting identified four key factors that influence interprofessional collaboration: i) person focused inclusive leadership to overcome competing demands and competition between health teams, ii) reorganisation of health services with a clear structure, appropriate resources and processes for interprofessional collaboration, iii) commitment and openness of the individual health professional to work collaboratively and iv) the key role and capacities of people with diabetes, who need to be included as team members. These four elements interact and need to come together to ensure successful interprofessional care.</div></div><div><h3>Implications</h3><div>The findings advocate for an inclusive leadership of the interprofessional team, reorganisation of work, empowerment of all team members, and inclusion of people with a chronic condition in the team. Health care providers are thus encouraged to support interprofessional care to address the needs of people living with a chronic condition in a humanitarian context.</div></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"12 ","pages":"Article 100355"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145043898","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: 2025-07-12DOI: 10.1016/j.jmh.2025.100343
Alexis Harerimana , Julian David Pillay , Gugu Mchunu
Background
Medical xenophobia, manifesting as discrimination and exclusion from healthcare based on nationality or documentation, threatens migrants’ and refugees’ rights and public health. This study maps evidence of what is known about medical xenophobia and healthcare exclusion of refugees and migrants in Africa.
Methodology
The framework established by Levac et al. offered a structured method for executing this scoping review. This research implemented a comprehensive search strategy to identify academic papers and grey literature. Databases such as CINAHL, Emcare, Medline Ovid, Scopus and Web of Science were utilised, focusing on the period from 2014 to 2024. A total of 20 articles were selected for data extraction and thematic synthesis.
Results
The scoping review identified pervasive medical xenophobia and exclusion of refugees and migrants in African healthcare systems. This phenomenon included discriminatory attitudes from healthcare personnel, cultural insensitivity, verbal abuse, poor or denial of care due to documentation status of refugees and migrants, financial exploitation, and linguistic discrimination in healthcare settings. Refugees and migrants often avoided healthcare services due to fear of harassment or deportation, worsening their physical, mental and maternal health outcomes. Interventions highlighted in the literature encompassed policy reforms, cultural sensitivity training for providers, community engagement, enhanced service accessibility, and ongoing monitoring to address systemic inequalities.
Conclusion
Addressing healthcare access inequities for refugees and migrants necessitates structural reforms to ensure accountability for inadequate treatment, uphold human rights and promote equity and culturally and linguistically inclusive practices.
医疗仇外心理，表现为基于国籍或证件的歧视和排斥，威胁着移民和难民的权利和公共健康。这项研究绘制了非洲难民和移民在医疗上的仇外心理和医疗排斥的已知证据。方法论：Levac等人建立的框架为执行范围审查提供了一种结构化的方法。本研究采用综合检索策略来识别学术论文和灰色文献。使用CINAHL、Emcare、Medline Ovid、Scopus和Web of Science等数据库，重点关注2014年至2024年这段时间。共选出20篇文章进行数据提取和专题综合。结果：范围审查确定了非洲医疗保健系统中普遍存在的医疗仇外心理和排斥难民和移民的现象。这一现象包括卫生保健人员的歧视态度、文化不敏感、言语虐待、由于难民和移民的证件状况而得不到或拒绝提供护理、经济剥削以及卫生保健环境中的语言歧视。难民和移民往往因为害怕骚扰或被驱逐出境而回避保健服务，从而使他们的身心和孕产妇健康状况恶化。文献中强调的干预措施包括政策改革、对提供者进行文化敏感性培训、社区参与、提高服务可及性以及持续监测以解决系统性不平等问题。结论：要解决难民和移民在获得医疗保健方面的不平等问题，就必须进行结构性改革，以确保对治疗不足的问责，维护人权，促进公平以及文化和语言包容的做法。
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Pub Date : 2025-01-01Epub Date: 2025-01-09DOI: 10.1016/j.jmh.2024.100295
Sarah Reda , Zarah Yusuf , Basel Karo , Balwinder Singh Chawla , Andreas Jansen , Saskia Lange , Jorge Martinez , Emily Dorothee Meyer , Julia Neufeind , Aarti Shrikrishana Singh , Elisa Wulkotte , Cath Jackson
About 900.000 Forcibly Displaced Myanmar Nationals (FDMN)/ Rohingya refugees live in makeshift camps in Cox's Bazar, Bangladesh. During the COVID-19 pandemic, protective behaviors were particularly important in this setting of previous severe infectious disease outbreaks. To identify barriers, drivers and interventions for those behaviors, a scoping review of MEDLINE, Embase, Web of Science, Global Health and grey literature was conducted in October 2021 and updated in June 2024. The modified Capability-Opportunity-Motivation-Behavior (COM-B) framework and Behavior Change Wheel were used to organize available evidence. A total of 4014 (3654 in 2021, 360 in 2024) records were reviewed and 51 (38 in 2021, 13 in 2024) articles included. Articles reported on protective behaviors (as a general concept), handwashing, social distancing, isolation/quarantine, mask wearing, testing, treatment and vaccination. Barriers and drivers to these behaviors spanned all four COM factors reflecting both individual and environmental influences. Most frequently cited barriers and drivers were found in the motivation (e.g. belief, fear, trust) and physical opportunity (e.g. information, the physical camp environment) factors. Gaps in the evidence were views of health service providers, and differences between camps and population groups. Most interventions focused on information, education or training (e.g. campaigns, community engagement) and environmental restructuring (e.g. increased provision of WASH facilities, COVID-19 isolation and treatment centres). Most articles reported recommendations for interventions. There was some evidence of implementation but little evaluation. This review identified complex and inter-related barriers and drivers to COVID-19 protective behaviors in Cox's Bazar, and many interventions to address these. Addressing the above-mentioned evidence gaps would assist future development of effective targeted interventions, tailored to the needs of specific population groups.
大约90万被迫流离失所的缅甸国民(FDMN)/罗兴亚难民生活在孟加拉国考克斯巴扎尔的临时营地。在2019冠状病毒病大流行期间，在以往严重传染病暴发的背景下，保护行为尤为重要。为了确定这些行为的障碍、驱动因素和干预措施，我们于2021年10月对MEDLINE、Embase、Web of Science、Global Health和灰色文献进行了范围审查，并于2024年6月进行了更新。采用改进的能力-机会-动机-行为（COM-B）框架和行为改变轮对现有证据进行组织。共审查了4014份（2021年3654份、2024年360份）记录和51份（2021年38份、2024年13份）文章。文章报道了保护行为（一般概念）、洗手、保持社交距离、隔离/检疫、佩戴口罩、检测、治疗和疫苗接种。这些行为的障碍和驱动因素跨越了所有四个COM因素，反映了个人和环境的影响。最常被提及的障碍和驱动因素是动机（如信念、恐惧、信任）和物理机会（如信息、物理营地环境）因素。证据的差距在于保健服务提供者的看法，以及难民营和人口群体之间的差异。大多数干预措施侧重于信息、教育或培训（如运动、社区参与）和环境重组（如增加提供讲卫生设施、COVID-19隔离和治疗中心）。大多数文章报道了干预措施的建议。有一些执行的证据，但几乎没有评价。本综述确定了科克斯巴扎尔地区COVID-19防护行为的复杂且相互关联的障碍和驱动因素，以及解决这些问题的许多干预措施。解决上述证据差距将有助于今后制定针对特定人口群体需要的有效目标干预措施。
{"title":"Barriers and drivers to COVID-19 protective behaviours of forcibly displaced myanmar nationals (FDMN)/ rohingya refugees in Cox's bazar, Bangladesh: A scoping review","authors":"Sarah Reda , Zarah Yusuf , Basel Karo , Balwinder Singh Chawla , Andreas Jansen , Saskia Lange , Jorge Martinez , Emily Dorothee Meyer , Julia Neufeind , Aarti Shrikrishana Singh , Elisa Wulkotte , Cath Jackson","doi":"10.1016/j.jmh.2024.100295","DOIUrl":"10.1016/j.jmh.2024.100295","url":null,"abstract":"<div><div>About 900.000 Forcibly Displaced Myanmar Nationals (FDMN)/ Rohingya refugees live in makeshift camps in Cox's Bazar, Bangladesh. During the COVID-19 pandemic, protective behaviors were particularly important in this setting of previous severe infectious disease outbreaks. To identify barriers, drivers and interventions for those behaviors, a scoping review of MEDLINE, Embase, Web of Science, Global Health and grey literature was conducted in October 2021 and updated in June 2024. The modified Capability-Opportunity-Motivation-Behavior (COM-B) framework and Behavior Change Wheel were used to organize available evidence. A total of 4014 (3654 in 2021, 360 in 2024) records were reviewed and 51 (38 in 2021, 13 in 2024) articles included. Articles reported on protective behaviors (as a general concept), handwashing, social distancing, isolation/quarantine, mask wearing, testing, treatment and vaccination. Barriers and drivers to these behaviors spanned all four COM factors reflecting both individual and environmental influences. Most frequently cited barriers and drivers were found in the motivation (e.g. belief, fear, trust) and physical opportunity (e.g. information, the physical camp environment) factors. Gaps in the evidence were views of health service providers, and differences between camps and population groups. Most interventions focused on information, education or training (e.g. campaigns, community engagement) and environmental restructuring (e.g. increased provision of WASH facilities, COVID-19 isolation and treatment centres). Most articles reported recommendations for interventions. There was some evidence of implementation but little evaluation. This review identified complex and inter-related barriers and drivers to COVID-19 protective behaviors in Cox's Bazar, and many interventions to address these. Addressing the above-mentioned evidence gaps would assist future development of effective targeted interventions, tailored to the needs of specific population groups.</div></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"11 ","pages":"Article 100295"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143101962","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: 2025-09-21DOI: 10.1016/j.jmh.2025.100362
Alexandra A. Sansosti , Tania Macaluso , Sanjay Saint , M. Todd Greene , Fabio Genco , Alessandra Diodati , Leuconoe Grazia Sisti , Alessandro Bartoloni , Francesco D’Arca , Giuseppe Canzone
Background
While Lampedusa Island has long represented the “Doorway to Europe,” migration is considered an emergent phenomenon rather than a constant occurrence. Vulnerable populations – particularly pregnant women – arriving there require both routine and urgent medical services. We describe a novel approach to triaging pregnant migrant women, observed clinical presentations, and the effects on healthcare resource utilization.
Methods
The Lampedusa Protocol was implemented in March 2023 by the Agenzia Sanitaria Provinciale (ASP) of Palermo and the Italian National Institute for Health, Migration and Poverty (INMP). Clinical and demographic data from 28 March 2023 to 31 May 2024 were collected and analyzed by cross-referencing the clinical databases of the policlinic of Lampedusa and the Italian Red Cross, the managing entity of the migrant hotspot. Resource utilization data were collected from the helicopter transfer data recorded by the emergency medical service for the island. Associations between patient characteristics and need for helicopter evacuation were assessed using multivariable logistic regression.
Findings
A total of 571 pregnant patients were assessed and treated between 3/28/2023-5/31/2024. Patients represented 23 nationalities, average age was 26 years (SD=6.6 years), and average ultrasound-estimated gestational age was 25.2 weeks (SD=9.6 weeks). The most common causes for needing helicopter transfer were late gestational age or concern for, or symptoms of, labor. Compared to the pre-implementation period, the proportion of patients requiring any flight decreased by 23% (24.5% to 18.9%, p= 0.027) and the proportion requiring dedicated urgent flights decreased by 52% (8.3% to 4.0%, p= 0.003) in the post-implementation period. No association was found between Multidimensional Global Poverty Index of origin country and requiring helicopter evacuation. Women with known nationality had reduced odds (OR = 0.49, 95% CI = 0.27-0.90, p = 0.02) of requiring urgent helicopter evacuation.
Interpretation
We demonstrate improved resource utilization with protocolized care pathways for maritime migrants in European borderlands.
Funding
Dr. Alexandra Sansosti, MD was funded in part by a research grant from the US-Italy Fulbright Commission for this project.
虽然兰佩杜萨岛长期以来一直代表着“通往欧洲的门户”，但移民被认为是一种新兴现象，而不是经常发生的现象。到达那里的弱势群体，特别是孕妇，需要常规和紧急医疗服务。我们描述了一种新的方法来鉴别怀孕的移民妇女，观察到的临床表现，以及对医疗资源利用的影响。方法《兰佩杜萨议定书》由巴勒莫省卫生机构（ASP）和意大利国家卫生、移民和贫困研究所（INMP）于2023年3月实施。收集了2023年3月28日至2024年5月31日的临床和人口统计数据，并通过交叉参考兰佩杜萨岛诊所和意大利红十字会（移民热点管理实体）的临床数据库进行了分析。资源利用数据是从岛上紧急医疗服务记录的直升机转移数据中收集的。使用多变量logistic回归评估患者特征与直升机疏散需求之间的关系。在2023年3月28日至2024年5月31日期间，共对571例孕妇进行了评估和治疗。患者来自23个国家，平均年龄26岁（SD=6.6岁），超声估计平均胎龄25.2周（SD=9.6周）。需要直升机转运的最常见原因是妊娠晚期或担心分娩或分娩症状。与实施前相比，需要任意航班的患者比例下降了23% (24.5% ~ 18.9%,p= 0.027)，实施后需要专门紧急航班的患者比例下降了52% （8.3% ~ 4.0%,p= 0.003）。原籍国多维全球贫困指数与需要直升机疏散之间没有关联。国籍已知的女性需要紧急直升机疏散的几率降低（OR = 0.49, 95% CI = 0.27-0.90, p = 0.02）。我们展示了通过对欧洲边境海上移民的协议化护理途径改善了资源利用。Alexandra Sansosti医学博士是由美国-意大利富布赖特委员会为该项目提供的部分研究资助。
{"title":"Delivering obstetric care to maritime migrants: The Lampedusa protocol","authors":"Alexandra A. Sansosti , Tania Macaluso , Sanjay Saint , M. Todd Greene , Fabio Genco , Alessandra Diodati , Leuconoe Grazia Sisti , Alessandro Bartoloni , Francesco D’Arca , Giuseppe Canzone","doi":"10.1016/j.jmh.2025.100362","DOIUrl":"10.1016/j.jmh.2025.100362","url":null,"abstract":"<div><h3>Background</h3><div>While Lampedusa Island has long represented the “Doorway to Europe,” migration is considered an emergent phenomenon rather than a constant occurrence. Vulnerable populations – particularly pregnant women – arriving there require both routine and urgent medical services. We describe a novel approach to triaging pregnant migrant women, observed clinical presentations, and the effects on healthcare resource utilization.</div></div><div><h3>Methods</h3><div>The Lampedusa Protocol was implemented in March 2023 by the Agenzia Sanitaria Provinciale (ASP) of Palermo and the Italian National Institute for Health, Migration and Poverty (INMP). Clinical and demographic data from 28 March 2023 to 31 May 2024 were collected and analyzed by cross-referencing the clinical databases of the policlinic of Lampedusa and the Italian Red Cross, the managing entity of the migrant hotspot. Resource utilization data were collected from the helicopter transfer data recorded by the emergency medical service for the island. Associations between patient characteristics and need for helicopter evacuation were assessed using multivariable logistic regression.</div></div><div><h3>Findings</h3><div>A total of 571 pregnant patients were assessed and treated between 3/28/2023-5/31/2024. Patients represented 23 nationalities, average age was 26 years (SD=6.6 years), and average ultrasound-estimated gestational age was 25.2 weeks (SD=9.6 weeks). The most common causes for needing helicopter transfer were late gestational age or concern for, or symptoms of, labor. Compared to the pre-implementation period, the proportion of patients requiring any flight decreased by 23% (24.5% to 18.9%, <em>p</em>= 0.027) and the proportion requiring dedicated urgent flights decreased by 52% (8.3% to 4.0%, <em>p</em>= 0.003) in the post-implementation period. No association was found between Multidimensional Global Poverty Index of origin country and requiring helicopter evacuation. Women with known nationality had reduced odds (OR = 0.49, 95% CI = 0.27-0.90, p = 0.02) of requiring urgent helicopter evacuation.</div></div><div><h3>Interpretation</h3><div>We demonstrate improved resource utilization with protocolized care pathways for maritime migrants in European borderlands.</div></div><div><h3>Funding</h3><div>Dr. Alexandra Sansosti, MD was funded in part by a research grant from the US-Italy Fulbright Commission for this project.</div></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"12 ","pages":"Article 100362"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145227195","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: 2025-05-21DOI: 10.1016/j.jmh.2025.100335
Philip Decicco , Jaya Prakash , Erica Nelson , Gonzalo Martínez de Vedia , Hanni Stoklosa
The H-2A Temporary Agricultural Workers program brings hundreds of thousands of foreign workers into the United States to work in the agricultural sector each year. It is well documented that H-2A workers are susceptible and subjected to unsafe working conditions and other workplace abuses. Employed in the agricultural sector, H-2A workers are exposed to higher rates of workplace hazards and riskier workplace settings, including risk for human trafficking. As foreign-born workers living on the same farms in which they are employed, they face language and information barriers when accessing resources outside of those provided by their employer. All these factors contribute to creating significant barriers for H-2A workers when accessing healthcare. This paper uses ArcGIS software and publicly available information to analyze the proximity and accessibility of healthcare resources to H-2A workers in Pennsylvania. We find that less than half of H-2A workers in Pennsylvania in 2021 resided within a 15-minute drive of the types of healthcare providers best suited to address their particular needs. We also posit that this methodology could be used in the future to better allocate and prioritize resources to create intervention points and address the unique needs of this at-risk worker population, including health care interventions for human trafficking victims.
{"title":"Migrant workers’ access to medical service providers in Pennsylvania","authors":"Philip Decicco , Jaya Prakash , Erica Nelson , Gonzalo Martínez de Vedia , Hanni Stoklosa","doi":"10.1016/j.jmh.2025.100335","DOIUrl":"10.1016/j.jmh.2025.100335","url":null,"abstract":"<div><div>The H-2A Temporary Agricultural Workers program brings hundreds of thousands of foreign workers into the United States to work in the agricultural sector each year. It is well documented that H-2A workers are susceptible and subjected to unsafe working conditions and other workplace abuses. Employed in the agricultural sector, H-2A workers are exposed to higher rates of workplace hazards and riskier workplace settings, including risk for human trafficking. As foreign-born workers living on the same farms in which they are employed, they face language and information barriers when accessing resources outside of those provided by their employer. All these factors contribute to creating significant barriers for H-2A workers when accessing healthcare. This paper uses ArcGIS software and publicly available information to analyze the proximity and accessibility of healthcare resources to H-2A workers in Pennsylvania. We find that less than half of H-2A workers in Pennsylvania in 2021 resided within a 15-minute drive of the types of healthcare providers best suited to address their particular needs. We also posit that this methodology could be used in the future to better allocate and prioritize resources to create intervention points and address the unique needs of this at-risk worker population, including health care interventions for human trafficking victims.</div></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"11 ","pages":"Article 100335"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144211860","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: 2023-12-20DOI: 10.1016/j.jmh.2023.100208
Jina Swartz , Bayard Roberts , David Cantor
This special series on ‘health and internal displacement’ is concerned primarily with the health needs of internally displaced persons (IDPs) in conflict contexts. Curated by editors from the recently established Health and Internal Displacement Network (HIDN), the series brings together a selection of thirteen new research articles from among many submitted in response to an open call for papers by HIDN and the Journal of Migration and Health. The aims of this series are to increase engagement with the health needs of IDPs and to support research, policy and programming in this relatively neglected area. The series focuses on IDP health but is not prescriptive in terms of health conditions, age groups, geographic region, or camp or urban setting, and reflects the diversity of IDP populations, contexts and needs.
{"title":"Researching health and internal displacement: Introduction to the special series","authors":"Jina Swartz , Bayard Roberts , David Cantor","doi":"10.1016/j.jmh.2023.100208","DOIUrl":"10.1016/j.jmh.2023.100208","url":null,"abstract":"<div><div>This special series on ‘health and internal displacement’ is concerned primarily with the health needs of internally displaced persons (IDPs) in conflict contexts. Curated by editors from the recently established Health and Internal Displacement Network (HIDN), the series brings together a selection of thirteen new research articles from among many submitted in response to an open call for papers by HIDN and the <em>Journal of Migration and Health</em>. The aims of this series are to increase engagement with the health needs of IDPs and to support research, policy and programming in this relatively neglected area. The series focuses on IDP health but is not prescriptive in terms of health conditions, age groups, geographic region, or camp or urban setting, and reflects the diversity of IDP populations, contexts and needs.</div></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"11 ","pages":"Article 100208"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139013985","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: 2025-03-31DOI: 10.1016/j.jmh.2025.100330
Daniela Del Carlo Gonçalves , Charles Agyemang , Eva L. van der Linden , Charles Hayfron Benjamin , Anja Lok , Henrike Galenkamp , Eric Moll van Charante , Felix P. Chilunga
Background
Migrant populations in Europe have a type 2 diabetes (T2D) burden two to five times that of non-migrants. However, the role of psychosocial stressors—whose experiences can uniquely vary across population groups—remains underexplored. We examined associations between work stress, home stress, and adverse life events with T2D across major ethnic groups in The Netherlands.
Methods
We used baseline data from HELIUS cohort (2011–2015), including 21,501 adults of Dutch, Moroccan, Turkish, South-Asian Surinamese, African Surinamese, and Ghanaian origin. Psychosocial stress was assessed using validated measures in preceding 12 months. T2D was defined by World Health Organization criteria. Robust Poisson regression estimated prevalence ratios (PRs), adjusting for age, sex, and education. Mediation and moderation analyses explored behavioural pathways and role of social support.
Results
Occasional work stress was inversely associated with T2D in total population (aPR 0.82; 95 % CI 0.75–0.93) and among Moroccan-origin participants [0.76 (0.63–0.97)]. Regular home stress was positively associated with T2D in total population [1.15 (1.03–1.28)], but not across ethnic groups. Adverse life events were linked to higher T2D risk overall [1.22 (1.03–1.41)], and among Dutch [1.48 (1.21–1.76)] and African Surinamese [1.43 (1.09–1.89)] origin populations. BMI and alcohol use partially mediated these associations. Social support buffered work and home stress.
Conclusion
Work stress, home stress, and adverse life events differentially influence T2D risk in diverse populations, with effects pronounced in Dutch, Moroccan and African Surinamese origin groups. Interventions targeting psychosocial stress may help reduce T2D in diverse populations.
欧洲移民人口患2型糖尿病（T2D）的负担是非移民人口的2至5倍。然而，社会心理压力因素的作用——其经历在不同人群中有独特的差异——仍未得到充分探索。我们研究了荷兰主要族群中工作压力、家庭压力和不良生活事件与T2D之间的关系。方法采用HELIUS队列（2011-2015）的基线数据，包括21,501名荷兰、摩洛哥、土耳其、南亚苏里南人、非洲苏里南人和加纳人。在前12个月使用有效的方法评估心理社会压力。T2D是根据世界卫生组织的标准定义的。稳健泊松回归估计患病率比（pr），调整了年龄、性别和教育程度。调解和调节分析探讨了社会支持的行为途径和作用。结果职业工作压力与总体人群T2D呈负相关(aPR 0.82；95% CI 0.75-0.93)和摩洛哥裔参与者[0.76(0.63-0.97)]。在总人口中，经常的家庭压力与T2D呈正相关[1.15(1.03-1.28)]，但在不同种族之间没有关系。总体而言，不良生活事件与较高的T2D风险相关[1.22(1.03-1.41)]，在荷兰人[1.48(1.21-1.76)]和非洲苏里南人[1.43(1.09-1.89)]的原籍人群中[1.48(1.21-1.76)]。BMI和酒精使用部分介导了这些关联。社会支持缓冲了工作和家庭压力。结论工作压力、家庭压力和不良生活事件对不同人群T2D风险的影响存在差异，在荷兰、摩洛哥和非洲苏里南裔人群中影响显著。针对心理社会压力的干预措施可能有助于减少不同人群的T2D。
{"title":"Impact of psychosocial stressors on type 2 diabetes among migrants and non-migrants in The Netherlands: The HELIUS study","authors":"Daniela Del Carlo Gonçalves , Charles Agyemang , Eva L. van der Linden , Charles Hayfron Benjamin , Anja Lok , Henrike Galenkamp , Eric Moll van Charante , Felix P. Chilunga","doi":"10.1016/j.jmh.2025.100330","DOIUrl":"10.1016/j.jmh.2025.100330","url":null,"abstract":"<div><h3>Background</h3><div>Migrant populations in Europe have a type 2 diabetes (T2D) burden two to five times that of non-migrants. However, the role of psychosocial stressors—whose experiences can uniquely vary across population groups—remains underexplored. We examined associations between work stress, home stress, and adverse life events with T2D across major ethnic groups in The Netherlands.</div></div><div><h3>Methods</h3><div>We used baseline data from HELIUS cohort (2011–2015), including 21,501 adults of Dutch, Moroccan, Turkish, South-Asian Surinamese, African Surinamese, and Ghanaian origin. Psychosocial stress was assessed using validated measures in preceding 12 months. T2D was defined by World Health Organization criteria. Robust Poisson regression estimated prevalence ratios (PRs), adjusting for age, sex, and education. Mediation and moderation analyses explored behavioural pathways and role of social support.</div></div><div><h3>Results</h3><div>Occasional work stress was inversely associated with T2D in total population (aPR 0.82; 95 % CI 0.75–0.93) and among Moroccan-origin participants [0.76 (0.63–0.97)]. Regular home stress was positively associated with T2D in total population [1.15 (1.03–1.28)], but not across ethnic groups. Adverse life events were linked to higher T2D risk overall [1.22 (1.03–1.41)], and among Dutch [1.48 (1.21–1.76)] and African Surinamese [1.43 (1.09–1.89)] origin populations. BMI and alcohol use partially mediated these associations. Social support buffered work and home stress.</div></div><div><h3>Conclusion</h3><div>Work stress, home stress, and adverse life events differentially influence T2D risk in diverse populations, with effects pronounced in Dutch, Moroccan and African Surinamese origin groups. Interventions targeting psychosocial stress may help reduce T2D in diverse populations.</div></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"11 ","pages":"Article 100330"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143760181","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}
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