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426 to 450 of 843Detecting and describing heterogeneity in health care cost trajectories among asylum seekers.
Background: The mechanism underlying the health care cost trajectories among asylum seekers is not well understood. In the canton of Vaud in Switzerland, a nurse-led health care and medical Network for Migrant Health ("Réseau santé et migration" RESAMI) has established a health care model focusing on the first year after arrival of asylum seekers, called the "community health phase". This model aims to provide tailored care and facilitate integration into the Swiss health care system. The aim of this study is to explore different health care cost trajectories among asylum seekers during this phase and identify the associated factors.
Methods: We detected different patterns of health care cost trajectories using time-series clustering of longitudinal data of asylum seekers in the canton of Vaud in Switzerland. These data included all adult asylum seekers and recipients of emergency aid wh…
matched on Transients and Migrants (mesh), Refugees (mesh), migrant (text)
Mental health service use among migrant and Swedish-born children and youth: a register-based cohort study of 472,129 individuals in Stockholm.
Purpose: Migrant children underutilize mental health services (MHS), but differences according to age, reason for migration, type of problem, and time have not been thoroughly analyzed. We aimed to explore utilization of MHS among migrant children and youth and to study if the hypothesized lower utilization could be explained by fewer neurodevelopmental assessments.
Methods: A cohort of the population aged 0-24 years in Stockholm, comprising 472,129 individuals were followed for maximum 10 years, between January 1, 2006 and December 31, 2015. We categorized individuals as accompanied refugee migrants, unaccompanied refugee migrants and non-refugee migrants, or Swedish-born. We used survival and logistic analyses to estimate rates of utilization of MHS.
Results: Migrant children and youth utilized less MHS than the majority population, with hazard ratios ranging from 0.62 (95% CI: 0.57; 0…
matched on Transients and Migrants (mesh), Refugees (mesh), migrant (text)
Moving towards culturally competent health systems for migrants? Applying systems thinking in a qualitative study in Malaysia and Thailand.
Background: Cultural competency describes interventions that aim to improve accessibility and effectiveness of health services for people from ethnic minority backgrounds. Interventions include interpreter services, migrant peer educators and health worker training to provide culturally competent care. Very few studies have focussed on cultural competency for migrant service use in Low- and Middle-Income Countries (LMIC). Migrants and refugees in Thailand and Malaysia report difficulties in accessing health systems and discrimination by service providers. In this paper we describe stakeholder perceptions of migrants' and health workers' language and cultural competency, and how this affects migrant workers' health, especially in Malaysia where an interpreter system has not yet been formalised.
Method: We conducted in-depth interviews with stakeholders in Malaysia (N = 44) and Thailand (N…
matched on Transients and Migrants (mesh), Refugees (mesh), migrant (text)
Supporting access to healthcare for refugees and migrants in European countries under particular migratory pressure.
Background: In 2015 the increased migratory pressure in Europe posed additional challenges for healthcare providers. The aim of this study was to inform the development of a "Resource Package" to support European Union (EU) member states in improving access to healthcare for refugees, asylum seekers and other migrants.
Methods: A mixed method approach was adopted: i) interviews and focus groups were carried out to gather up-to-date information on the challenges the different healthcare providers were facing related to the refugee crisis; ii) to complement the results of the FGs, a literature review was conducted to collect available evidence on barriers and solutions related to access to healthcare for refugees and migrants.
Results: The different actors providing healthcare for refugees and migrants faced challenges related to the phases of the migration trajectory: arrival, transit and…
matched on Transients and Migrants (mesh), Refugees (mesh), migrant (text)
Adolescents' perceptions and experiences of pregnancy in refugee and migrant communities on the Thailand-Myanmar border: a qualitative study.
Background: Adolescent pregnancy remains a global health concern, contributing to 11% of all births worldwide and 23% of the overall burden of disease in girls aged 15-19 years. Premature motherhood can create a negative cycle of adverse health, economic and social outcomes for young women, their babies and families. Refugee and migrant adolescent girls might be particularly at risk due to poverty, poor education and health infrastructure, early marriage, limited access to contraception and traditional beliefs. This study aims to explore adolescents' perceptions and experiences of pregnancy in refugee and migrant communities on the Thailand-Myanmar border.
Methods: In June 2016 qualitative data were collected in one refugee camp and one migrant clinic along the Thailand-Myanmar border by conducting 20 individual interviews with pregnant refugee and migrant adolescents and 4 focus group d…
matched on Transients and Migrants (mesh), Refugees (mesh), migrant (text)
Pre-Migration Trauma Exposure and Mental Health Functioning among Central American Migrants Arriving at the US Border.
In recent years, increasing numbers of families and individuals have arrived at the U.S. border from Central America, in particular, from Honduras, El Salvador, and Guatemala. This study sought to examine pre-migration trauma exposure and current mental health functioning of migrant families arriving at the U.S. border from the Northern Triangle region, with specific attention to the reasons offered for leaving their home country and the frequency with which migrant families appear to satisfy legal criteria for asylum We interviewed 234 adults in McAllen, Texas, using a structured interview and standardized questionnaires to assess exposure to trauma prior to migration, reasons for leaving their home country and symptoms of posttraumatic stress and depression. We found that 191 participants (83%) cited violence as a reason for fleeing their country, 119 individuals (69%) did not report t…
matched on Transients and Migrants (mesh), Refugees (mesh), migrant (text)
Refugee migration and risk of schizophrenia and other non-affective psychoses: cohort study of 1.3 million people in Sweden.
Objective: To determine whether refugees are at elevated risk of schizophrenia and other non-affective psychotic disorders, relative to non-refugee migrants from similar regions of origin and the Swedish-born population.
Design: Cohort study of people living in Sweden, born after 1 January 1984 and followed from their 14th birthday or arrival in Sweden, if later, until diagnosis of a non-affective psychotic disorder, emigration, death, or 31 December 2011.
Setting: Linked Swedish national register data.
Participants: 1,347,790 people, including people born in Sweden to two Swedish-born parents (1,191,004; 88.4%), refugees (24,123; 1.8%), and non-refugee migrants (132,663; 9.8%) from four major refugee generating regions: the Middle East and north Africa, sub-Saharan Africa, Asia, and Eastern Europe and Russia.
Main outcome measures: Cox regression analysis was used to estimate adjusted h…
matched on Transients and Migrants (mesh), Refugees (mesh), migrant (text)
Psychopathology and resident status - comparing asylum seekers, refugees, illegal migrants, labor migrants, and residents.
Purpose: This study aimed to describe, compare, and predict mental health outcomes of different migrant groups and native residents in Switzerland.
Subjects and methods: Asylum seekers (n=65); refugees holding permanent protection visas (n=34); illegal migrants (n=21); labor migrants (n=26); and residents (n=56) completed an assessment by questionnaire. Main outcome variables were symptoms of posttraumatic stress, anxiety and depression. It was tested whether resident status predicted psychopathology over and above the influence of control variables including social desirability, traumatic event types and post-migration resources.
Results: Asylum seekers (54.0%) and refugees (41.4%) fulfilled criteria of PTSD most frequently. Clinically relevant symptoms of anxiety and depression were most frequently reported by asylum seekers (84.6% and 63.1%, resp.) and illegal migrants (both 47.6%). R…
matched on Transients and Migrants (mesh), Refugees (mesh), migrant (text)
Diabetes self-management in a Latino social environment.
Purpose: The purpose of this qualitative descriptive study was to explore the sociocultural influences and social context associated with living with type 2 diabetes among migrant Latino adults.
Methods: A qualitative descriptive study using grounded theory techniques was conducted. In-depth semistructured interviews were completed with 10 participants (6 female and 4 male) ranging in age from 46 to 65 years and with a duration of diabetes diagnosis ranging from 1.5 to 40 years.
Results: An overarching meta-theme of self-management in a social environment emerged. Every aspect of the process of self-management, as described in the 4 major themes-(1) family cohesion, (2) social stigma of disease, (3) social expectations/perception of "illness," and (4) disease knowledge and understanding-was influenced by the social context.
Conclusions: The familist traditions, central to the Mexican cul…
matched on Transients and Migrants (mesh), Mexico (mesh), migrant (text)
Forbearance coping, identification with heritage culture, acculturative stress, and psychological distress among Chinese international students.
Based on Berry's (1997) theoretical framework for acculturation, our goal in this study was to examine whether the use of a culturally relevant coping strategy (i.e., forbearance coping, a predictor) would be associated with a lower level of psychological distress (a psychological outcome), for whom (i.e., those with weaker vs. stronger identification with heritage culture, a moderator), and under what situations (i.e., lower vs. higher acculturative stress, a moderator). A total of 188 Chinese international students completed an online survey. Results from a hierarchical regression indicated a significant 3-way interaction of forbearance coping, identification with heritage culture, and acculturative stress on psychological distress. For those with a weaker identification with their heritage culture, when acculturative stress was higher, the use of forbearance coping was positively asso…
matched on Emigrants and Immigrants (mesh), Acculturation (mesh)
Sargent CF (2006)MEDLINE-indexed journal, not yet read by usMedical anthropology quarterly17 citations Reproductive strategies and Islamic discourse: Malian migrants negotiate everyday life in Paris, France.
Approximately 37 thousand Malians currently reside in France as part of the West African diaspora. Primarily Muslim, both women and men confront challenges to their understandings of Islamic prohibitions and expectations, especially those addressing conjugal relations and reproduction. Biomedical policies generate marital conflicts and pose health dilemmas for women who face family and community pressures to reproduce but biomedical encouragement to limit childbearing. For many women, contraception represents a reprieve from repeated pregnancies and fatigue in spite of resistance from those who contest women's reproductive decisions as antithetical to Islam. French social workers play a particularly controversial role by introducing women to a discourse of women's rights that questions the authority of husbands and of religious doctrine. Women and men frame decisions and debate in divers…
matched on Transients and Migrants (mesh), immigrant (text), migrant (text)
The role of social support in the acculturation and mental health of unaccompanied minor asylum seekers.
There is a lack of knowledge about psychosocial resources that may sustain post-resettlement psychological adjustment among unaccompanied minor asylum-seekers. The aim of this study is to investigate the impact of social support from family abroad and friends on acculturation, discrimination, and mental health among these vulnerable children and youth. Questionnaire data were collected from a population-based multi-ethnic sample involving 895 unaccompanied minors resettled in municipalities in all regions of the country. They met in groups in their local communities. The informants were on average 18.6 years, and had an average length of stay in Norway of 3.5 years. The findings showed that the participants suffered from high levels of ongoing war related intrusive symptoms and depression. Still, at the same time they engaged in adaptation processes that are normative to youth with immig…
matched on Acculturation (mesh), resettlement (text), Refugees (mesh), immigrant (text)
Baird MB (2012)MEDLINE-indexed journal, not yet read by usANS. Advances in nursing science26 citations Well-being in refugee women experiencing cultural transition.
This article presents a situation-specific theory of well-being in refugee women experiencing cultural transition. The theory resulted from 2 studies, an ethnography and a community-based collaborative action research project, with refugee women from South Sudan, who were resettled to the United States. The theory extends the middle-range theory of transition to include cultural transition as a distinct type of transition with a unique set of properties and conditions including 3 phases-separation, liminality, and integration. Community action research is discussed as a culturally relevant intervention for nurses working with immigrants and refugee populations to foster well-being in resettlement.
matched on Acculturation (mesh), resettlement (text), Refugees (mesh), immigrant (text)
Mental health of Somali adolescent refugees: the role of trauma, stress, and perceived discrimination.
The primary purpose of this study was to examine relations between trauma exposure, post-resettlement stressors, perceived discrimination, and mental health symptoms in Somali adolescent refugees resettled in the U.S. Participants were English-speaking Somali adolescent refugees between the ages of 11 and 20 (N = 135) who had resettled in the U.S. Participants were administered an interview battery comprising self-report instruments that included the UCLA Posttraumatic Stress Disorder (PTSD) Index, the War Trauma Screening Scale, the Every Day Discrimination scale, the Adolescent Post-War Adversities Scale, and the Acculturative Hassles Inventory. Results indicated that cumulative trauma was related to PTSD and depression symptoms. Further, post-resettlement stressors, acculturative stressors, and perceived discrimination were also associated with greater PTSD symptoms after accounting f…
matched on Acculturation (mesh), resettlement (text), Refugees (mesh), immigrant (text)
Help Seeking Attitudes Among Cambodian and Laotian Refugees: Implications for Public Mental Health Approaches.
This is a pilot study of demographic and acculturation factors in relation to attitudes toward seeking psychological help among Lao and Cambodian refugees and immigrants in the United States of America. Cambodian and Laotian American adults in the United States of America were approached to complete help-seeking attitudes and acculturation scales. T test and hierarchical multiple regression analyses were used to analyze the relationships between the demographic and acculturation variables, and attitudes toward seeking psychological help. Out of 270 target subjects approached there were 108 respondents. Of the demographic variables, gender was associated with favorable attitudes towards psychological help-seeking. As expected, women were significantly more likely than men to recognize the need for help, to seek psychological help, to be more open to discussing mental health problems, and …
matched on Acculturation (mesh), Asian (mesh), Refugees (mesh), immigrant (text)
Secondary Traumatic Stress and Burnout Among Refugee Resettlement Workers: The Role of Coping and Emotional Intelligence.
To promote a better understanding of the impact of refugee resettlement work on refugee resettlement workers, this study examined the prevalence rates of deleterious mental health and occupational outcomes, such as secondary traumatic stress and burnout, among a sample of 210 refugee resettlement workers at six refugee resettlement agencies in the United States. The study also explored coping mechanisms used by service providers to manage work-related stress and the influence of such strategies and emotional intelligence on secondary traumatic stress and burnout. Our findings show that certain coping strategies, including self-distraction, humor, venting, substance use, behavioral disengagement, and self-blame, were strongly related to deleterious outcomes, βs = .18 to .38, ps = .023 to < .001. Emotional intelligence was a negative correlate for all outcomes, βs = -.25 to -.30, ps < .001…
matched on Emigration and Immigration (mesh), resettlement (text)
Family Medicine With Refugee Newcomers During the COVID-19 Pandemic.
Certain members of society are disproportionately affected by the COVID-19 crisis and the added strain being placed on already overextended health care systems. In this article, we focus on refugee newcomers. We outline vulnerabilities refugee newcomers face in the context of COVID-19, including barriers to accessing health care services, disproportionate rates of mental health concerns, financial constraints, racism, and higher likelihoods of living in relatively higher density and multigenerational dwellings. In addition, we describe the response to COVID-19 by a community-based refugee primary health center in Ontario, Canada. This includes how the clinic has initially responded to the crisis as well as recommendations for providing services to refugee newcomers as the COVID-19 crisis evolves. Recommendations include the following actions: (1) consider social determinants of health in…
matched on Emigrants and Immigrants (mesh), Refugees (mesh)
Brown R (2018)MEDLINE-indexed journal, not yet read by usDemography35 citations The Mexican Drug War and Early-Life Health: The Impact of Violent Crime on Birth Outcomes.
This study examines the relationship between exposure to violent crime in utero and birth weight using longitudinal data from a household survey conducted in Mexico. Controlling for selective migration and fertility, the results suggest that early gestational exposure to the recent escalation of the Mexican Drug War is associated with a substantial decrease in birth weight. This association is especially pronounced among children born to mothers of low socioeconomic status and among children born to mothers who score poorly on a mental health index.
matched on Emigration and Immigration (mesh), Mexico (mesh)
The Impact of Work Demand and Gender on Occupational and Psychosocial Stress in Hispanic Farmworkers.
Hispanic farmworkers experience hazardous work conditions, language barriers, poverty, and limited healthcare access that increase their risk for health problems. We sought to characterize occupational and lifestyle stressors in farmworker couples and to examine the impact of seasonal work demand and gender on health outcomes. We administered surveys to 31 couples (N = 62) in May (low work demand) and September (high work demand) of 2012. Measures included acculturation, perceived stress, depressive symptoms, quality of life, decision latitude, support (supervisor, co-worker), and work-family conflict. This population did not report significant differences in stress in low and high work demand times. Women reported more work-family conflict (F = 19.06, p 0.0001; F = 11.28, p = 0.0015) and less supervisor support (F = 6.56, p = 0.0135). Women experienced more conflict between work and fam…
matched on Emigrants and Immigrants (mesh), Mexico (mesh)
Correa-Velez I, Ryan J (2012)MEDLINE-indexed journal, not yet read by usWomen and birth : journal of the Australian College of Midwives74 citations Developing a best practice model of refugee maternity care.
Background: About one third of refugee and humanitarian entrants to Australia are women age 12-44 years. Pregnant women from refugee backgrounds may have been exposed to a range of medical and psychosocial issues that can impact maternal, fetal and neonatal health.
Research question: What are the key elements that characterise a best practice model of maternity care for women from refugee backgrounds? This paper outlines the findings of a project which aimed at developing such a model at a major maternity hospital in Brisbane, Australia.
Participants and methods: This multifaceted project included a literature review, consultations with key stakeholders, a chart audit of hospital use by African-born women in 2006 that included their obstetric outcomes, a survey of 23 African-born women who gave birth at the hospital in 2007-08, and a survey of 168 hospital staff members.
Results: The mat…
matched on Emigrants and Immigrants (mesh), Refugees (mesh)
The relationship between trauma, post-migration problems and the psychological well-being of refugees and asylum seekers.
Background: There is growing evidence of the impact of post-migration factors on the mental health of refugees. To date, few UK studies have been conducted.
Aims: The study investigated the relationship between trauma, post-migration problems, social support and the mental health of refugees and asylum seekers.
Methods: Refugees and asylum seekers (n = 47) were recruited mainly from clinical settings. Self-report measures of post-migration problems, mental health problems and social support were completed in an interview.
Results: Bivariate associations were identified between increased symptoms and number of traumas, adaptation difficulties, loss of culture and support and confidant support. In multivariate analyses post-migration problems were significantly associated with post-traumatic stress disorder symptoms and emotional distress. There was no significant association of symptoms a…
matched on Emigration and Immigration (mesh), Refugees (mesh)
Mental health of newly arrived Burmese refugees in Australia: contributions of pre-migration and post-migration experience.
Objective: This study documents the mental health status of people from Burmese refugee backgrounds recently arrived in Australia, then examines the contributions of gender, pre-migration and post-migration factors in predicting mental health.
Method: Structured interviews, including a demographic questionnaire, the Harvard Trauma Questionnaire, the Post-migration Living Difficulties Checklist and Hopkins Symptom Checklist assessed pre-migration trauma, post-migration living difficulties, depression, anxiety, somatization and traumatization symptoms in a sample of 70 adults across five Burmese ethnic groups.
Results: Substantial proportions of participants reported psychological distress in symptomatic ranges including: post-traumatic stress disorder (9%), anxiety (20%) and depression (36%), as well as significant symptoms of somatization (37%). Participants reported multiple and severe …
matched on Emigration and Immigration (mesh), Refugees (mesh)
Bird CE, Seeman T, Escarce JJ, Basurto-Dávila R, Finch BK, Dubowitz T, Heron M, Hale L, Merkin SS, Weden M, Lurie N (2010)MEDLINE-indexed journal, not yet read by usJournal of epidemiology and community health167 citations Neighbourhood socioeconomic status and biological 'wear and tear' in a nationally representative sample of US adults.
Objective: To assess whether neighbourhood socioeconomic status (NSES) is independently associated with disparities in biological 'wear and tear' measured by allostatic load in a nationally representative sample of US adults.
Design: Cross-sectional study.
Setting: Population-based US survey, the Third National Health and Nutrition Examination Survey (NHANES III), merged with US census data describing respondents' neighbourhoods.
Participants: 13,184 adults from 83 counties and 1805 census tracts who completed NHANES III interviews and medical examinations and whose residential addresses could be reliably geocoded to census tracts.
Main outcome measures: A summary measure of biological risk, incorporating nine biomarkers that together represent allostatic load across metabolic, cardiovascular and inflammatory subindices.
Results: Being male, older, having lower income, less education, be…
matched on Emigrants and Immigrants (mesh), Mexican Americans (mesh)
Model minority at risk: expressed needs of mental health by Asian American young adults.
The objective of this study is to obtain and discuss in-depth information on mental health problems, including the status, barriers, and potential solutions in 1.5 and 2nd generation Asian American young adults. As a part of the Health Needs Assessment project, the researchers conducted two focus groups with 17 young adults (mainly 1.5 or 2nd generation) from eight Asian American communities (Asian Indian, Cambodian, Chinese, Indonesian, Korean, Taiwanese, Thai, and Vietnamese) in Montgomery County, Maryland. We developed a moderator's guide with open-ended questions and used it to collect qualitative data. Using a software, we organized and identified emergent themes by major categories. Participants reported a several common sources of stress that affect the mental health of Asian American young adults including: pressure to meet parental expectations of high academic achievement and l…
matched on Emigrants and Immigrants (mesh), Asian (mesh)
Coping and resilience in refugees from the Sudan: a narrative account.
Objective: The purpose of this paper was to identify and explicate coping and resilience themes employed by 13 re-settled Sudanese refugees.
Method: A sample of 13 Sudanese refugees was asked to describe their experience of coping in the three periods of their migration, namely: pre migration from Sudan, transit, and post migration in their host country. Members of the sample participated in qualitative interviews conducted with the assistance a bilingual community worker.
Results: Three themes that characterized the experience of re-settled refugees across all periods were: religious beliefs, social support and personal qualities. A fourth less salient, theme, comparison with others, also emerged in the post-migration context.
Conclusions: A number of themes associated with coping and resilience in response to trauma were identified. These themes may be translated into strategies to ass…
matched on Emigration and Immigration (mesh), Refugees (mesh)