Pub Date : 2024-01-01DOI: 10.1016/j.jmh.2024.100224
Sofia Argibay , Amy H. Auchincloss , M. Pia Chaparro , Caroline Kravitz , Alexandra Eastus , Brent A. Langellier
Introduction
Low-income immigrants who are eligible to participate in the Supplemental Nutrition Assistance Program (SNAP) participate at lower rates compared to non-immigrants. Immigrant households may be more likely to participate in SNAP if they live in areas with policies that integrate them into society and protect them from deportation.
Methods
Data on low-income immigrant households came from the 2019 American Community Survey (N = 87,678). The outcome was whether any household member received SNAP in the previous 12 months. Immigrant policy exposures came from two sources: the State Immigration Policy Resource, which includes 18 immigrant criminalizing and integrating policies, and a database that identified ‘sanctuary policies’ (SP), which we summarized at the county level. Multivariable logistic regression adjusted for person/household-level and area-level confounders.
Results
Living in a jurisdiction with a SP was associated with 21% higher odds of enrolling in SNAP compared to living in a jurisdiction without a SP (adjusted odds ratio [aOR] 1.21, 95% CI=1.11,1.31). Relative to the least immigrant friendly states, living in the most immigrant-friendly states was associated with 16% higher odds of SNAP enrollment (aOR=1.16, 95%CI=1.06–1.28). When SP and state-level immigrant friendly policy environment were cross-classified, SNAP participation was 23% and 26% higher for those living in jurisdictions with one- and both- exposures, respectively, relative to those with neither (aOR 1.23; CI 1.12,1.36; aOR 1.26; CI 1.15,1.37).
Conclusions
Many at high risk of food insecurity – including immigrants and citizens in households with immigrants – are eligible for SNAP but under-enroll. Policies that welcome and safeguard immigrants could reduce under enrollment.
{"title":"Impact of county and state immigration policies on immigrant household enrollment in the supplemental nutrition assistance program","authors":"Sofia Argibay , Amy H. Auchincloss , M. Pia Chaparro , Caroline Kravitz , Alexandra Eastus , Brent A. Langellier","doi":"10.1016/j.jmh.2024.100224","DOIUrl":"https://doi.org/10.1016/j.jmh.2024.100224","url":null,"abstract":"<div><h3>Introduction</h3><p>Low-income immigrants who are eligible to participate in the Supplemental Nutrition Assistance Program (SNAP) participate at lower rates compared to non-immigrants. Immigrant households may be more likely to participate in SNAP if they live in areas with policies that integrate them into society and protect them from deportation.</p></div><div><h3>Methods</h3><p>Data on low-income immigrant households came from the 2019 American Community Survey (<em>N</em> = 87,678). The outcome was whether any household member received SNAP in the previous 12 months. Immigrant policy exposures came from two sources: the State Immigration Policy Resource, which includes 18 immigrant criminalizing and integrating policies, and a database that identified ‘sanctuary policies’ (SP), which we summarized at the county level. Multivariable logistic regression adjusted for person/household-level and area-level confounders.</p></div><div><h3>Results</h3><p>Living in a jurisdiction with a SP was associated with 21% higher odds of enrolling in SNAP compared to living in a jurisdiction without a SP (adjusted odds ratio [aOR] 1.21, 95% CI=1.11,1.31). Relative to the least immigrant friendly states, living in the most immigrant-friendly states was associated with 16% higher odds of SNAP enrollment (aOR=1.16, 95%CI=1.06–1.28). When SP and state-level immigrant friendly policy environment were cross-classified, SNAP participation was 23% and 26% higher for those living in jurisdictions with one- and both- exposures, respectively, relative to those with neither (aOR 1.23; CI 1.12,1.36; aOR 1.26; CI 1.15,1.37).</p></div><div><h3>Conclusions</h3><p>Many at high risk of food insecurity – including immigrants and citizens in households with immigrants – are eligible for SNAP but under-enroll. Policies that welcome and safeguard immigrants could reduce under enrollment.</p></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S266662352400014X/pdfft?md5=7f98a2690aa6e75dda76cf71ba03d07a&pid=1-s2.0-S266662352400014X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140338746","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 : 2024-01-01DOI: 10.1016/j.jmh.2024.100217
Mayuri Gogoi , Christopher A. Martin , Paul W. Bird , Martin J. Wiselka , Judi Gardener , Kate Ellis , Valerie Renals , Adam J. Lewszuk , Sally Hargreaves , Manish Pareek
Background
Vaccine preventable diseases (VPDs) such as measles and rubella cause significant morbidity and mortality globally every year. The World Health Organization (WHO), reported vaccine coverage for both measles and rubella to be 71 % in 2019, indicating an immunity gap. Migrants in the EU/EEA may be at high risk of VPDs due to under-immunisation and poor living conditions. However, there are limited data on VPD seroprotection rates amongst migrants living in the United Kingdom (UK).
Methods
We conducted an exploratory cross-sectional serosurvey amongst a sample of adult migrants living in Leicester, UK to: (a) determine seroprotection rates for measles, varicella zoster, and rubella in this group; (b) identify risk factors associated with seronegativity and, (c) understand if self-reported vaccine or diseases history is an effective measure of seroprotection. Participants gave a blood sample and completed a questionnaire asking basic demographic details and vaccine and disease history for the three VPDs. We summarised the data using median and interquartile range (IQR) for non-parametric continuous variables and count and percentage for categorical variables. We used logistic regression to establish predictors of seroprotection against these diseases. We examined the reliability of self-reported vaccination/disease history for prediction of seroprotection through a concordance analysis.
Results
149 migrants were included in the analysis. Seroprotection rates were: varicella zoster 98 %, rubella 92.6 % and measles 89.3 %. Increasing age was associated with seroprotection (OR 1.07 95 % CI 1.01–1.13 for each year increase in age). Migrants from Africa and the Middle East (aOR 15.16 95 % CI 1.31 - 175.06) and South/East Asia and Pacific regions (aOR 15.43 95 %CI 2.38 - 100.00) are significantly more likely to be seroprotected against measles as compared to migrants from Europe and Central Asia. The proportions of migrants unsure about their vaccination and disease history combined were 53.0 % for measles; 57.7 % for rubella; 43.0 % for varicella. There was no agreement between self-reported vaccination/disease history and serostatus.
Conclusion
Our findings suggest lower levels of seroprotection against measles in migrants living in Leicester, UK, with younger migrants and those from Europe and Central Asia more likely to lack seroprotection. A high proportion of surveyed migrants were unaware of their vaccination/disease history and self-reported vaccine/disease was a poor predictor of seroprotection against VPDs which is important for clinical decision-making regarding catch-up vaccination in this population. Our results, although derived from a small sample, suggest that there may be gaps in seroimmunity for certain VPDs in particular migrant populations. These findings should inform future qualitative studies investigating barriers to vaccine uptake
{"title":"Risk of vaccine preventable diseases in UK migrants: A serosurvey and concordance analysis","authors":"Mayuri Gogoi , Christopher A. Martin , Paul W. Bird , Martin J. Wiselka , Judi Gardener , Kate Ellis , Valerie Renals , Adam J. Lewszuk , Sally Hargreaves , Manish Pareek","doi":"10.1016/j.jmh.2024.100217","DOIUrl":"https://doi.org/10.1016/j.jmh.2024.100217","url":null,"abstract":"<div><h3>Background</h3><p>Vaccine preventable diseases (VPDs) such as measles and rubella cause significant morbidity and mortality globally every year. The World Health Organization (WHO), reported vaccine coverage for both measles and rubella to be 71 % in 2019, indicating an immunity gap. Migrants in the EU/EEA may be at high risk of VPDs due to under-immunisation and poor living conditions. However, there are limited data on VPD seroprotection rates amongst migrants living in the United Kingdom (UK).</p></div><div><h3>Methods</h3><p>We conducted an exploratory cross-sectional serosurvey amongst a sample of adult migrants living in Leicester, UK to: (a) determine seroprotection rates for measles, varicella zoster, and rubella in this group; (b) identify risk factors associated with seronegativity and, (c) understand if self-reported vaccine or diseases history is an effective measure of seroprotection. Participants gave a blood sample and completed a questionnaire asking basic demographic details and vaccine and disease history for the three VPDs. We summarised the data using median and interquartile range (IQR) for non-parametric continuous variables and count and percentage for categorical variables. We used logistic regression to establish predictors of seroprotection against these diseases. We examined the reliability of self-reported vaccination/disease history for prediction of seroprotection through a concordance analysis.</p></div><div><h3>Results</h3><p>149 migrants were included in the analysis. Seroprotection rates were: varicella zoster 98 %, rubella 92.6 % and measles 89.3 %. Increasing age was associated with seroprotection (OR 1.07 95 % CI 1.01–1.13 for each year increase in age). Migrants from Africa and the Middle East (aOR 15.16 95 % CI 1.31 - 175.06) and South/East Asia and Pacific regions (aOR 15.43 95 %CI 2.38 - 100.00) are significantly more likely to be seroprotected against measles as compared to migrants from Europe and Central Asia. The proportions of migrants unsure about their vaccination and disease history combined were 53.0 % for measles; 57.7 % for rubella; 43.0 % for varicella. There was no agreement between self-reported vaccination/disease history and serostatus.</p></div><div><h3>Conclusion</h3><p>Our findings suggest lower levels of seroprotection against measles in migrants living in Leicester, UK, with younger migrants and those from Europe and Central Asia more likely to lack seroprotection. A high proportion of surveyed migrants were unaware of their vaccination/disease history and self-reported vaccine/disease was a poor predictor of seroprotection against VPDs which is important for clinical decision-making regarding catch-up vaccination in this population. Our results, although derived from a small sample, suggest that there may be gaps in seroimmunity for certain VPDs in particular migrant populations. These findings should inform future qualitative studies investigating barriers to vaccine uptake ","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666623524000072/pdfft?md5=af99e35884ca593e5840986a4b7e97c0&pid=1-s2.0-S2666623524000072-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139999058","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 : 2024-01-01DOI: 10.1016/j.jmh.2024.100262
Background
There are many African asylum seekers and refugees (AAR) in Asia. However, little research has been conducted on their well-being within the sociocultural milieu. This systematic review explores the characteristics of AAR's psychological and mental well-being and how their acculturation practices, social networks and support (i.e. social capital), health-related knowledge and skills (i.e., health literacy) influence their psychological and mental well-being.
Methods
The study included relevant peer-reviewed articles from any Asian country/region, published in English. No date restriction was applied. Five databases (i.e. Scopus, PubMed, Web of Science, PsycINFO, and CINAHL) were searched for studies conducted about AAR from any of the 54 African countries and residing in any of the 51 Asian countries. Following a predefined inclusion criteria and quality assessment, nine articles were included in this study. Narrative synthesis approach was used to analyse the articles.
Results
It was found that AARs face significant challenges that culminate in poor psychological and mental well-being, including conditions such as depression and discontent with their lives. Notwithstanding, being in a safe place made some of them optimistic about their future. However, many AARs had difficulties adjusting to the host culture. They had limited awareness of the prevailing health system and services and faced restrictions on their rights to social services, partly because of difficulty obtaining appropriate information. The few social bonds and bridges they possessed enabled them to develop a sense of belonging and protected them from psychological distress. However, problematic social relationships increased the chances of poor health-related outcomes.
Conclusion
The psychological and mental well-being of AAR in Asia is concerning. Hence, more research on how critical health determinants (i.e. social capital, health literacy and acculturation processes from this study) directly and interactively influence their well-being across age cohorts. Given their roles in promoting AAR's well-being, appropriate interventions to improve those critical health determinants are also sorely needed.
{"title":"Interplay of sociocultural factors, health literacy and well-being among African asylum seekers and refugees in Asia: A systematic review","authors":"","doi":"10.1016/j.jmh.2024.100262","DOIUrl":"10.1016/j.jmh.2024.100262","url":null,"abstract":"<div><h3>Background</h3><p>There are many African asylum seekers and refugees (AAR) in Asia. However, little research has been conducted on their well-being within the sociocultural milieu. This systematic review explores the characteristics of AAR's psychological and mental well-being and how their acculturation practices, social networks and support (i.e. social capital), health-related knowledge and skills (i.e., health literacy) influence their psychological and mental well-being.</p></div><div><h3>Methods</h3><p>The study included relevant peer-reviewed articles from any Asian country/region, published in English. No date restriction was applied. Five databases (i.e. Scopus, PubMed, Web of Science, PsycINFO, and CINAHL) were searched for studies conducted about AAR from any of the 54 African countries and residing in any of the 51 Asian countries. Following a predefined inclusion criteria and quality assessment, nine articles were included in this study. Narrative synthesis approach was used to analyse the articles.</p></div><div><h3>Results</h3><p>It was found that AARs face significant challenges that culminate in poor psychological and mental well-being, including conditions such as depression and discontent with their lives. Notwithstanding, being in a safe place made some of them optimistic about their future. However, many AARs had difficulties adjusting to the host culture. They had limited awareness of the prevailing health system and services and faced restrictions on their rights to social services, partly because of difficulty obtaining appropriate information. The few social bonds and bridges they possessed enabled them to develop a sense of belonging and protected them from psychological distress. However, problematic social relationships increased the chances of poor health-related outcomes.</p></div><div><h3>Conclusion</h3><p>The psychological and mental well-being of AAR in Asia is concerning. Hence, more research on how critical health determinants (i.e. social capital, health literacy and acculturation processes from this study) directly and interactively influence their well-being across age cohorts. Given their roles in promoting AAR's well-being, appropriate interventions to improve those critical health determinants are also sorely needed.</p></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666623524000515/pdfft?md5=7d90a50c6e5f04a29ac2a4ec4ffe80aa&pid=1-s2.0-S2666623524000515-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141964093","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 : 2024-01-01DOI: 10.1016/j.jmh.2024.100265
Background
The number of migrants at the Mexico-US border has increased to historic levels, and frequently changing immigration policy impacts this population as they await entry into the US. This study evaluated the usability and health effects of the Customs and Border Protection (CBP) One™ mobile application among asylum seekers near the US port of entry in Reynosa, Mexico.
Methods
We conducted semi-structured qualitative interviews with 20 asylum seekers in Reynosa, Mexico, in February 2023. Our objective was to explore the subjective experiences of migrants, usability of CBP One™, and presence of perceived health effects from using the application. Interviews were conducted until saturation occurred, transcribed verbatim into Word, coded in NVivo using a validated, team-based coding methodology, and analyzed according to internal domains, external domains, and health effects regarding CBP One™.
Results
Twenty participants originated from eight countries throughout Latin America and the Caribbean. In total, 18 subthemes were identified among internal, external, and effects domains. Internal themes included a confusing application interface (80%), technical malfunction (60%), and perceived racial bias from the photo-capture features (15%). External themes challenging CBP One™ use included unavailable appointment slots (80%), inequity and inaccessibility (35%), and inadequate internet (25%). Most perceived effects were negative (85%), including worsening mental health effects (40%), exacerbation of pre-existing physical conditions (35%), and forgoing health expenditures to pay for internet (25%).
Conclusions
Our findings suggest that asylum seekers at the Reynosa port of entry perceive CBP One™ negatively, with detrimental effects towards their mental and physical health. This study highlights how immigration policy can influence health and suggests that more creative and humane approaches are needed for people seeking asylum at the Mexico-US border.
{"title":"Health effects and user perceptions of the US Customs and Border Patrol One™ mobile application: A qualitative analysis among asylum seekers at the Mexico-US border","authors":"","doi":"10.1016/j.jmh.2024.100265","DOIUrl":"10.1016/j.jmh.2024.100265","url":null,"abstract":"<div><h3>Background</h3><p>The number of migrants at the Mexico-US border has increased to historic levels, and frequently changing immigration policy impacts this population as they await entry into the US. This study evaluated the usability and health effects of the Customs and Border Protection (CBP) One™ mobile application among asylum seekers near the US port of entry in Reynosa, Mexico.</p></div><div><h3>Methods</h3><p>We conducted semi-structured qualitative interviews with 20 asylum seekers in Reynosa, Mexico, in February 2023. Our objective was to explore the subjective experiences of migrants, usability of CBP One™, and presence of perceived health effects from using the application. Interviews were conducted until saturation occurred, transcribed verbatim into Word, coded in NVivo using a validated, team-based coding methodology, and analyzed according to internal domains, external domains, and health effects regarding CBP One™.</p></div><div><h3>Results</h3><p>Twenty participants originated from eight countries throughout Latin America and the Caribbean. In total, 18 subthemes were identified among internal, external, and effects domains. Internal themes included a confusing application interface (80%), technical malfunction (60%), and perceived racial bias from the photo-capture features (15%). External themes challenging CBP One™ use included unavailable appointment slots (80%), inequity and inaccessibility (35%), and inadequate internet (25%). Most perceived effects were negative (85%), including worsening mental health effects (40%), exacerbation of pre-existing physical conditions (35%), and forgoing health expenditures to pay for internet (25%).</p></div><div><h3>Conclusions</h3><p>Our findings suggest that asylum seekers at the Reynosa port of entry perceive CBP One™ negatively, with detrimental effects towards their mental and physical health. This study highlights how immigration policy can influence health and suggests that more creative and humane approaches are needed for people seeking asylum at the Mexico-US border.</p></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666623524000540/pdfft?md5=7a0f88dde6077d6d2c1b4f06b6e07e76&pid=1-s2.0-S2666623524000540-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141954058","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 : 2024-01-01DOI: 10.1016/j.jmh.2024.100232
Latha S Davda , David R Radford , Sasha Scambler , Jennifer E Gallagher
Introduction
The Global Strategy for Human Resources for Health 2030, requires member states to half their dependency on an international workforce by 2030. In order to design policies towards that goal, country-specific research on migration motivations of the health workforce is required. The United Kingdom (UK) is a net importer of health professionals and whilst there is a body of research on doctors’ and nurses’ migration, there is no research on the migration motivations of migrant dentists in the UK. This research explored the migration motivations of internationally qualified dentists (IQDs) in the UK and presents a typology to understand the global migration of dentists in the context of oral health workforce.
Methods
The paper presents qualitative data from semi-structured interviews conducted between August 2014 and October 2017, of IQDs working in the United Kingdom. The topic guide for interviews was informed by the literature, with new themes added inductively. A phenomenological approach involving an epistemological stance of interpretivism, was used with framework analysis.
Results
A total of 38 internationally qualified dentists (M = 18, F = 20), migrating from the five World Health Organization regions, and working in general practice, NHS hospitals and in community dental services across the four nations of the UK were interviewed. Seven types of internationally qualified dentists were identified working in the UK. They were livelihood migrants, career-orientated migrants, dependant migrants, backpacker migrants, commuter migrants, undocumented migrants, and education-tourist migrant. The categories were based on their migration motivations, which were complex, multifactorial, and included personal, professional, national, and international drivers. The typology, based on their migration motivations, offered a structured, comprehensive understanding of the migrant dental workforce. This typology involving dentists provides additional dimensions to commuter and undocumented migrants described in the context of other health professionals. The education-tourist migrant is a new category proposed as an extension to existing typology in health professional migration.
Conclusions
The typology of internationally qualified dentists has congruency with other health professionals’ typology in categories previously described and demonstrates that each of these categories are complex, fluid and change in response to policy changes. The new category of education-tourist migrant along with oral health dimensions of commuter and undocumented migrants adds to the existing typology in health professional migration.
{"title":"A typology of internationally qualified dentists in the United Kingdom","authors":"Latha S Davda , David R Radford , Sasha Scambler , Jennifer E Gallagher","doi":"10.1016/j.jmh.2024.100232","DOIUrl":"https://doi.org/10.1016/j.jmh.2024.100232","url":null,"abstract":"<div><h3>Introduction</h3><p>The Global Strategy for Human Resources for Health 2030, requires member states to half their dependency on an international workforce by 2030. In order to design policies towards that goal, country-specific research on migration motivations of the health workforce is required. The United Kingdom (UK) is a net importer of health professionals and whilst there is a body of research on doctors’ and nurses’ migration, there is no research on the migration motivations of migrant dentists in the UK. This research explored the migration motivations of internationally qualified dentists (IQDs) in the UK and presents a typology to understand the global migration of dentists in the context of oral health workforce.</p></div><div><h3>Methods</h3><p>The paper presents qualitative data from semi-structured interviews conducted between August 2014 and October 2017, of IQDs working in the United Kingdom. The topic guide for interviews was informed by the literature, with new themes added inductively. A phenomenological approach involving an epistemological stance of interpretivism, was used with framework analysis.</p></div><div><h3>Results</h3><p>A total of 38 internationally qualified dentists (<em>M</em> = 18, <em>F</em> = 20), migrating from the five World Health Organization regions, and working in general practice, NHS hospitals and in community dental services across the four nations of the UK were interviewed. Seven types of internationally qualified dentists were identified working in the UK. They were <em>livelihood migrants, career-orientated migrants, dependant migrants, backpacker migrants, commuter migrants, undocumented migrants</em>, and <em>education-tourist migrant</em>. The categories were based on their migration motivations, which were complex, multifactorial, and included personal, professional, national, and international drivers. The typology, based on their migration motivations, offered a structured, comprehensive understanding of the migrant dental workforce. This typology involving dentists provides additional dimensions to <em>commuter</em> and <em>undocumented</em> migrants described in the context of other health professionals. The <em>education-tourist migrant</em> is a new category proposed as an extension to existing typology in health professional migration.</p></div><div><h3>Conclusions</h3><p>The typology of internationally qualified dentists has congruency with other health professionals’ typology in categories previously described and demonstrates that each of these categories are complex, fluid and change in response to policy changes. The new category of <em>education-tourist migrant</em> along with oral health dimensions of <em>commuter</em> and <em>undocumented migrants</em> adds to the existing typology in health professional migration.</p></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666623524000229/pdfft?md5=44568c0083ac3d3721e3abf9074ede44&pid=1-s2.0-S2666623524000229-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141078144","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 : 2024-01-01DOI: 10.1016/j.jmh.2024.100271
Introduction
The full-scale Russian war has caused refugees to experience many stressful events, which may have a long-term adverse impact on their physical and mental health. Understanding the factors associated with increasing/decreasing stress is essential for the psychosocial support services for refugees. The Perceived Stress Scale (PSS) is a popular tool for assessing life stress perception through self-reporting. The purposes of the study were: 1) to examine the psychometric qualities of the Ukrainian versions of the PSS-14 and PSS-10; 2) to determine the level of perceived stress; 3) to reveal factors associated with perceived stress in the sample of Ukrainian female refugees in the Czech Republic (N = 919).
Methods
Perceived stress was measured by the Ukrainian versions of the Perceived Stress Scale (PSS-14 and PSS-10) which were validated by applying exploratory and confirmatory factor analysis. Linear regressions were run to understand associations between self-reported physical health conditions, the barriers to adaptation in the host country, the determinants of social health and perceived stress.
Results
Both PSS-14 and PSS-10 scales had a high level of internal consistency. Two factors (involving positive and negative items) were extracted based on exploratory factor analysis. The external consistency was confirmed by analysing correlations of the PSS-14/PSS-10 and coping strategies as well as self-reported physical and mental health. Ukrainian female refugees in the Czech Republic experienced moderate to high levels of perceived stress. The study found that on the one hand, a decrease in self-reported physical and mental health statuses, worsening health due to the war, low housing quality, financial disadvantages, experience of cultural differences issues and discrimination, healthcare access inequalities, lack of Czech language skills, failure to integrate into social activities within Ukrainian community, lack of social support, and applying an avoidant coping strategy are factors associated with forced migration that could increase perceived stress in the sample of Ukrainian female refugees. On the contrary, the level of perceived stress of participants could decrease with increasing social support, including such factors as regular communication with relatives and friends who are staying in Ukraine, and having good relations with loved ones, friends, and locals.
Conclusions
The Ukrainian version of PSS-10 has good psychometric properties and can be relied upon to measure perceived stress. The study revealed factors associated with the perceived stress in the sample of Ukrainian female refugees in the Czech Republic and emphasised the necessity of psychosocial support services and developing interventions to help cope with stress among Ukrainian female refugees in the host country.
{"title":"Assessing psychometric of the perceived stress scale and identifying stress-associated factors in a sample of Ukrainian female refugees in the Czech Republic","authors":"","doi":"10.1016/j.jmh.2024.100271","DOIUrl":"10.1016/j.jmh.2024.100271","url":null,"abstract":"<div><h3>Introduction</h3><div>The full-scale Russian war has caused refugees to experience many stressful events, which may have a long-term adverse impact on their physical and mental health. Understanding the factors associated with increasing/decreasing stress is essential for the psychosocial support services for refugees. The Perceived Stress Scale (PSS) is a popular tool for assessing life stress perception through self-reporting. The purposes of the study were: 1) to examine the psychometric qualities of the Ukrainian versions of the PSS-14 and PSS-10; 2) to determine the level of perceived stress; 3) to reveal factors associated with perceived stress in the sample of Ukrainian female refugees in the Czech Republic (<em>N</em> = 919).</div></div><div><h3>Methods</h3><div>Perceived stress was measured by the Ukrainian versions of the Perceived Stress Scale (PSS-14 and PSS-10) which were validated by applying exploratory and confirmatory factor analysis. Linear regressions were run to understand associations between self-reported physical health conditions, the barriers to adaptation in the host country, the determinants of social health and perceived stress.</div></div><div><h3>Results</h3><div>Both PSS-14 and PSS-10 scales had a high level of internal consistency. Two factors (involving positive and negative items) were extracted based on exploratory factor analysis. The external consistency was confirmed by analysing correlations of the PSS-14/PSS-10 and coping strategies as well as self-reported physical and mental health. Ukrainian female refugees in the Czech Republic experienced moderate to high levels of perceived stress. The study found that on the one hand, a decrease in self-reported physical and mental health statuses, worsening health due to the war, low housing quality, financial disadvantages, experience of cultural differences issues and discrimination, healthcare access inequalities, lack of Czech language skills, failure to integrate into social activities within Ukrainian community, lack of social support, and applying an avoidant coping strategy are factors associated with forced migration that could increase perceived stress in the sample of Ukrainian female refugees. On the contrary, the level of perceived stress of participants could decrease with increasing social support, including such factors as regular communication with relatives and friends who are staying in Ukraine, and having good relations with loved ones, friends, and locals.</div></div><div><h3>Conclusions</h3><div>The Ukrainian version of PSS-10 has good psychometric properties and can be relied upon to measure perceived stress. The study revealed factors associated with the perceived stress in the sample of Ukrainian female refugees in the Czech Republic and emphasised the necessity of psychosocial support services and developing interventions to help cope with stress among Ukrainian female refugees in the host country.</div></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142445433","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 : 2024-01-01DOI: 10.1016/j.jmh.2024.100268
Background
Sex workers face substantial health inequities related to sexual health and gender-based violence, many of which are amplified for the large proportion of workers who are racialized im/migrants. While criminalization and stigma are known barriers to health care for this population, we know little about health insurance coverage, and in particular how this relates to im/migration experience and racialization. We examined associations between im/migration status, duration, and racialization on gaps in health insurance coverage in a cohort of women sex workers.
Methods
Analyses used data from a prospective, community-based cohort of women sex workers in Vancouver, BC (Sept 2014-August 2021). Interviewer-administered questionnaires were by experiential (current/former sex workers) and community-based staff. We developed multivariable logistic regression confounder models with generalized estimating equations (GEE) to examine associations between migration and racialization exposures of interest and health insurance coverage.
Results
Of 644 sex workers, 411 (63.8%) reported lacking health insurance coverage for services needed during the 7-year study. In multivariable GEE analysis, precarious im/migration status (adjusted odds ratio (AOR) 2.37, 95% confidence interval (CI) 1.56 – 3.60), recent (AOR 4.22, 95% CI 2.42 – 7.35) and long-term (AOR 2.13, 95% CI 1.54 – 2.96) migration, and being a racialized Asian im/migrant (AOR 3.06, 95% CI 2.14 – 4.39) were associated with recent lack of health insurance coverage.
Conclusion
Policy and program reforms are needed to decouple health insurance access from immigration status, remove mandatory waiting periods for health insurance coverage, and ensure that provincial insurance provides sufficient coverage for marginalized women's healthcare needs.
{"title":"Gaps in health coverage for racialized im/migrant sex workers in metro Vancouver: Findings of a community-based cohort study (2014–2021)","authors":"","doi":"10.1016/j.jmh.2024.100268","DOIUrl":"10.1016/j.jmh.2024.100268","url":null,"abstract":"<div><h3>Background</h3><div>Sex workers face substantial health inequities related to sexual health and gender-based violence, many of which are amplified for the large proportion of workers who are racialized im/migrants. While criminalization and stigma are known barriers to health care for this population, we know little about health insurance coverage, and in particular how this relates to im/migration experience and racialization. We examined associations between im/migration status, duration, and racialization on gaps in health insurance coverage in a cohort of women sex workers.</div></div><div><h3>Methods</h3><div>Analyses used data from a prospective, community-based cohort of women sex workers in Vancouver, BC (Sept 2014-August 2021). Interviewer-administered questionnaires were by experiential (current/former sex workers) and community-based staff. We developed multivariable logistic regression confounder models with generalized estimating equations (GEE) to examine associations between migration and racialization exposures of interest and health insurance coverage.</div></div><div><h3>Results</h3><div>Of 644 sex workers, 411 (63.8%) reported lacking health insurance coverage for services needed during the 7-year study. In multivariable GEE analysis, precarious im/migration status (adjusted odds ratio (AOR) 2.37, 95% confidence interval (CI) 1.56 – 3.60), recent (AOR 4.22, 95% CI 2.42 – 7.35) and long-term (AOR 2.13, 95% CI 1.54 – 2.96) migration, and being a racialized Asian im/migrant (AOR 3.06, 95% CI 2.14 – 4.39) were associated with recent lack of health insurance coverage.</div></div><div><h3>Conclusion</h3><div>Policy and program reforms are needed to decouple health insurance access from immigration status, remove mandatory waiting periods for health insurance coverage, and ensure that provincial insurance provides sufficient coverage for marginalized women's healthcare needs.</div></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142538066","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 : 2023-12-01DOI: 10.1016/j.jmh.2023.100208
Jina Swartz, Bayard Roberts, David Cantor
{"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":"https://doi.org/10.1016/j.jmh.2023.100208","url":null,"abstract":"","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2023-12-01","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}
Vaccination against COVID-19 is an essential public health tool for pandemic control. Inclusion of migrants in COVID-19 vaccination is not only ethically necessary from a right-to-health perspective but also technically indispensable for disease control. This study aimed to characterize the inclusion of international migrants, refugees, and asylum seekers in COVID-19 vaccination policies in Latin American countries that have the greatest recent increase in the reception of migrants.
We conducted a content analysis of public policy documents issued between March 11, 2020, and June 30, 2022 by the Ministries of Health of seven countries: Brazil, Chile, Colombia, Costa Rica, Ecuador, Mexico and Peru. Documents were located through Ministries of Health web pages, references in scientific literature, and the Pan American Health Organization's Information Platform on Health and Migration in the Americas. A content analysis was performed of the documents that were located, along six dimensions: migrants' right to vaccination, temporality of vaccination, administrative discretion, policies to facilitate access, language or cultural considerations, and normative, ethical or technical justifications provided.
Eighty-six public policy documents were reviewed. Their contents showed that none of the countries explicitly excluded migrants from vaccination, nor did they explicitly define restrictions on this population. One barrier that was detected was to require identity documents in order to be vaccinated or to receive a vaccination certificate, which could be difficult for migrants to obtain. Few countries defined actions to facilitate or promote the vaccination of migrants. The documents that mentioned justifications for vaccinating migrants presented reasons that were mainly based on the recognition of the right to health, the principle of non-discrimination and equity.
The countries studied generally had inclusive policies but were limited in terms of dealing with potential barriers to access. The lack of mechanisms to guarantee the right to health is a limitation that countries in the region should address.
{"title":"Incorporating migrants into National COVID-19 Vaccination Plans in Latin America: A comparative analysis of policies in seven countries","authors":"Ietza Bojorquez-Chapela , Maylen Liseth Rojas-Botero , Diana Patricia Marín , María Alejandra Riveros , Aura Yanira Roa , Julián Alfredo Fernández-Niño","doi":"10.1016/j.jmh.2023.100207","DOIUrl":"https://doi.org/10.1016/j.jmh.2023.100207","url":null,"abstract":"<div><p>Vaccination against COVID-19 is an essential public health tool for pandemic control. Inclusion of migrants in COVID-19 vaccination is not only ethically necessary from a right-to-health perspective but also technically indispensable for disease control. This study aimed to characterize the inclusion of international migrants, refugees, and asylum seekers in COVID-19 vaccination policies in Latin American countries that have the greatest recent increase in the reception of migrants.</p><p>We conducted a content analysis of public policy documents issued between March 11, 2020, and June 30, 2022 by the Ministries of Health of seven countries: Brazil, Chile, Colombia, Costa Rica, Ecuador, Mexico and Peru. Documents were located through Ministries of Health web pages, references in scientific literature, and the Pan American Health Organization's Information Platform on Health and Migration in the Americas. A content analysis was performed of the documents that were located, along six dimensions: migrants' right to vaccination, temporality of vaccination, administrative discretion, policies to facilitate access, language or cultural considerations, and normative, ethical or technical justifications provided.</p><p>Eighty-six public policy documents were reviewed. Their contents showed that none of the countries explicitly excluded migrants from vaccination, nor did they explicitly define restrictions on this population. One barrier that was detected was to require identity documents in order to be vaccinated or to receive a vaccination certificate, which could be difficult for migrants to obtain. Few countries defined actions to facilitate or promote the vaccination of migrants. The documents that mentioned justifications for vaccinating migrants presented reasons that were mainly based on the recognition of the right to health, the principle of non-discrimination and equity.</p><p>The countries studied generally had inclusive policies but were limited in terms of dealing with potential barriers to access. The lack of mechanisms to guarantee the right to health is a limitation that countries in the region should address.</p></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2023-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666623523000570/pdfft?md5=7d79a3b6a20a5c74e4252406b75fb181&pid=1-s2.0-S2666623523000570-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138390145","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 : 2023-11-04DOI: 10.1016/j.jmh.2023.100203
Jessica Carter , Felicity Knights , Anna Deal , Alison F Crawshaw , Sally E Hayward , Rebecca Hall , Philippa Matthews , Farah Seedat , Yusuf Ciftci , Dominik Zenner , Fatima Wurie , Ines Campos-Matos , Azeem Majeed , Ana Requena-Mendez , Sally Hargreaves
Background
Migrants in Europe face a disproportionate burden of undiagnosed infection, including tuberculosis, blood-borne viruses, and parasitic infections and many belong to an under-immunised group. The European Centre for Disease Control (ECDC) has called for innovative strategies to deliver integrated multi-disease screening to migrants within primary care, yet this is poorly implemented in the UK. We did an in-depth qualitative study to understand current practice, barriers and solutions to infectious disease screening in primary care, and to seek feedback on a collaboratively developed digitalised integrated clinical decision-making tool called Health Catch UP!, which supports multi-infection screening for migrant patients.
Methods
Two-phase qualitative study of UK primary healthcare professionals, in-depth semi-structured telephone-interviews were conducted. In Phase A, we conducted interviews with clinical staff (general practitioners (GPs), nurses, health-care-assistants (HCAs)); these informed data collection and analysis for phase B (administrative staff). Data were analysed iteratively, using thematic analysis.
Results
In phase A, 48 clinicians were recruited (25 GPs, 15 nurses, seven HCAs, one pharmacist) and 16 administrative staff (11 Practice-Managers, five receptionists) in phase B. Respondents were positive about primary care's ability to effectively deliver infectious disease screening. However, we found current infectious disease screening lacks a standardised approach and many practices have no system for screening meaning migrant patients are not always receiving evidence-based care (i.e., NICE/ECDC/UKHSA screening guidelines). Barriers to screening were reported at patient, staff, and system-levels. Respondents reported poor implementation of existing screening initiatives (e.g., regional latent TB screening) citing overly complex pathways that required extensive administrative/clinical time and lacked financial/expert support. Solutions included patient/staff infectious disease champions, targeted training and specialist support, simplified care pathways for screening and management of positive results, and financial incentivisation. Participants responded positively to Health Catch-UP!, stating it would systematically integrate data and support clinical decision-making, increase knowledge, reduce missed screening opportunities, and normalisation of primary care-based infectious disease screening for migrants.
Conclusions
Our results suggest that implementation of infectious disease screening in migrant populations is not comprehensively done in UK primary care. Primary health care professionals support the concept of innovative digital tools like Health Catch-UP! and that they could significantly improve disease detection and effective implementation of screening guidance but that they require robust testing and resourcing.
{"title":"Multi-infection screening for migrant patients in UK primary care: Challenges and opportunities","authors":"Jessica Carter , Felicity Knights , Anna Deal , Alison F Crawshaw , Sally E Hayward , Rebecca Hall , Philippa Matthews , Farah Seedat , Yusuf Ciftci , Dominik Zenner , Fatima Wurie , Ines Campos-Matos , Azeem Majeed , Ana Requena-Mendez , Sally Hargreaves","doi":"10.1016/j.jmh.2023.100203","DOIUrl":"10.1016/j.jmh.2023.100203","url":null,"abstract":"<div><h3>Background</h3><p>Migrants in Europe face a disproportionate burden of undiagnosed infection, including tuberculosis, blood-borne viruses, and parasitic infections and many belong to an under-immunised group. The European Centre for Disease Control (ECDC) has called for innovative strategies to deliver integrated multi-disease screening to migrants within primary care, yet this is poorly implemented in the UK. We did an in-depth qualitative study to understand current practice, barriers and solutions to infectious disease screening in primary care, and to seek feedback on a collaboratively developed digitalised integrated clinical decision-making tool called Health Catch UP!, which supports multi-infection screening for migrant patients.</p></div><div><h3>Methods</h3><p>Two-phase qualitative study of UK primary healthcare professionals, in-depth semi-structured telephone-interviews were conducted. In Phase A, we conducted interviews with clinical staff (general practitioners (GPs), nurses, health-care-assistants (HCAs)); these informed data collection and analysis for phase B (administrative staff). Data were analysed iteratively, using thematic analysis.</p></div><div><h3>Results</h3><p>In phase A, 48 clinicians were recruited (25 GPs, 15 nurses, seven HCAs, one pharmacist) and 16 administrative staff (11 Practice-Managers, five receptionists) in phase B. Respondents were positive about primary care's ability to effectively deliver infectious disease screening. However, we found current infectious disease screening lacks a standardised approach and many practices have no system for screening meaning migrant patients are not always receiving evidence-based care (i.e., NICE/ECDC/UKHSA screening guidelines). Barriers to screening were reported at patient, staff, and system-levels. Respondents reported poor implementation of existing screening initiatives (e.g., regional latent TB screening) citing overly complex pathways that required extensive administrative/clinical time and lacked financial/expert support. Solutions included patient/staff infectious disease champions, targeted training and specialist support, simplified care pathways for screening and management of positive results, and financial incentivisation. Participants responded positively to Health Catch-UP!, stating it would systematically integrate data and support clinical decision-making, increase knowledge, reduce missed screening opportunities, and normalisation of primary care-based infectious disease screening for migrants.</p></div><div><h3>Conclusions</h3><p>Our results suggest that implementation of infectious disease screening in migrant populations is not comprehensively done in UK primary care. Primary health care professionals support the concept of innovative digital tools like Health Catch-UP! and that they could significantly improve disease detection and effective implementation of screening guidance but that they require robust testing and resourcing.</p></di","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2023-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666623523000533/pdfft?md5=9114d79e10ce7076e17265f38805b0e6&pid=1-s2.0-S2666623523000533-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135411432","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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