Journal of Migration and Health最新文献

Aims

This study aims, probably for the first time, to compare the fertility intentions of migrants and non-migrants of the same nationality at origin based on their self-rated health, wellbeing, and gender.

Methods

The study utilized data from the Families of Poles in the Netherlands (FPN) survey and the Generations and Gender Survey (GGS). This study used Blinder-Oaxaca decomposition models and generalized ordered logit models (gologit).

Results

The findings reveal that both migrants and non-migrants who have good self-rated health and wellbeing are more likely to express a desire to have children in the short-term. The impact of perceived health on the intention to have children is significant for both female and male irrespective of their migration status. Additionally, the average fertility intentions score is higher for Polish migrants residing in the Netherlands compared to Polish non-migrants residing in Poland across the models. The study emphasizes the role good perceived health plays in shaping fertility intentions.

Background

Post-traumatic stress disorder (PTSD) is one of the most important and common disorders caused by war trauma. The aim of this study was to determine the relationship between psychosocial factors and PTSD in war-torn immigrants in Mehran, Iran.

Method

The present study was conducted by descriptive and correlational method. The data were collected from 245 people (121 women and 124 men) from war-torn immigrants 45 years and older who migrated from Mehran to Ilam during the Iran–Iraq war. The measuring tools were as follows: Post Traumatic Stress Disorder Scale, Multidimensional Scale of Perceived Social Support (MDPSS), Coping Strategies Scale (CSS-R), Multidimensional Health Locus of Control scale.

Results

The prevalence rate of PTSD among war-torn immigrants in Mehran was 35.1 %. A significant negative correlation was observed between perceived social support and PTSD (p < .01). Coping strategies, including seeking social support, reappraisal/adaptation, problem-focused coping, and active coping, all showed significant negative correlations with PTSD (p < .01). Conversely, a significant positive correlation was found between avoidance coping strategies and self-control and PTSD (p < .01). In addition, there was a significant positive correlation between the external locus of control (believing in chance) and PTSD (P < 0.01) and significant negative correlation between internal locus of control and PTSD (P < .01).

Conclusion

Weakness in social support, locus of control and also inappropriate coping strategies against war trauma were among the strong risk factors for PTSD. Therefore, social and behavioral interventions are recommended to increase social support, teaching problem-solving skills and strengthen individual control among war-torn immigrants to reduce the risk of developing PTSD.

Objective

Methods

Results

Conclusions

Background

The rise of global forced migration urges healthcare systems to respond to the needs of forced migrants (FM) during pregnancy and childbirth. Yet, comprehensive data on the health outcomes of pregnant FM in destination countries remain scarce. This study aimed to describe the characteristics and maternal and perinatal outcomes of pregnancy in this specific migrant population on a national scale in the Netherlands and to explore differences from other populations.

Methods

The Dutch perinatal registry was linked to national migration data to analyze pregnancy outcomes in FM (2014–2019), using non-migrants (NM) and resident migrants (RM) as reference populations. We reported outcome rates (% [95 % CI]) for a range of primary and secondary pregnancy outcomes. Primary outcomes included perinatal mortality, small for gestational age infants (SGA), preterm birth, and emergency cesarean section (CS), for which we also calculated the crude relative risk (RR [95 % CI]) of FM compared to NM and RM. In addition, we conducted binary logistic regression analyses on primary outcomes to report adjusted odds ratios (aORs [95 % CIs]) while controlling for multiple births, maternal age and parity.

Findings

Compared to the NM group, the FM group had increased risks of perinatal mortality (RR 1.50 [95 % CI 1.20–1.88]), SGA (1.65 [1.59–1.71], and emergency CS (1.19 [1.13–1.25]). Compared to RM, FM still had elevated risks of SGA (1.17 [1.13–1.22]). In contrast, the risk of preterm birth was lower in FM than in NM (0.81 [0.76–0.86]) and RM (0.83 [0.77–0.88]). These differences were confirmed in the adjusted analysis. Differences in secondary outcomes included higher rates of late antenatal care in FM (29.4 % [28.5–30.3]) than in NM (6.7 % [6.6–6.9]) and RM (15.5 % [15.1–15.9]). Rates of planned CS were similarly elevated (14.3 % [95 % CI 13.7–14.8] versus 7.·8 % [7.7–7.8] and 9.6 % [9.5–9.7]), while FM had lower rates of postpartum hemorrhage (3.9 % [3.6–4.2]) versus 6.8 % [6.8–6.9] and 5.7 % [5.6–5.9]).

Conclusion

This first Dutch registry-based study demonstrated increased risks of multiple, though not all, adverse pregnancy outcomes in forced migrants. Our results emphasize the imperative to further unravel and address migration-related disparities, dismantle structural barriers to health among forced migrants, and improve the inclusivity of data systems. Collaborative policy, clinical practice, and research efforts are essential to ensure equitable care for every individual, regardless of migration status.

Objective

Trans and non-binary (TNB) immigrants, refugees, and newcomers (IRN) face intersecting challenges and barriers, including stigma and persecution in countries of origin, and others unique to the Canadian resettlement process. The present study aimed to investigate factors that are associated with having a primary healthcare provider among TNB IRN.

Design

Trans PULSE Canada was a community-based, national study of health and wellbeing among 2,873 TNB people residing in Canada, aged 14 and older, who were recruited using a multi-mode convenience sampling approach.. The survey asked questions about identity, community, service access, health – and IRN were asked questions specific to immigration/settlement.

Results

Of the 313 IRN participants who completed the full survey version (age M = 34.1, SE=0.75), 76.4 % had a primary healthcare provider. TNB IRN largely reported being Canadian citizens (59.8 %), gender non-binary or similar (46.9 %), currently living in Ontario (35.5 %), and having immigrated from the United States (32.1 %). Chi-square analyses revealed that having a primary healthcare provider was associated with age, gender identity, citizenship status, region of origin, current location in Canada, length of time since immigrating to Canada, status in gender affirming medical care, and having extended health insurance. With modified Poisson regression, we found that TNB IRN who were non-permanent residents, originating from European, African, and Oceania regions, or living in Quebec and the Prairie provinces were less likely to have a primary healthcare provider.

Conclusion

Results may inform settlement organizations of the unique needs and barriers of TNB IRN. Schools and LGBTQ+ organizations may better serve this population – especially those originating from highlighted regions, who live in Quebec or the Prairie provinces, and/or are non-permanent residents – by offering programs that connect them to primary healthcare providers who are competent in cross-cultural trans health.

Purpose

To survey community-based migrant-serving organizations (MSOs) in New York City (NYC) regarding their early experiences during the COVID-19 pandemic and perspectives on academic collaborations.

Methods

We developed and emailed a survey via Qualtrics (12/2020-1/2021) to 122 MSOs in NYC collecting data about the organizations; challenges posed by COVID-19; and interest in potential intersectoral collaboration. Descriptive analysis focused on the pandemic's impact on service provision, type of MSO, and organizational capacity.

Results

Thirty-eight MSOs participated (RR=31%). COVID-19-related challenges included limited staff capacity, organizational funding, and technological and resource limitations of communities served. Organizational capacity correlated with types of services offered: smaller organizations offered health and social services, while larger organizations focused on education and employment. MSOs indicated interest in collaboration on migrant policy advocacy and communications, access to interns, and resources regarding best practices and policies.

Conclusions

MSOs in NYC have struggled with funding, staffing, and service provision. They specified fruitful areas for collaboration with academic research institutions.

Implications

Development of an academic-based migrant health resource hub will serve an identified need among MSOs in NYC.

Education plays a crucial role in the adaptation and broader societal inclusion of immigrant students and their families. The current study explored the inclusion of migrants in Ecuador's school system as a fundamental tenet of protecting their health and well-being. We conducted a thematic analysis of 13 policy documents, 12 national laws and international agreements, and 31 key informant interviews, applying a human rights lens. We find that, although the 2008 Ecuadorian Constitution and migration laws protect the right of migrants to health and education, key informants argue that these laws are poorly implemented. Furthermore, they agree that the health sector generally does not consider education as a relevant setting for health. In contrast, the public education sector and non-profit organizations at the national and local levels appear to recognize the importance of coordination across the health and education sectors, including school-based initiatives for migrant inclusion.

In line with the peer reviewers comments, the authors have added highlights in stead of an abstract. It was felt that it was better able to capture the findings and is more in line with the paper's target audience.

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Urban refugees may be disproportionately affected by socio-environmental stressors that shape alcohol use, and this may have been exacerbated by additional stressors in the COVID-19 pandemic. This multi-method study aimed to understand experiences of, and contextual factors associated with, alcohol use during the pandemic among urban refugee youth in Kampala, Uganda. We conducted a cross-sectional survey (n = 335), in-depth individual interviews (IDI) (n = 24), and focus groups (n = 4) with urban refugee youth in Kampala. We also conducted key informant interviews (n = 15) with a range of stakeholders in Kampala. We conducted multivariable logistic regression analyses with survey data to examine socio-demographic and ecosocial (structural, community, interpersonal) factors associated with ever using alcohol and alcohol misuse. We applied thematic analyses across qualitative data to explore lived experiences, and perceived impacts, of alcohol use. Among survey participants (n = 335, mean age= 20.8, standard deviation: 3.01), half of men and one-fifth of women reported ever using alcohol. Among those reporting any alcohol use, half (n = 66, 51.2 %) can be classified as alcohol misuse. In multivariable analyses, older age, gender (men vs. women), higher education, and perceived increased pandemic community violence against women and children were associated with significantly higher likelihood of ever using alcohol. In multivariable analyses, very low food security, relationship status, transactional sex, and lower social support were associated with increased likelihood of alcohol misuse. Qualitative findings revealed: (1) alcohol use as a coping mechanism for stressors (e.g., financial insecurity, refugee-related stigma); and (2) perceived impacts of alcohol use on refugee youth health (e.g., physical, mental). Together findings provide insight into multi-level contexts that shape vulnerability to alcohol mis/use among urban refugee youth in Kampala and signal the need for gender-tailored strategies to reduce socio-environmental stressors.