101
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van Mierlo B, Nagel N, van de Put W. Inspiring Life in Frozen Communities: Supporting Migrant Women in Brussels to Regain Control over their Lives. Community Ment Health J 2021; 57:598-605. [PMID: 33165689 DOI: 10.1007/s10597-020-00743-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Accepted: 11/03/2020] [Indexed: 11/29/2022]
Abstract
In Brussels, many migrant women without legal status have no or limited access to health care and other basic services. Their access to descent care is mainly hampered by a lack of information, limited financial resources and poor experiences in the past. Three non-governmental organisations joint efforts to help migrant women without legal status to come out of their isolation. Action research during the implementation process was conducted in order to know which elements contributed to increased feelings of trust and reinforced autonomy among the target group and more willingness to support migrants among a larger population. Our major conclusion is that mental health and well-being is largely defined by (the quality of) social relations and interactions - an aspect that is too often forgotten as a result of the medicalization of mental health related problems.
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Affiliation(s)
| | | | - Willem van de Put
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
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102
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Wallace M, Wilson B. Age variations and population over-coverage: Is low mortality among migrants merely a data artefact? Population Studies 2021; 76:81-98. [PMID: 33565944 DOI: 10.1080/00324728.2021.1877331] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The migrant mortality advantage has been observed extensively, but its authenticity is debated. In particular, concerns persist that the advantage is an artefact of the data, generated by the problems of recording mobility among foreign-born populations. Here, we build on the intersection of two recent developments: the first showing substantial age variation in the advantage-a deep U-shaped advantage at peak migration ages-and the second showing high levels of population over-coverage, the principal source of data artefact, at the same ages. We use event history analysis of Sweden's population registers (2010-15) to test whether this over-coverage can explain age variation in the migrant mortality advantage. We document its U-shape in Sweden and, crucially, demonstrate that large mortality differentials persist after adjusting for estimated over-coverage. Our findings contribute to ongoing debate by demonstrating that the migrant mortality advantage is real and by ruling out one of its primary mechanisms.
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Affiliation(s)
| | - Ben Wilson
- Stockholm University.,London School of Economics
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103
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The effect of migration on the incidence and mortality of bloodstream infection: a Danish register-based cohort study. Clin Microbiol Infect 2021; 27:1474-1480. [PMID: 33549766 DOI: 10.1016/j.cmi.2021.01.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 01/17/2021] [Accepted: 01/26/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVES To investigate bloodstream infection (BSI) related to migrant status by comparing the incidence and mortality in migrants with that in non-migrants. METHODS In this register-based cohort study we linked a cohort of migrants and non-migrants with a bacteraemia database covering two regions in Denmark. We included first-time BSI between January 2000 and December 2015 in individuals ≥18 years. Migrants were categorized according to status: refugees or family-reunified migrants. Incidence rate ratio and mortality rate ratio were analysed using Poisson regression. RESULTS We identified 493 080 non-migrants, of which 3405 had BSI, and 80 740 migrants with 576 cases; of the latter, 40 222 were family-reunified migrants with 226 cases and 40 518 were refugees with 350 cases. Refugees had a higher risk of BSI than non-migrants (adjusted IRR 1.19, 95%CI 1.01-1.40). Family-reunified migrants and refugees had a higher risk of Gram-negative BSIs (adjusted IRR 1.23, 95%CI 1.00-1.51 and 1.57, 95%CI 1.32-1.86), respectively, and a lower risk of Gram-positive BSIs (adjusted IRR 0.65, 95%CI 0.51-0.83 and 0.77, 95%CI 0.63-0.95), respectively, compared to non-migrants. Originating from Southeast Asia and the Pacific was associated with an increased risk of BSI compared to non-migrants (adjusted IRR 1.26, 95%CI 1.07-1.49). We found no differences in the adjusted 30-day or 90-day mortality according to migrant status. CONCLUSIONS Vulnerability towards BSI differs according to migrant status. Refugees had a higher risk of BSI overall. Both refugees and family-reunified migrants had a higher incidence of Gram-negative BSI than non-migrants. Similarly, migrants from Southeast Asia and the Pacific had a higher risk of BSI than non-migrants.
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104
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Agadjanian V, Hayford SR, Jansen NA. Men's migration and women's mortality in rural Mozambique. Soc Sci Med 2021; 270:113519. [PMID: 33358449 PMCID: PMC7990049 DOI: 10.1016/j.socscimed.2020.113519] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 11/08/2020] [Accepted: 11/09/2020] [Indexed: 11/16/2022]
Abstract
Labor migration is widespread and growing across the world. As migration grows, the economic outcomes of migration increasingly diversify, and so do its consequences for the well-being and health of both migrants and non-migrating household members. A considerable body of scholarship has examined the effects of migration on the physical and mental health of 'left-behind' household members. The impact of migration on mortality, particularly of non-migrating marital partners, is less well understood. Addressing this gap, we use data from a longitudinal survey of married women conducted over twelve years in rural Mozambique to examine the association between men's labor out-migration and their non-migrating wives' mortality. The analyses detect no significant differences when comparing non-migrants' wives to migrants' wives in the aggregate but point to instructive variation among migrants' wives according to the economic success of migration, as measured by the effects of migration on the household's material well-being. Specifically, women married to less successful migrants had higher mortality risks over the project span than women married to more successful migrants, regardless of other individual and household-level factors. Importantly for this setting with high HIV prevalence, the advantage of wives of more successful migrants is significant for HIV/AIDS-unrelated deaths but not for HIV/AIDS-related deaths. We situate these findings within the cross-national scholarship on migration and health.
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105
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Tønnessen M, Aradhya S, Mussino E. How Assad changed population growth in Sweden and Norway: Syrian refugees' impact on Nordic national and municipal demography. PLoS One 2021; 16:e0244670. [PMID: 33471846 PMCID: PMC7816981 DOI: 10.1371/journal.pone.0244670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 12/15/2020] [Indexed: 11/19/2022] Open
Abstract
In an increasingly interconnected world, the demographic effects of wars are not confined only to war zones and neighbouring areas; wars and conflicts may also change populations far away. Without the war in Syria under President Assad and the associated mass exodus of Syrian refugees, the population trends in distant countries like Sweden and Norway over the last few years would have been different. We create hypothetical scenarios of the population developments in Sweden and Norway without a war in Syria from 2011 onwards, where excess immigration due to the war and associated excess births are removed. The results indicate that population growth in 2016 would have been roughly 36% lower in Sweden and 26% lower in Norway without the Syrian war. The number of births in 2017 would have been about 3% lower in Sweden and 1% lower in Norway. One in ten municipalities would have had a population decline in 2016 instead of a population increase, and the largest immigrant group in Sweden by January 2019 would still be of Finnish origin.
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Affiliation(s)
- Marianne Tønnessen
- Norwegian Institute for Urban and Regional Research, Oslo Metropolitan University, Oslo, Norway
- * E-mail:
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106
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Zhang N, Nazroo J, Vanhoutte B. The relationship between rural to urban migration in China and risk of depression in later life: An investigation of life course effects. Soc Sci Med 2021; 270:113637. [PMID: 33421918 DOI: 10.1016/j.socscimed.2020.113637] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 12/16/2020] [Accepted: 12/18/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Migrating between rural and urban areas over the life course profoundly shapes the conditions of later life. In the Chinese context, living in urban areas with an urban Hukou is associated with socioeconomic advantage. This study attempts to investigate how migration into urban areas in China is related to these processes and the association with risk of depression in later life by focusing on the timing and the type of migration (rural-urban residential mobility and/or institutional transition of Hukou status). METHODS We use sequence analysis to identify migration trajectories in the China Health and Retirement Longitudinal Study. Then we estimate how and why these trajectories are associated with risk of depression at older ages using a random intercept hierarchical linear model, distinguishing between three levels: city, household and individual. RESULTS The type of migration path taken over the life course is differentially associated with mental wellbeing in later life in China. Urban migration with rural-urban Hukou conversion during young adulthood is associated with lower levels of depression in later life. Urban migration at older ages regardless of Hukou transitions is protective against depression in old age. Formal social protection, particularly having a private pension, contributes substantially to the mental health advantage of social groups with an urban Hukou. Informal social mechanisms such as familial support are relevant, but only explain a small part of the differences in mental health. CONCLUSION Having an urban Hukou has an independent protective role in shaping mental wellbeing in later life in China, potentially in part due to the entitlement to a private pension attached to this status. With weakening informal support in contemporary China, enhanced formal social protections in the form of adequate pensions should be put in place to mitigate structural inequalities associated with migration in old age.
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Affiliation(s)
- Nan Zhang
- Social Statistics School of Social Sciences, University of Manchester, Oxford Road, Manchester, M13 9PL, UK; Manchester Institute for Collaborative Research on Ageing (MICRA), University of Manchester, Oxford Road, Manchester, M13 9PL, UK; Cathie Marsh Institute for Social Research (CMI), University of Manchester, Oxford Road, Manchester, M13 9PL, UK.
| | - James Nazroo
- Manchester Institute for Collaborative Research on Ageing (MICRA), University of Manchester, Oxford Road, Manchester, M13 9PL, UK; Cathie Marsh Institute for Social Research (CMI), University of Manchester, Oxford Road, Manchester, M13 9PL, UK; Sociology, School of Social Sciences, University of Manchester, Oxford Road, Manchester, M13 9PL, UK.
| | - Bram Vanhoutte
- École de Santé Publique, Université Libre de Bruxelles, Route de Lennik 808, CP5911070, Brussels, Belgium.
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107
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Burns R, Zhang CX, Patel P, Eley I, Campos-Matos I, Aldridge RW. Migration health research in the United Kingdom: A scoping review. J Migr Health 2021; 4:100061. [PMID: 34405201 PMCID: PMC8352015 DOI: 10.1016/j.jmh.2021.100061] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 07/05/2021] [Accepted: 07/05/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND One in seven people living in the United Kingdom (UK) is an international migrant, rendering migrants an important population group with diverse and dynamic health and healthcare needs. However, there has been no attempt to map contemporary trends within migration health research conducted in the UK. The aim of this scoping review was to describe trends within migration health research and identify gaps for future research agendas. METHODS PubMed and Embase were systematically searched for empirical research with a primary focus on the concepts "health" and "migrants" published between 2001 and 2019. Findings were analysed using the UCL-Lancet Commission on Migration and Health Conceptual Framework for Migration and Health. RESULTS In total, 399 studies were included, with almost half (41.1%; 164/399) published in the last five years of the study period between 2015 and 2019 and a third (34.1%; 136/399) conducted in London. Studies included asylum seekers (14.8%; 59/399), refugees (12.3%; 49/399), and undocumented migrants or migrants with insecure status (3.5%; 14/399), but most articles (74.9%; 299/399) did not specify a migrant sub-group. The most studied health topics were specific disease outcomes such as infectious diseases (24.1% of studies) and mental health (19.1%) compared to examining systems or structures that impact health (27.8%), access to healthcare (26.3%), or specific exposures or behaviours (35.3%). CONCLUSIONS There has been a growing interest in migration health. Ensuring a diverse geographic distribution of research conducted in the UK and disaggregation by migrant sub-group is required for a nuanced and region-specific understanding of specific health needs, interventions and appropriate service delivery for different migrant populations. More research is needed to understand how migration policy and legislation intersect with both the social determinants of health and access to healthcare to shape the health of migrants in the UK.
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Affiliation(s)
- Rachel Burns
- Centre of Public Health Data Science, Institute of Health Informatics, University College London, 222 Euston Road, London NW1 2DA, United Kingdom
- Corresponding author at: Centre of Public Health Data Science, Institute of Health Informatics, University College London, 222 Euston Road, London NW1 2DA, United Kingdom.
| | - Claire X. Zhang
- Centre of Public Health Data Science, Institute of Health Informatics, University College London, 222 Euston Road, London NW1 2DA, United Kingdom
- Public Health England, Wellington House, 133-155 Waterloo Rd, South Bank, London SE1 8UG, United Kingdom
| | - Parth Patel
- Centre of Public Health Data Science, Institute of Health Informatics, University College London, 222 Euston Road, London NW1 2DA, United Kingdom
| | - Ida Eley
- Centre of Public Health Data Science, Institute of Health Informatics, University College London, 222 Euston Road, London NW1 2DA, United Kingdom
| | - Ines Campos-Matos
- Public Health England, Wellington House, 133-155 Waterloo Rd, South Bank, London SE1 8UG, United Kingdom
- Collaborative Centre for Inclusion Health, Institute of Epidemiology and Healthcare, University College London, 1-19 Torrington Place, London WC1E 7HB, United Kingdom
| | - Robert W. Aldridge
- Centre of Public Health Data Science, Institute of Health Informatics, University College London, 222 Euston Road, London NW1 2DA, United Kingdom
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108
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Jang S, Cho H, Kang C, Jang S. Antidepressant adherence and its predictors in immigrants with depression: A population-based study. Medicine (Baltimore) 2020; 99:e23308. [PMID: 33371064 PMCID: PMC7748329 DOI: 10.1097/md.0000000000023308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Accepted: 10/21/2020] [Indexed: 11/26/2022] Open
Abstract
Immigrants in Korea are relatively vulnerable in terms of medication self-management and have low levels of medication adherence. We aimed to evaluate antidepressant adherence and its patterns in immigrants and to identify predictors of nonadherence.In this matched cohort study using the National Health Insurance claims database, immigrants who were newly prescribed antidepressants were identified (n = 2,398). The immigrants were matched with native-born Koreans in a 1:1 ratio. Antidepressant adherence was measured by the medication possession ratio at monthly intervals. Logistic regression was performed to compare antidepressant nonadherence between immigrants and native-born Koreans, and to identify factors affecting immigrants' nonadherence.The average medication possession ratio of immigrants was 27.1%, which was lower than that of native-born Koreans (30.9%) (P = .038). Immigrants had a lower likelihood of adherence than native-born Koreans (odds ratio [OR] 0.76, 95% confidence interval [CI] 0.3-0.92). Older age, visiting a psychiatrist for the first diagnosis of depression (OR 2.24, 95% CI 1.60-3.13), achieving appropriateness of care (OR 3.54, 95% CI 2.51-4.98), and having a usual source of care (OR 1.69, 95% CI 1.25-2.27) were associated with a higher likelihood of adherence in immigrants.This study showed that antidepressant adherence of immigrants was lower than that of native-born Koreans. However, it appears that visiting a psychiatrist, achieving appropriateness of care, and having a usual source of care might increase antidepressant adherence among immigrants. Further research that focuses on cultural and/or linguistic factors affecting immigrants' adherence and healthcare utilization is suggested as a way to increase adherence.
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Affiliation(s)
- Suhyun Jang
- College of Pharmacy and Gachon Institute of Pharmaceutical Sciences, Gachon University, Incheon
| | - Hyemin Cho
- College of Pharmacy and Gachon Institute of Pharmaceutical Sciences, Gachon University, Incheon
| | - Cinoo Kang
- Department of Biostatics and Epidemiology Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Sunmee Jang
- College of Pharmacy and Gachon Institute of Pharmaceutical Sciences, Gachon University, Incheon
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109
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Country of birth and mortality risk in hypertension with and without diabetes: the Swedish primary care cardiovascular database. J Hypertens 2020; 39:1155-1162. [PMID: 33298686 DOI: 10.1097/hjh.0000000000002744] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Hypertension and diabetes are common and are both associated with high cardiovascular morbidity and mortality. We aimed to investigate associations between mortality risk and country of birth among hypertensive individuals in primary care with and without concomitant diabetes, which has not been studied previously. In addition, we aimed to study the corresponding risks of myocardial infarction and ischemic stroke. METHODS This observational cohort study of 62 557 individuals with hypertension diagnosed 2001-2008 in the Swedish Primary Care Cardiovascular Database assessed mortality by the Swedish Cause of Death Register, and myocardial infarction and ischemic stroke by the National Patient Register. Cox regression models were used to estimate study outcome hazard ratios by country of birth and time updated diabetes status, with adjustments for multiple confounders. RESULTS During follow-up time without diabetes using Swedish-born as reference, adjusted mortality hazard ratios per country of birth category were Finland: 1.26 (95% confidence interval 1.15-1.38), high-income European countries: 0.84 (0.74-0.95), low-income European countries: 0.84 (0.71-1.00) and non-European countries: 0.65 (0.56-0.76). The corresponding adjusted mortality hazard ratios during follow-up time with diabetes were high-income European countries: 0.78 (0.63-0.98), low-income European countries: 0.74 (0.57-0.96) and non-European countries: 0.56 (0.44-0.71). During follow-up without diabetes, the corresponding adjusted hazard ratio of myocardial infarction was increased for Finland: 1.16 (1.01-1.34), whereas the results for ischemic stroke were inconclusive. CONCLUSION In Sweden, hypertensive immigrants (with the exception for Finnish-born) with and without diabetes have a mortality advantage, as compared to Swedish-born.
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110
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Sze S, Pan D, Nevill CR, Gray LJ, Martin CA, Nazareth J, Minhas JS, Divall P, Khunti K, Abrams KR, Nellums LB, Pareek M. Ethnicity and clinical outcomes in COVID-19: A systematic review and meta-analysis. EClinicalMedicine 2020; 29:100630. [PMID: 33200120 PMCID: PMC7658622 DOI: 10.1016/j.eclinm.2020.100630] [Citation(s) in RCA: 370] [Impact Index Per Article: 92.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 10/26/2020] [Accepted: 10/26/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Patients from ethnic minority groups are disproportionately affected by Coronavirus disease (COVID-19). We performed a systematic review and meta-analysis to explore the relationship between ethnicity and clinical outcomes in COVID-19. METHODS Databases (MEDLINE, EMBASE, PROSPERO, Cochrane library and MedRxiv) were searched up to 31st August 2020, for studies reporting COVID-19 data disaggregated by ethnicity. Outcomes were: risk of infection; intensive therapy unit (ITU) admission and death. PROSPERO ID: 180654. FINDINGS 18,728,893 patients from 50 studies were included; 26 were peer-reviewed; 42 were from the United States of America and 8 from the United Kingdom. Individuals from Black and Asian ethnicities had a higher risk of COVID-19 infection compared to White individuals. This was consistent in both the main analysis (pooled adjusted RR for Black: 2.02, 95% CI 1.67-2.44; pooled adjusted RR for Asian: 1.50, 95% CI 1.24-1.83) and sensitivity analyses examining peer-reviewed studies only (pooled adjusted RR for Black: 1.85, 95%CI: 1.46-2.35; pooled adjusted RR for Asian: 1.51, 95% CI 1.22-1.88). Individuals of Asian ethnicity may also be at higher risk of ITU admission (pooled adjusted RR 1.97 95% CI 1.34-2.89) (but no studies had yet been peer-reviewed) and death (pooled adjusted RR/HR 1.22 [0.99-1.50]). INTERPRETATION Individuals of Black and Asian ethnicity are at increased risk of COVID-19 infection compared to White individuals; Asians may be at higher risk of ITU admission and death. These findings are of critical public health importance in informing interventions to reduce morbidity and mortality amongst ethnic minority groups.
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Affiliation(s)
- Shirley Sze
- Department of Cardiovascular Sciences, University of Leicester, United Kingdom
| | - Daniel Pan
- Department of Respiratory Sciences, University of Leicester, United Kingdom
- Department of Infection and HIV Medicine, University Hospitals Leicester NHS Trust, United Kingdom
| | - Clareece R Nevill
- Department of Health Sciences, University of Leicester, United Kingdom
| | - Laura J Gray
- Department of Health Sciences, University of Leicester, United Kingdom
| | - Christopher A Martin
- Department of Respiratory Sciences, University of Leicester, United Kingdom
- Department of Infection and HIV Medicine, University Hospitals Leicester NHS Trust, United Kingdom
| | - Joshua Nazareth
- Department of Respiratory Sciences, University of Leicester, United Kingdom
- Department of Infection and HIV Medicine, University Hospitals Leicester NHS Trust, United Kingdom
| | - Jatinder S Minhas
- Department of Cardiovascular Sciences, University of Leicester, United Kingdom
| | - Pip Divall
- University Hospitals of Leicester, Education Centre Library, Glenfield Hospital and Leicester Royal Infirmary, United Kingdom
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, United Kingdom
| | - Keith R Abrams
- Department of Health Sciences, University of Leicester, United Kingdom
| | - Laura B Nellums
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, United Kingdom
| | - Manish Pareek
- Department of Respiratory Sciences, University of Leicester, United Kingdom
- Department of Infection and HIV Medicine, University Hospitals Leicester NHS Trust, United Kingdom
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111
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Linton NM, DeBolt C, Newman LP, Tasslimi A, Matheson J. Mortality Rate and Causes of Death Among Refugees Resettled in Washington State, 2006-2016. J Immigr Minor Health 2020; 22:3-9. [PMID: 31773449 DOI: 10.1007/s10903-019-00949-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Cause of death among refugees resettled in the United States is not well documented. This evaluation determined cause of death among refugees who resettled to and died in Washington State. Records of refugees who arrived in Washington State from 2006 to 2016 were linked to state death records for the same period. Rates and proportions of death were calculated and compared to those for all Washingtonians. From 2006 to 2016, 171 of 30,243 refugees (0.6%) resettled to and died in Washington. The age-adjusted all-cause mortality rate was 3.93 (95% CI 3.12-4.75) per 1000 refugees, compared to 6.98 (95% CI 6.96-7.00) per 1000 Washingtonians. Malignant neoplasms and heart disease were the leading causes of death for both refugees and Washingtonians. Determining cause of death among refugee populations can identify emerging trends in mortality. This information can be used to help inform disease and injury prevention interventions for refugee communities.
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Affiliation(s)
- Natalie M Linton
- Office of Communicable Disease Epidemiology, Washington State Department of Health, 1610 NE 150th St, Shoreline, WA, 98155, USA.,CDC/CSTE Applied Epidemiology Fellowship, Shoreline, WA, USA
| | - Charla DeBolt
- Office of Communicable Disease Epidemiology, Washington State Department of Health, 1610 NE 150th St, Shoreline, WA, 98155, USA
| | - Laura P Newman
- Office of Communicable Disease Epidemiology, Washington State Department of Health, 1610 NE 150th St, Shoreline, WA, 98155, USA. .,Department of Global Health, University of Washington, Seattle, WA, USA.
| | - Azadeh Tasslimi
- Office of Communicable Disease Epidemiology, Washington State Department of Health, 1610 NE 150th St, Shoreline, WA, 98155, USA
| | - Jasmine Matheson
- Office of Communicable Disease Epidemiology, Washington State Department of Health, 1610 NE 150th St, Shoreline, WA, 98155, USA
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112
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Hraiech S, Papazian L, Azoulay E. Migrants in the intensive care unit: time to show we care. Intensive Care Med 2020; 47:473-475. [PMID: 33231732 DOI: 10.1007/s00134-020-06318-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 11/02/2020] [Indexed: 01/01/2023]
Affiliation(s)
- Sami Hraiech
- Service de Médecine Intensive - Réanimation, APHM, Hôpital Nord, Marseille, France.,CEReSS - Center for Studies and Research On Health Services and Quality of Life EA3279, Aix-Marseille University, Paris, France
| | - Laurent Papazian
- Service de Médecine Intensive - Réanimation, APHM, Hôpital Nord, Marseille, France.,CEReSS - Center for Studies and Research On Health Services and Quality of Life EA3279, Aix-Marseille University, Paris, France
| | - Elie Azoulay
- Service de Médecine Intensive Et Réanimation, Assistance Publique Hôpitaux de Paris, Hôpital Saint-Louis, Paris, France.
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113
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Srisai P, Phaiyarom M, Suphanchaimat R. Perspectives of Migrants and Employers on the National Insurance Policy (Health Insurance Card Scheme) for Migrants: A Case Study in Ranong, Thailand. Risk Manag Healthc Policy 2020; 13:2227-2238. [PMID: 33117001 PMCID: PMC7585867 DOI: 10.2147/rmhp.s268006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 09/24/2020] [Indexed: 01/09/2023] Open
Abstract
Background and Purposes Thailand has implemented a nationwide insurance policy for migrants, namely the Health Insurance Card Scheme (HICS), for a long time. However, numerous implementation challenges remain and migrant perspectives on the policy are rarely known. The aim of this study was to examine migrant service users’ perspectives and their consequent response towards the HICS. Methods A qualitative case-study approach was employed. In-depth interviews with ten local migrants and four employers were conducted in one of the most densely migrant-populated provinces in Thailand. Document review was used as a means for data triangulation. Inductive thematic analysis was exercised on interview data. Results The findings revealed that most migrants were not aware of the benefit, they are entitled to receive from the HICS due to unclear communication and inadequate announcements about the policy. The registration costs needed for legalising migrants’ precarious status were a major concern. Adequate support from employers was a key determining factor that encouraged migrants to participate in the registration process and purchase the insurance card. Some employers sought assistance from private intermediaries or brokers to facilitate the registration process for migrants. Conclusion Proper communication and promotion regarding the benefits of the HICS and local authorities taking action to expedite the registration process for migrants are recommended. The policy should also establish a mechanism to receive feedback from migrants. This will help resolve implementation challenges and lead to further improvement of the policy.
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Affiliation(s)
- Patinya Srisai
- International Health Policy Program (IHPP), The Ministry of Public Health, Nonthaburi 11000, Thailand
| | - Mathudara Phaiyarom
- International Health Policy Program (IHPP), The Ministry of Public Health, Nonthaburi 11000, Thailand
| | - Rapeepong Suphanchaimat
- International Health Policy Program (IHPP), The Ministry of Public Health, Nonthaburi 11000, Thailand.,Division of Epidemiology, Department of Disease Control, The Ministry of Public Health, Nonthaburi 11000, Thailand
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114
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Narla NP, Surmeli A, Kivlehan SM. Agile Application of Digital Health Interventions during the COVID-19 Refugee Response. Ann Glob Health 2020; 86:135. [PMID: 33117656 PMCID: PMC7566526 DOI: 10.5334/aogh.2995] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
The intersection of digital health platforms and refugee health in the context of the novel 2019 coronavirus disease (COVID-19) has not yet been explored. We discuss the ability of a novel mobile health (mhealth) platform to be effectively adapted to improve health access for vulnerable displaced populations. In a preliminary analysis of 200 Syrian refugee women, we found positive user feedback and uptake of an mhealth application to increase access to preventive maternal and child health services for Syrian refugees under temporary protection in Turkey. Rapid adaptation of this application was successfully implemented during a global pandemic state to perform symptomatic assessment, disseminate health education, and bolster national prevention efforts. We propose that mhealth interventions can provide an innovative, cost-effective, and user-friendly approach to access the dynamic needs of refugees and other displaced populations, particularly during an emerging infectious disease outbreak.
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Affiliation(s)
- Nirmala P. Narla
- Division of Medical Critical Care, Boston Children’s Hospital and Harvard Medical School, MA, US
| | - Aral Surmeli
- Medical Rescue Association of Turkey (MEDAK), Istanbul, TR
| | - Sean M. Kivlehan
- Department of Emergency Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, US
- Harvard Humanitarian Initiative, Cambridge, MA, US
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115
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Poole DN, Hedt-Gauthier B, Bärnighausen T, Verguet S, Castro MC. Spatial-temporal trends in forced migrant mortality, 2014-2018. BMJ Glob Health 2020; 5:bmjgh-2020-002885. [PMID: 33037060 PMCID: PMC7549474 DOI: 10.1136/bmjgh-2020-002885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 09/02/2020] [Accepted: 09/16/2020] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION The identification of spatial-temporal clusters of forced migrant mortality is urgently needed to inform preventative policies and humanitarian response. As a first step towards understanding the geography of forced migrant mortality, this study investigates spatial-temporal patterns in death at a global scale. METHODS We used information on the location and dates of forced migrant deaths reported in the International Organization for Migration's Missing Migrant Project from 2014 to 2018. Kulldorff's spatial-temporal and seasonal scans were used to detect spatial-temporal and temporal heterogeneity in mortality. RESULTS A total of 16 314 deaths were reported during the study period. A preponderance of deaths occurred at sea each year (range 26%-54% across 5 years). Twelve spatial-temporal clusters of forced migrant mortality were detected by maximum likelihood testing. Annually, the period of August-October was associated with a 40-percentage-point increase in the risk of mortality, relative to other time periods. CONCLUSIONS Death during forced migration occurs close to national borders and during periods of intense conflict. This evidence may inform the design of policies and targeting of interventions to prevent forced migration-related deaths.
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Affiliation(s)
- Danielle N Poole
- Neukom Institute for Computational Science, Dartmouth College, Hanover, New Hampshire, USA .,Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, Massachusetts, USA
| | - Bethany Hedt-Gauthier
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA.,Department of Biostatistics, Harvard T H Chan School of Public Health, Boston, Massachusetts, USA
| | - Till Bärnighausen
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany.,Africa Health Research Institute, KwaZulu-Natal, South Africa
| | - Stéphane Verguet
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, Massachusetts, USA
| | - Marcia C Castro
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, Massachusetts, USA
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Dutheil F, Pélangeon S, Duclos M, Vorilhon P, Mermillod M, Baker JS, Pereira B, Navel V. Protective Effect on Mortality of Active Commuting to Work: A Systematic Review and Meta-analysis. Sports Med 2020; 50:2237-2250. [PMID: 33034873 DOI: 10.1007/s40279-020-01354-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Sedentary behaviour is a major risk of mortality. However, data are contradictory regarding the effects of active commuting on mortality. OBJECTIVES To perform a systematic review and meta-analysis on the effects of active commuting on mortality. METHODS The PubMed, Cochrane Library, Embase, and Science Direct databases were searched for studies reporting mortality data and active commuting (walking or cycling) to or from work. We computed meta-analysis stratified on type of mortality, type of commuting, and level of commuting, each with two models (based on fully adjusted estimates of risks, and on crude or less adjusted estimates). RESULTS 17 studies representing 829,098 workers were included. Using the fully adjusted estimates of risks, active commuting decreased all-cause mortality by 9% (95% confidence intervals 3-15%), and cardiovascular mortality by 15% (3-27%) (p < 0.001). For stratification by type of commuting, walking decreased significantly all-cause mortality by 13% (1-25%), and cycling decreased significantly both all-cause mortality by 21% (11-31%) and cardiovascular mortality by 33% (10-55%) (p < 0.001). For stratification by level of active commuting, only high level decreased all-cause mortality by 11% (3-19%) and both intermediate and high level decreased cardiovascular mortality. Low level did not decrease any type of mortality. Cancer mortality did not decrease with walking or cycling, and the level of active commuting had no effect. Low level walking did not decrease any type of mortality, intermediate level of walking decreased only all-cause mortality by 15% (2-28%), and high level of walking decreased both all-cause and cardiovascular mortality by 19% (8-30%) and by 31% (9-52%), respectively. Both low, intermediate and high intensities of cycling decreased all-cause mortality. Meta-analysis based on crude or less fully adjusted estimates retrieved similar results, with also significant reductions of cancer mortality with cycling (23%, 5-42%), high level of active commuting (14%, 4-24%), and high level of active commuting by walking (16%, 0-32%). CONCLUSION Active commuting decreases mainly all-cause and cardiovascular mortality, with a dose-response relationship, especially for walking. Preventive strategies should focus on the benefits of active commuting.
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Affiliation(s)
- Frédéric Dutheil
- CNRS, LaPSCo, Physiological and Psychosocial Stress, CHU Clermont-Ferrand, University Hospital of Clermont-Ferrand, Preventive and Occupational Medicine, Université Clermont Auvergne, Witty Fit, 63000, Clermont-Ferrand, France. .,Faculty of Health, School of Exercise Science, Melbourne, Australia2 General Medicine, AMUAC, Australian Catholic University, 63000, Clermont-Ferrand, France.
| | | | - Martine Duclos
- INRA, UMR 1019, CRNH-Auvergne, University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Sport Medicine and Functional Explorations, Université Clermont Auvergne, 63000, Clermont-Ferrand, France
| | - Philippe Vorilhon
- Université Clermont Auvergne, UPU ACCePPT, 63000, Clermont-Ferrand, France
| | - Martial Mermillod
- Université Grenoble Alpes, Université Savoie Mont Blanc, CNRS, LPNC, 38000, Grenoble, France.,Institut Universitaire de France, Paris, France
| | - Julien S Baker
- Centre for Health and Exercise Science Research, Department of Sport, Physical Education and Health, Hong Kong Baptist University, Kowloon Tong, Hong Kong
| | - Bruno Pereira
- CHU Clermont-Ferrand, Clinical Research and Innovation Direction, University Hospital of Clermont Ferrand, 63000, Clermont-Ferrand, France
| | - Valentin Navel
- CNRS, INSERM, GReD, Translational Approach To Epithelial Injury and Repair, CHU Clermont-Ferrand, University Hospital of Clermont-Ferrand, Ophthalmology, Université Clermont Auvergne, 63000, Clermont-Ferrand, France
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A population-based cohort study of socio-demographic risk factors for COVID-19 deaths in Sweden. Nat Commun 2020; 11:5097. [PMID: 33037218 PMCID: PMC7547672 DOI: 10.1038/s41467-020-18926-3] [Citation(s) in RCA: 193] [Impact Index Per Article: 48.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 09/18/2020] [Indexed: 12/23/2022] Open
Abstract
As global deaths from COVID-19 continue to rise, the world’s governments, institutions, and agencies are still working toward an understanding of who is most at risk of death. In this study, data on all recorded COVID-19 deaths in Sweden up to May 7, 2020 are linked to high-quality and accurate individual-level background data from administrative registers of the total population. By means of individual-level survival analysis we demonstrate that being male, having less individual income, lower education, not being married all independently predict a higher risk of death from COVID-19 and from all other causes of death. Being an immigrant from a low- or middle-income country predicts higher risk of death from COVID-19 but not for all other causes of death. The main message of this work is that the interaction of the virus causing COVID-19 and its social environment exerts an unequal burden on the most disadvantaged members of society. Better understanding of who is at highest risk of death from COVID-19 is important for public health planning. Here, the authors demonstrate an unequal mortality burden associated with socially disadvantaged groups in Sweden.
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118
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Vivier T, Moro MR, Baubet T, Pionnie-Dax N, Grandclerc S, Lachal J. [Suicidal behaviors in migrant youths: Male experiences]. Encephale 2020; 47:123-129. [PMID: 32928530 DOI: 10.1016/j.encep.2020.04.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 04/22/2020] [Accepted: 04/28/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Suicide is the second leading cause of death among adolescents. Boys are more affected than girls, although they report fewer suicide attempts and rely less on care. Few studies have examined the experience of suicidal thoughts and behavior among young boys. In order to improve their health care, it is necessary to consider the socio-cultural aspects and the construction of the meaning given by adolescent boys to suicidal behaviors in France. METHOD This is a qualitative, complementary and inductive study. All teens included have presented suicidal thoughts in the months preceding the inclusion. The existence of self-mutilation and/or suicidal act is sought but is not included within the criteria of inclusion, the various contexts will enrich the data. Semi-structured interviews are transcribed and analyzed by the Interpretative Phenomenological Analysis. RESULTS Ten adolescents between 14 and 20 years old were included in the study. Three axes of experience emerge: the relationship to oneself, the relationship to the other, the relationship to death. Some themes are common to experiences of both boys and girls, others are more specific to the boys' experience. The inner struggle, testing one's limits and an isolating unspeakable are thus common, highlighting the difficulty for adolescents to mentalize and verbalize emotions and feelings. Difficulties in connecting with others, and feelings of loneliness and isolation, are at the core of the participants' experience. However, the experience of boys appears specific in the difficulty to represent the irreversibility of death which can lead to suicidal behavior without direct intentionality. The narrative of suicidal acts, in its formulation, is quite different from that of young girls. One can assume that the difficulty of expressing suffering could lead young boys to develop a discourse that overshadows the question of their death, or in contrast magnifies it in a rewarding stage from which they pride themselves. The fear of being isolated or rejected seems almost insurmountable for the boys interviewed. The fear of the judgment of peers or the family is mixed with the imperative to face the problem by oneself and reinforces the feeling of isolation in a retroactive loop. The story of the suicidal act can take a positive and enriching tone in the participant's stories. This only applies to adolescents with a history of suicidal gesture. The experience of acting out and its consequences seems to be integrated by the adolescent as elements which participate to a certain extent to the construction of their identity. This ameliorative feature can be compared to the hegemonic social models of masculinity. The sociological notion of gender identity makes it possible to think of this construction in a dynamic way and to propose adaptations of the caregivers' attitude during the first interviews with a suicidal teenager. During the first meetings, the caregiver should explore the adolescent's representations of the suicidal crisis in a neutral, self-interested, and unbiased way, including when the representations are disturbing or shocking for the caregiver. For example, when the patient values or glorifies suicidal behavior or when care is experienced as a sign of weakness and vulnerability. Respect of these proposals can indeed support weakened narcissistic foundations and favor encounter and alliance. This can only be done with the conviction that these representations are not frozen, but in construction, and that they can be secondarily mobilized in the therapeutic relationship. For that purpose, a work of elaboration on the representations of the masculinity will be able to lead the young person to reconsider his perception of care and suicidal behaviors. Reflexivity on the part of the caregiver about his own representations of masculinity seems necessary. CONCLUSION Therapeutic management must explore and respect the adolescent's representations of masculinity and then mobilize them to bring the young person to reconsider his perception of care and suicidal behavior.
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Affiliation(s)
- T Vivier
- Université Paris 13, UFR des Lettres, des sciences de l'homme et des sociétés unité transversale de recherche psychogenèse et psychopathologie, UTRPP EA4403, 93430 Villetaneuse, France.
| | - M-R Moro
- Hôpital Cochin, Maison de Solenn, AP-HP, 75014 Paris, France; Université de Paris, PCPP, 92100 Boulogne-Billancourt, France; Université Paris-Saclay, UVSQ, inserm, CESP, Team DevPsy, 94807 Villejuif, France
| | - T Baubet
- Université Paris-Saclay, UVSQ, inserm, CESP, Team DevPsy, 94807 Villejuif, France; Assistance publique-Hôpitaux de Paris (AP-HP), hôpital Avicenne, service de psychopathologie, université de Paris 13, 93009 Bobigny cedex, France; Centre national de ressources et de résilience (CNRR), 93009 Bobigny, France
| | - N Pionnie-Dax
- Établissement public de santé mentale ERASME, pôle de psychiatrie de l'enfant et l'adolescent, 92160 Antony, France
| | - S Grandclerc
- Hôpital Cochin, Maison de Solenn, AP-HP, 75014 Paris, France; Établissement public de santé mentale ERASME, pôle de psychiatrie de l'enfant et l'adolescent, 92160 Antony, France
| | - J Lachal
- Hôpital Cochin, Maison de Solenn, AP-HP, 75014 Paris, France; Université de Paris, PCPP, 92100 Boulogne-Billancourt, France; Université Paris-Saclay, UVSQ, inserm, CESP, Team DevPsy, 94807 Villejuif, France
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Strømme EM, Haj-Younes J, Hasha W, Fadnes LT, Kumar B, Igland J, Diaz E. Changes in health among Syrian refugees along their migration trajectories from Lebanon to Norway: a prospective cohort study. Public Health 2020; 186:240-245. [PMID: 32861924 DOI: 10.1016/j.puhe.2020.07.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 07/09/2020] [Accepted: 07/13/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Conflict-driven displacement is an indisputable social determinant of health. Yet, data on changes in health along the migration trajectories of refugees are scarce. This study aims to assess the longitudinal changes in somatic and mental health and use of medication among Syrian refugees relocating from a conflict-near transit setting in the Middle East to a resettlement setting in Europe. Further, we examine different health status trajectories and factors that predict health in the early postmigration period. STUDY DESIGN This is a prospective cohort study. METHODS Survey data were collected during 2017-2018 among adult Syrian refugees in Lebanon selected for quota resettlement and at follow-up approximately one year after resettlement in Norway. Our primary outcomes were non-communicable disease (NCD), chronic impairment, chronic pain, anxiety/depression, post-traumatic stress symptoms, and daily use of drugs. We estimated longitudinal changes in prevalence proportions using generalized estimating equations and evaluated effect modification of health outcomes. RESULTS Altogether, 353 Syrians participated. NCDs declined (12%-9%), while the prevalence of chronic impairment, chronic pain, and use of drugs remained nearly unchanged (29%-28%, 30%-28%, and 20%-18%) between baseline and follow-up. Conversely, mental health outcomes improved (anxiety/depression 33%-11%, post-traumatic stress disorder 5%-2%). Effect modifiers for improvement over time included younger age, short length of stay, and non-legal status in the transit country before resettlement in Europe. CONCLUSIONS We find that mental health outcomes improve from a conflict-near transit setting in Lebanon to an early resettlement setting in Norway, while somatic health outcomes remain stable. Temporal changes in health among moving populations warrant attention, and long-term changes need further scrutiny.
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Affiliation(s)
- E M Strømme
- Department of Global Public Health and Primary Care, University of Bergen, PO Box 7804, 5020, Bergen, Norway.
| | - J Haj-Younes
- Department of Global Public Health and Primary Care, University of Bergen, PO Box 7804, 5020, Bergen, Norway.
| | - W Hasha
- Department of Global Public Health and Primary Care, University of Bergen, PO Box 7804, 5020, Bergen, Norway.
| | - L T Fadnes
- Department of Global Public Health and Primary Care, University of Bergen, PO Box 7804, 5020, Bergen, Norway; Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway.
| | - B Kumar
- Unit for Migration and Health, Norwegian Institute of Public Health, PO Box 222 Skøyen, 0213, Oslo, Norway.
| | - J Igland
- Department of Global Public Health and Primary Care, University of Bergen, PO Box 7804, 5020, Bergen, Norway.
| | - E Diaz
- Department of Global Public Health and Primary Care, University of Bergen, PO Box 7804, 5020, Bergen, Norway; Unit for Migration and Health, Norwegian Institute of Public Health, PO Box 222 Skøyen, 0213, Oslo, Norway.
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Amiri S. Worldwide prevalence of smoking in immigration: A global systematic review and meta-analysis. J Addict Dis 2020; 38:567-579. [PMID: 32780650 DOI: 10.1080/10550887.2020.1800888] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Sohrab Amiri
- Behavioral Sciences Research Center, Lifestyle Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
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121
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Health System Response during the European Refugee Crisis: Policy and Practice Analysis in Four Italian Regions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17155458. [PMID: 32751174 PMCID: PMC7432017 DOI: 10.3390/ijerph17155458] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 07/03/2020] [Accepted: 07/21/2020] [Indexed: 11/17/2022]
Abstract
The decentralization of the provision of health services at the subnational level produces variations in healthcare offered to asylum seekers (ASs) across the different Italian regions, even if they are entitled to healthcare through the national health service. The present study aims to map the healthcare path and regional policies for ASs upon arrival and identify challenges and best practices. This is a multicentric, qualitative study of migrant health policies and practices at the regional level within four Italian regions. For the analysis, a dedicated tool for the systematic comparison of policies and practices was developed. The collection and analysis of data demonstrated the presence of many items of international recommendations, even if many gaps exist and differences between regions remain. The analysis of practices permitted the identification of three models of care and access. Some aspects identified are as follows: fragmentation and barriers to access; a weakness in or lack of a governance system, with the presence of many actors involved; variability in the response between territories. The inclusion of ASs in healthcare services requires intersectoral actions, involving healthcare sectors and other actors within local social structures, in order to add value to local resources and practices, reinforce networks and contribute to social integration.
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Zuo Z, Jiang Y, Zeng S, Li Y, Fan J, Guo Y, Tao H. The value of microRNAs as the novel biomarkers for colorectal cancer diagnosis: A meta-analysis. Pathol Res Pract 2020; 216:153130. [PMID: 32853954 DOI: 10.1016/j.prp.2020.153130] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 06/30/2020] [Accepted: 07/08/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Numerous studies have reported that microRNAs (miRNAs) hold great potential as the biomarkers for colorectal cancer (CRC). However, inconsistent results have made it challenging to evaluate their diagnostic performance. Thus, the aim of this meta-analysis was to systematically assess the pooled efficacy of miRNAs for CRC diagnosis. METHODS A search for eligible studies up to October 30, 2019 was conducted using PubMed, Web of Science and EMBASE databases. A random-effects model was used to evaluate the pooled sensitivity and specificity. The summary receiver operator characteristic (SROC) curve and area under the curve (AUC) were calculated to assess the overall diagnostic efficacy. RESULTS A total of 3258 CRC patients and 2683 healthy controls were identified in 35 included studies. The overall diagnostic accuracy was as follows: sensitivity, 0.80 [95 % confidence interval (CI) 0.75-0.83]; specificity, 0.80 (95 % CI, 0.75-0.84); positive likelihood ratio (PLR), 4.0 (95 % CI, 3.2-5.0); negative likelihood ratio (NLR), 0.26 (95 % CI, 0.21-0.31); diagnostic odds ratio (DOR), 16 (95 % CI, 11-23); and AUC, 0.87 (95 % CI, 0.83-0.89). CONCLUSION The results indicated that miRNAs, particularly serum-derived miRNAs, can serve as the powerful and promising biomarkers for early CRC screening.
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Affiliation(s)
- Zhihua Zuo
- Department of Clinical Laboratory, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, China.
| | - Yao Jiang
- Department of Clinical Laboratory, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, China.
| | - Shanshui Zeng
- Department of Clinical Laboratory, Guangzhou Women and Children's Medical Centre, Guangzhou Medical University, Guangzhou, 510623, China.
| | - Yiqin Li
- Department of Clinical Laboratory, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, China.
| | - Jia Fan
- Department of Clinical Laboratory, Traditional Chinese Medicine Hospital Affiliated to Southwest Medical University, Luzhou, 646000, China.
| | - Yongcan Guo
- Department of Clinical Laboratory, Traditional Chinese Medicine Hospital Affiliated to Southwest Medical University, Luzhou, 646000, China.
| | - Hualin Tao
- Department of Clinical Laboratory, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, China.
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Gimeno-Feliu LA, Pastor-Sanz M, Poblador-Plou B, Calderón-Larrañaga A, Díaz E, Prados-Torres A. Multimorbidity and chronic diseases among undocumented migrants: evidence to contradict the myths. Int J Equity Health 2020; 19:113. [PMID: 32631325 PMCID: PMC7336489 DOI: 10.1186/s12939-020-01225-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 06/18/2020] [Indexed: 11/10/2022] Open
Abstract
Background There is little verified information on the global health status of undocumented migrants (UMs). Our aim is to compare the prevalence of the main chronic diseases and of multimorbidity in undocumented migrants, documented migrants, and Spanish nationals in a Spanish autonomous community. Methods Retrospective observational study of all users of the public health system of the region of Aragon over 1 year (2011): 930,131 Spanish nationals; 123,432 documented migrants (DMs); and 17,152 UMs. Binary logistic regression was performed to examine the association between migrant status (Spanish nationals versus DMs and UMs) and both multimorbidity and individual chronic diseases, adjusting for age and sex. Results The prevalence of individual chronic diseases in UMs was lower than in DMs and much lower than in Spanish nationals. Comparison with the corresponding group of Spanish nationals revealed odds ratios (OR) of 0.1–0.3 and 0.3–0.5 for male and female UMs, respectively (p < 0.05 in all cases). The risk of multimorbidity was lower for UMs than DMs, both for men (OR, 0.12; 95%CI 0.11–0.13 versus OR, 0.53; 95%CI 0.51–0.54) and women (OR, 0.18; 95%CI 0.16–0.20 versus OR, 0.74; 95%CI 0.72–0.75). Conclusions Analysis of data from a health system that offers universal coverage to all immigrants, irrespective of legal status, reveals that the prevalence of chronic disease and multimorbidity is lower in UMs as compared with both DMs and Spanish nationals. These findings refute previous claims that the morbidity burden in UM populations is higher than that of the native population of the host country.
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Affiliation(s)
- Luis Andrés Gimeno-Feliu
- EpiChron Research Group on Chronic Diseases, Aragón Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, Zaragoza, Spain. .,Aragón Healthcare Service, San Pablo Health Centre, Zaragoza, Spain. .,Health Services Research on Chronic Patients Network (REDISSEC), Carlos III Health Institute, Madrid, Spain. .,Department of Medicine, Psychiatry and Dermatology, University of Zaragoza, Zaragoza, Spain.
| | | | - Beatriz Poblador-Plou
- EpiChron Research Group on Chronic Diseases, Aragón Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, Zaragoza, Spain.,Health Services Research on Chronic Patients Network (REDISSEC), Carlos III Health Institute, Madrid, Spain
| | - Amaia Calderón-Larrañaga
- EpiChron Research Group on Chronic Diseases, Aragón Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, Zaragoza, Spain.,Health Services Research on Chronic Patients Network (REDISSEC), Carlos III Health Institute, Madrid, Spain.,Department of Neurobiology, Care Sciences and Society, Aging Research Center, Karolinska Institutet, Stockholm, Sweden
| | - Esperanza Díaz
- Department of Global Public Health and Primary Care, Research Group for General Practice, University of Bergen, Bergen, Norway.,Norwegian Centre for Minority Health Research, Oslo, Norway
| | - Alexandra Prados-Torres
- EpiChron Research Group on Chronic Diseases, Aragón Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, Zaragoza, Spain.,Health Services Research on Chronic Patients Network (REDISSEC), Carlos III Health Institute, Madrid, Spain
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Oliva-Arocas A, Pereyra-Zamora P, Copete JM, Vergara-Hernández C, Martínez-Beneito MA, Nolasco A. Socioeconomic Inequalities in Mortality among Foreign-Born and Spanish-Born in Small Areas in Cities of the Mediterranean Coast in Spain, 2009-2015. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E4672. [PMID: 32610538 PMCID: PMC7370214 DOI: 10.3390/ijerph17134672] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 06/14/2020] [Accepted: 06/19/2020] [Indexed: 12/28/2022]
Abstract
Many studies have analysed socioeconomic inequalities and its association with mortality in urban areas. However, few of them have differentiated between native and immigrant populations. This study is an ecological study of mortality by overall mortality and analyses the inequalities in mortality in these populations according to the level of deprivation in small areas of large cities in the Valencian Community, from 2009 to 2015. The census tract was classified into five deprivation levels using an index based on socioeconomic indicators from the 2011 census. Rates and relative risks of death were calculated by sex, age, level of deprivation and country of birth. Poisson regression models have been used. In general, there was a higher risk of death in natives at the levels of greatest deprivation, which did not happen in immigrants. During the 2009-2015 period, there were socioeconomic inequalities in mortality, particularly in natives, who presented a higher risk of death than immigrants. Future interventions and social policies should be implemented in order to reduce inequalities in mortality amongst socioeconomic levels and to maintain the advantage that the immigrant population enjoys.
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Affiliation(s)
- Adriana Oliva-Arocas
- Research Unit for the Analysis of Mortality and Health Statistics, Department of Community Nursing, Preventive Medicine, Public Health and History of Science, University of Alicante, 03080 Alicante, Spain; (A.O.-A.); (J.M.C.); (A.N.)
| | - Pamela Pereyra-Zamora
- Research Unit for the Analysis of Mortality and Health Statistics, Department of Community Nursing, Preventive Medicine, Public Health and History of Science, University of Alicante, 03080 Alicante, Spain; (A.O.-A.); (J.M.C.); (A.N.)
| | - José M. Copete
- Research Unit for the Analysis of Mortality and Health Statistics, Department of Community Nursing, Preventive Medicine, Public Health and History of Science, University of Alicante, 03080 Alicante, Spain; (A.O.-A.); (J.M.C.); (A.N.)
| | - Carlos Vergara-Hernández
- Área de Desigualdades en Salud, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), 46035 Valencia, Spain;
| | | | - Andreu Nolasco
- Research Unit for the Analysis of Mortality and Health Statistics, Department of Community Nursing, Preventive Medicine, Public Health and History of Science, University of Alicante, 03080 Alicante, Spain; (A.O.-A.); (J.M.C.); (A.N.)
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Multi-mass breast cancer classification based on hybrid descriptors and memetic meta-heuristic learning. SN APPLIED SCIENCES 2020. [DOI: 10.1007/s42452-020-3103-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
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Eiset AH, Aoun MP, Haddad RS, Naja WJ, Fuursted K, Nielsen HV, Stensvold CR, Nielsen MS, Gottlieb A, Frydenberg M, Wejse C. Asylum seekers' and Refugees' Changing Health (ARCH) study protocol: an observational study in Lebanon and Denmark to assess health implications of long-distance migration on communicable and non-communicable diseases and mental health. BMJ Open 2020; 10:e034412. [PMID: 32461293 PMCID: PMC7259863 DOI: 10.1136/bmjopen-2019-034412] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 04/24/2020] [Accepted: 05/05/2020] [Indexed: 01/09/2023] Open
Abstract
INTRODUCTION By end of 2018, the European Union countries hosted approximately 2.5 million refugees and Lebanon alone hosted more than 1 million. The majority of refugees worldwide came from Syria. The prevailing study design in published studies on asylum seekers' and refugees' health leaves a number of fundamental research questions unanswerable. In the Asylum seekers' and Refugees' Changing Health (ARCH) study, we examine the health of a homogeneous group of refugees and asylum seekers in two very different host countries with very different migration histories. We aim to study the health impact of the migration process, living conditions, access to healthcare, gene-environment interactions and the health transition. METHODS AND ANALYSIS ARCH is an international multisite study of the health of adult (>18 years old) Syrian refugees and asylum seekers in Lebanon and Denmark. Using a standardised framework, we collect information on mental and physical health using validated scales and biological samples. We aim to include 220 participants in Danish asylum centres and 1100 participants in Lebanese refugee camps and settlements. We will use propensity score weights to control for confounding and multiple imputation to handle missing data. ETHICS AND DISSEMINATION Ethical approval has been obtained in Lebanon and Denmark. In the short term, we will present the cross-sectional association between long-distance migration and the results of the throat and wound swab, blood and faeces samples and mental health screenings. In the longer term, we are planning to follow the refugees in Denmark with collection of dried blood spots, mental health screenings and semistructured qualitative interviews on the participant's health and access to healthcare in the time lived in Denmark. Here, we present an overview of the background for the ARCH study as well as a thorough description of the methodology.
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Affiliation(s)
- Andreas Halgreen Eiset
- Center for Global Health (GloHAU), Department of Public Health, Aarhus University, Aarhus, Denmark
- Clinic for PTSD and Anxiety, Aarhus University Hospital, Aarhus, Denmark
| | | | - Ramzi S Haddad
- Department of Psychiatry, Lebanese University, Beirut, Lebanon
| | - Wadih J Naja
- Department of Psychiatry, Lebanese University, Beirut, Lebanon
| | - Kurt Fuursted
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Kobenhavn, Denmark
| | - Henrik Vedel Nielsen
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Kobenhavn, Denmark
| | | | | | - Annemarie Gottlieb
- Clinic for PTSD and Anxiety, Aarhus University Hospital, Aarhus, Denmark
| | | | - Christian Wejse
- Center for Global Health (GloHAU), Department of Public Health, Aarhus University, Aarhus, Denmark
- Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark
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Li M, Holliday L, Roder D, Tervonen H, Anazodo A, Dallapozza L, Hesketh E, Currow D. Degree of Cancer Spread at Presentation and Survival Among Adolescents and Young Adults in New South Wales, Australia. J Adolesc Young Adult Oncol 2020; 10:156-163. [PMID: 32456575 DOI: 10.1089/jayao.2020.0023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: Five-year relative cancer survival increased from 80% to 89% among adolescent and young adult (AYA) Australians between 1985-1989 and 2011-2015. New South Wales (NSW), with a third of the Australian population, has long recorded degree of spread (localized, regional, or distant) at diagnosis. This study complements national data by investigating survival increases after adjusting for differences in degree of spread, cancer type, and sociodemographic characteristics. Methods: Population-based NSW Cancer Registry data, for malignant solid cancers where degree of spread was applicable, were analyzed for ages 15-24 years in 1980-2015. Subhazard ratios (SHRs) from competing risk regression indicated risk of death from the primary cancer as opposed to other causes. Multiple logistic regression was used to model odds ratios for more extensive compared with localized spread at diagnosis. Results: Approximately 72% of cancers had a localized degree of spread. Adjusted SHRs for cancer-specific mortality decreased from 1980-1989 to 2010-2015 (SHR: 0.73, 95% confidence interval: 0.55-0.95). Adjusted odds ratios (aORs) for more advanced versus localized spread were lowest for melanoma and lip, oral cavity, and pharyngeal carcinoma, and highest for breast carcinoma, Ewing tumor, and colorectal carcinoma. The aOR for more advanced versus localized cancer was higher for men than women. Conclusions: Cancer survival increased to a statistically significantly in AYAs during 1980-2015, after adjusting for degree of spread, cancer type, and sociodemographic characteristics. We attribute this mostly to treatment gains. Linked data should be used to explore treatment contributions.
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Affiliation(s)
- Ming Li
- Cancer Information & Analysis, Cancer Institute NSW, Alexandria, Sydney, Australia.,Cancer Research Institute, School of Health Sciences, University of South Australia, Adelaide, Australia
| | - Laura Holliday
- Cancer Information & Analysis, Cancer Institute NSW, Alexandria, Sydney, Australia
| | - David Roder
- Cancer Information & Analysis, Cancer Institute NSW, Alexandria, Sydney, Australia.,Cancer Research Institute, School of Health Sciences, University of South Australia, Adelaide, Australia
| | - Hanna Tervonen
- Cancer Information & Analysis, Cancer Institute NSW, Alexandria, Sydney, Australia
| | - Antoinette Anazodo
- School of Women's and Children's Health, University of New South Wales, Randwick, Australia.,Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia.,Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Randwick, Australia
| | - Luciano Dallapozza
- Cancer Centre for Children, Royal Alexandra Hospital for Children, Westmead Hospital, Westmead, Australia
| | - Elizabeth Hesketh
- Hunter and Northern New South Wales Youth Cancer Service, Calvary Mater Newcastle, Australia
| | - David Currow
- Cancer Information & Analysis, Cancer Institute NSW, Alexandria, Sydney, Australia
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Diverse and Complex Challenges to Migrant and Refugee Mental Health: Reflections of the M8 Alliance Expert Group on Migrant Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103530. [PMID: 32443521 PMCID: PMC7277923 DOI: 10.3390/ijerph17103530] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 05/08/2020] [Accepted: 05/12/2020] [Indexed: 12/17/2022]
Abstract
Forced migration is likely to continue to grow in the coming years due to climate change, disease outbreaks, conflict, and other factors. There are a huge number of challenges to maintaining good health, and specifically good mental health, among migrants at all stages of migration. It is vital to fully understand these diverse challenges so that we can work towards overcoming them. In 2017, as a response to the growing health challenges faced by migrants and refugees, the M8 Alliance created an expert group focussing on migrant and refugee health. The group meets annually at the Sapienza University of Rome, Italy, and this article is based on the discussions that took place at the third annual meeting (6–7 June 2019) and a special session on “Protecting the Mental Health of Refugees and Migrants,” which took place on 27 October at the World Health Summit 2019 in Berlin. Our discussions are also supported by supplementary literature to present the diverse and complex challenges to the mental health of migrants and refugees. We conclude with some lessons learned and hope for the future.
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Analysis of Refugee Children Hospitalized in a Tertiary Pediatric Hospital. J Immigr Minor Health 2020; 23:11-18. [DOI: 10.1007/s10903-020-01026-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Noori T, Hargreaves S, Greenaway C, van der Werf M, Driedger M, Morton RL, Hui C, Requena-Mendez A, Agbata E, Myran DT, Pareek M, Campos-Matos I, Nielsen RT, Semenza J, Nellums LB, Pottie K. Strengthening screening for infectious diseases and vaccination among migrants in Europe: What is needed to close the implementation gaps? Travel Med Infect Dis 2020; 39:101715. [PMID: 32389827 DOI: 10.1016/j.tmaid.2020.101715] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 04/24/2020] [Accepted: 04/26/2020] [Indexed: 12/14/2022]
Abstract
Migration to the European Union (EU)/European Economic Area (EEA) affects the epidemiology of infectious diseases, including tuberculosis (TB), HIV, hepatitis B/C, and parasitic diseases. Some sub-populations of migrants are also considered to be an under-immunised group and thus at risk of vaccine-preventable diseases. Providing high-risk migrants access to timely and efficacious screening and vaccination, and understanding how best to implement more integrated screening and vaccination programmes into European health systems ensuring linkage to care and treatment, is key to improving the health of migrants and their communities, alongside meeting national and regional targets for infection surveillance, control, and elimination. The European Centre for Disease Prevention and Control (ECDC) has responded to calls to action to improve migrant health and strengthen universal health coverage by developing evidence-based guidance for policy makers, public health experts, and front-line healthcare professionals on how to approach screening and vaccination in newly arrived migrants within the EU/EEA. In this Commentary, we provide a perspective towards developing efficacious screening and vaccination of newly arrived migrants, with a focus on defining implementation challenges and evidence gaps in high-migrant receiving EU/EEA countries. There is a need now to leverage the increasing momentum around migrant health to both strengthen the evidence-base and to advocate for universal access to health care for all migrants in the EU/EEA, including undocumented migrants. This should include voluntary, confidential, and non-stigmatising screening and vaccination that should be free of charge and facilitate linkage to appropriate care and treatment.
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Affiliation(s)
- Teymur Noori
- European Centre for Disease Prevention and Control, Stockholm, Sweden.
| | - Sally Hargreaves
- Institute for Infection and Immunity, St. George's, University of London, London, United Kingdom
| | - Christina Greenaway
- Division of Infectious Diseases, Jewish General Hospital, McGill University, Montreal, Canada; Centre for Clinical Epidemiology of the Lady Davis Institute for Medical Research, Jewish General Hospital. JD MacLean Centre for Tropical Diseases at McGill, McGill University Health Centre, McGill University, Canada
| | | | - Matt Driedger
- Department of Medicine, University of Ottawa, Ottawa, Canada
| | - Rachael L Morton
- NHMRC Clinical Trials Centre, The University of Sydney, Sydney, Australia
| | | | - Ana Requena-Mendez
- ISGlobal, Barcelona Institute for Global Health, Hospital Clinic-Universitat de Barcelona, Barcelona, Spain
| | - Eric Agbata
- Department of Paediatrics, Obstetrics, Gynaecology and Preventive Medicine, Universitat Autònoma de Barcelona, Bellaterra, 08193, Barcelona, Spain; Faculty of Health Science, University of Roehampton London, London, SW15 5PU, United Kingdom
| | - Daniel T Myran
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Manish Pareek
- Department of Respiratory Sciences, University of Leicester, Leicester, United Kingdom
| | - Ines Campos-Matos
- Health Improvement Directorate, Public Health England, London, United Kingdom
| | - Rikke Thoft Nielsen
- Department of Clinical Microbiology, University Hospital Hvidovre, Denmark; Research Centre for Migration, Ethnicity and Health, Department of Public Health, University of Copenhagen, Denmark
| | - Jan Semenza
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Laura B Nellums
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, UK
| | - Kevin Pottie
- Department of Family Medicine and School of Epidemiology and Public Health, University of Ottawa, Canada
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Eborall H, Wobi F, Ellis K, Willars J, Abubakar I, Griffiths C, Pareek M. Integrated screening of migrants for multiple infectious diseases: Qualitative study of a city-wide programme. EClinicalMedicine 2020; 21:100315. [PMID: 32322806 PMCID: PMC7170938 DOI: 10.1016/j.eclinm.2020.100315] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 02/04/2020] [Accepted: 02/27/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Migrants from certain regions are at increased risk of key infectious diseases (including HIV, tuberculosis (TB), hepatitis B and hepatitis C). Although guidelines increasingly recommend integrated screening for multiple infections to reduce morbidity little is known about what migrants and healthcare professionals think about this approach. METHODS Prospective qualitative study in Leicester, United Kingdom within a novel city-wide integrated screening programme in three iterative phases to understand views about infections and integrated screening. Phase 1 focus groups (nine) with migrants from diverse communities (n = 74); phase 2 semi-structured interviews with healthcare professionals involved in the screening pathway (n = 32); phase 3 semi-structured interviews (n = 23) with individuals having tested positive for one/more infections through the programme. Analysis was informed by the constant comparative process and iterative across phases 1-3. FINDINGS Migrants' awareness of TB, HIV and hepatitis B/C varied, with greater awareness of TB and HIV than hepatitis B/C; perceived susceptibility to the infections was low. The integrated screening programme was well-received by migrants and professionals; concerns were limited to data-sharing. As anticipated, given the target group, language was cited as a challenge but mitigated by various interpretation strategies. INTERPRETATION This large qualitative analysis is the first to confirm that integrated screening for key infectious diseases is feasible, positively viewed by, and acceptable to, migrants and healthcare professionals. These findings support recent guideline recommendations and therefore have important implications for policy-makers and clinicians as programmes of this type are more widely implemented in diverse settings. FUNDING National Institute for Health Research.
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Affiliation(s)
- Helen Eborall
- Department of Health Sciences, University of Leicester, United Kingdom
| | - Fatimah Wobi
- Department of Health Sciences, University of Leicester, United Kingdom
- Department of Respiratory Sciences, University of Leicester, United Kingdom
| | - Kate Ellis
- Department of Infection and HIV Medicine, University Hospitals Leicester NHS Trust, United Kingdom
| | - Janet Willars
- Department of Health Sciences, University of Leicester, United Kingdom
| | - Ibrahim Abubakar
- Institute of Global Health, University College London, London, United Kingdom
| | - Chris Griffiths
- Institute of Population Health Sciences, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Manish Pareek
- Department of Respiratory Sciences, University of Leicester, United Kingdom
- Department of Infection and HIV Medicine, University Hospitals Leicester NHS Trust, United Kingdom
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Cézard G, Gruer L, Steiner M, Douglas A, Davis C, Buchanan D, Katikireddi SV, Millard A, Sheikh A, Bhopal R. Ethnic variations in falls and road traffic injuries resulting in hospitalisation or death in Scotland: the Scottish Health and Ethnicity Linkage Study. Public Health 2020; 182:32-38. [PMID: 32151824 PMCID: PMC7294220 DOI: 10.1016/j.puhe.2020.01.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 01/09/2020] [Accepted: 01/23/2020] [Indexed: 02/05/2023]
Abstract
Objectives To investigate ethnic differences in falls and road traffic injuries (RTIs) in Scotland. Study design A retrospective cohort of 4.62 million people, linking the Scottish Census 2001, with self-reported ethnicity, to hospitalisation and death records for 2001–2013. Methods We selected cases with International Classification of Diseases–10 diagnostic codes for falls and RTIs. Using Poisson regression, age-adjusted risk ratios (RRs, multiplied by 100 as percentages) and 95% confidence intervals (CIs) were calculated by sex for 10 ethnic groups with the White Scottish as reference. We further adjusted for country of birth and socio-economic status (SES). Results During about 49 million person-years, there were 275,995 hospitalisations or deaths from fall-related injuries and 43,875 from RTIs. Compared with the White Scottish, RRs for falls were higher in most White and Mixed groups, e.g., White Irish males (RR: 131; 95% CI: 122–140) and Mixed females (126; 112–143), but lower in Pakistani males (72; 64–81) and females (72; 63–82) and African females (79; 63–99). For RTIs, RRs were higher in other White British males (161; 147–176) and females (156; 138–176) and other White males (119; 104–137) and females (143; 121–169) and lower in Pakistani females (74; 57–98). The ethnic variations differed by road user type, with few cases among non-White motorcyclists and non-White female cyclists. The RRs were minimally altered by adjustment for country of birth or SES. Conclusion We found important ethnic variations in injuries owing to falls and RTIs, with generally lower risks in non-White groups. Culturally related differences in behaviour offer the most plausible explanation, including variations in alcohol use. The findings do not point to the need for new interventions in Scotland at present. However, as the ethnic mix of each country is unique, other countries could benefit from similar data linkage-based research. Ethnic inequalities in injuries are demonstrated in Scotland based on a large sample size and a fine ethnic granularity. White minority ethnic groups had the highest risks of fall-related injuries in Scotland. Fall-related injuries were the least likely in the Pakistani population. Ethnic differences in road traffic injuries varied by the type of road user. Ethnic differences in injuries were not explained by socio-economic status or country of birth.
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Affiliation(s)
- G Cézard
- School of Geography and Sustainable Development, University of St Andrews, St Andrews, UK; Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK.
| | - L Gruer
- Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - M Steiner
- Environmental & Occupational Medicine, Section of Population Health, University of Aberdeen, Aberdeen, UK
| | - A Douglas
- Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - C Davis
- Information Services Division (ISD), NHS National Services Scotland, Edinburgh, UK
| | - D Buchanan
- Information Services Division (ISD), NHS National Services Scotland, Edinburgh, UK
| | - S V Katikireddi
- MRC Social & Public Health Sciences Unit, Evaluation of Social Interventions Programme, University of Glasgow, Glasgow, UK
| | - A Millard
- NHS Health Scotland, Directorate of Public Health Science, Glasgow, UK
| | - A Sheikh
- Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - R Bhopal
- Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
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Pimentel V, Pingarilho M, Alves D, Diogo I, Fernandes S, Miranda M, Pineda-Peña AC, Libin P, Martins MRO, Vandamme AM, Camacho R, Gomes P, Abecasis A. Molecular Epidemiology of HIV-1 Infected Migrants Followed up in Portugal: Trends between 2001-2017. Viruses 2020; 12:v12030268. [PMID: 32121161 PMCID: PMC7150888 DOI: 10.3390/v12030268] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 02/21/2020] [Accepted: 02/25/2020] [Indexed: 11/16/2022] Open
Abstract
Migration is associated with HIV-1 vulnerability. Objectives: To identify long-term trends in HIV-1 molecular epidemiology and antiretroviral drug resistance (ARV) among migrants followed up in Portugal Methods: 5177 patients were included between 2001 and 2017. Rega, Scuel, Comet, and jPHMM algorithms were used for subtyping. Transmitted drug resistance (TDR) and Acquired drug resistance (ADR) were defined as the presence of surveillance drug resistance mutations (SDRMs) and as mutations of the IAS-USA 2015 algorithm, respectively. Statistical analyses were performed. Results: HIV-1 subtypes infecting migrants were consistent with the ones prevailing in their countries of origin. Over time, overall TDR significantly increased and specifically for Non-nucleoside reverse transcriptase inhibitor (NNRTIs) and Nucleoside reverse transcriptase inhibitor (NRTIs). TDR was higher in patients from Mozambique. Country of origin Mozambique and subtype B were independently associated with TDR. Overall, ADR significantly decreased over time and specifically for NRTIs and Protease Inhibitors (PIs). Age, subtype B, and viral load were independently associated with ADR. Conclusions: HIV-1 molecular epidemiology in migrants suggests high levels of connectivity with their country of origin. The increasing levels of TDR in migrants could indicate an increase also in their countries of origin, where more efficient surveillance should occur.
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Affiliation(s)
- Victor Pimentel
- Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical/Universidade Nova de Lisboa (IHMT/UNL), 1349-008 Lisboa, Portugal; (V.P.); (M.P.); (D.A.); (M.M.); (A.-C.P.-P.); (M.R.O.M.); (A.-M.V.)
| | - Marta Pingarilho
- Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical/Universidade Nova de Lisboa (IHMT/UNL), 1349-008 Lisboa, Portugal; (V.P.); (M.P.); (D.A.); (M.M.); (A.-C.P.-P.); (M.R.O.M.); (A.-M.V.)
| | - Daniela Alves
- Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical/Universidade Nova de Lisboa (IHMT/UNL), 1349-008 Lisboa, Portugal; (V.P.); (M.P.); (D.A.); (M.M.); (A.-C.P.-P.); (M.R.O.M.); (A.-M.V.)
| | - Isabel Diogo
- Laboratório de Biologia Molecular (LMCBM, SPC, CHLO-HEM), 1349-019 Lisboa, Portugal; (I.D.); (S.F.); (P.G.)
| | - Sandra Fernandes
- Laboratório de Biologia Molecular (LMCBM, SPC, CHLO-HEM), 1349-019 Lisboa, Portugal; (I.D.); (S.F.); (P.G.)
| | - Mafalda Miranda
- Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical/Universidade Nova de Lisboa (IHMT/UNL), 1349-008 Lisboa, Portugal; (V.P.); (M.P.); (D.A.); (M.M.); (A.-C.P.-P.); (M.R.O.M.); (A.-M.V.)
| | - Andrea-Clemencia Pineda-Peña
- Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical/Universidade Nova de Lisboa (IHMT/UNL), 1349-008 Lisboa, Portugal; (V.P.); (M.P.); (D.A.); (M.M.); (A.-C.P.-P.); (M.R.O.M.); (A.-M.V.)
- Molecular Biology and Immunology Department, Fundación Instituto de Inmunología de Colombia, Basic Sciences Department, School of Medicine and Health Sciences, Universidad del Rosario, Bogotá 111321, Colombia
| | - Pieter Libin
- KU Leuven, Clinical and Epidemiological Virology, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, 3000 Leuven, Belgium; (P.L.); (R.C.)
- Artificial Intelligence lab, Department of computer science, Vrije Universiteit Brussel, 1050 Brussels, Belgium
| | - M. Rosário O. Martins
- Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical/Universidade Nova de Lisboa (IHMT/UNL), 1349-008 Lisboa, Portugal; (V.P.); (M.P.); (D.A.); (M.M.); (A.-C.P.-P.); (M.R.O.M.); (A.-M.V.)
| | - Anne-Mieke Vandamme
- Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical/Universidade Nova de Lisboa (IHMT/UNL), 1349-008 Lisboa, Portugal; (V.P.); (M.P.); (D.A.); (M.M.); (A.-C.P.-P.); (M.R.O.M.); (A.-M.V.)
- KU Leuven, Clinical and Epidemiological Virology, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, 3000 Leuven, Belgium; (P.L.); (R.C.)
| | - Ricardo Camacho
- KU Leuven, Clinical and Epidemiological Virology, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, 3000 Leuven, Belgium; (P.L.); (R.C.)
| | - Perpétua Gomes
- Laboratório de Biologia Molecular (LMCBM, SPC, CHLO-HEM), 1349-019 Lisboa, Portugal; (I.D.); (S.F.); (P.G.)
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Superior de Ciências da Saúde Egas Moniz, 2829-511 Caparica, Portugal
| | - Ana Abecasis
- Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical/Universidade Nova de Lisboa (IHMT/UNL), 1349-008 Lisboa, Portugal; (V.P.); (M.P.); (D.A.); (M.M.); (A.-C.P.-P.); (M.R.O.M.); (A.-M.V.)
- Correspondence:
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Honkaniemi H, Juárez SP, Katikireddi SV, Rostila M. Psychological distress by age at migration and duration of residence in Sweden. Soc Sci Med 2020; 250:112869. [PMID: 32120203 PMCID: PMC8325349 DOI: 10.1016/j.socscimed.2020.112869] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Revised: 12/02/2019] [Accepted: 02/18/2020] [Indexed: 11/24/2022]
Abstract
Migrants suffer from worse psychological health than natives in many countries, yet the extent to which this varies by age at migration and duration of residence in the receiving context remains unexplored in Sweden. Drawing on a life course approach, we investigate differences in psychological distress by age at migration and duration of residence in working-age migrants to Sweden, and examine the role of various social determinants of health in explaining these differences relative to Swedish-born. Using pooled cross-sectional data from the 2011/2015 Health on Equal Terms survey in Västra Götaland Region, Sweden (n = 58,428), we applied logistic regression analysis to calculate predicted probabilities and average marginal effects (AME) of migrant status, by age at migration and duration of residence, on psychological distress. Analyses were stratified by sex and region of origin and controlled for indicators of socioeconomic status (SES), social cohesion, and discrimination to assess their potential contribution to differences in migrants' and natives' psychological distress. All migrants except men from OECD-predominant regions had a greater probability of psychological distress than Swedish-born (ranging from AME 0.031 [95% Confidence Interval or CI 0.000-0.062] for OECD women to AME 0.115 [95% CI 0.074-0.156] for non-OECD men). Marginal effects of migration status on psychological distress probabilities generally increased with age at migration and duration of residence. Differences between migrants and natives were largely attenuated after controlling for social determinants, the greatest contribution coming from inequalities in social cohesion, followed by inequalities in discrimination and SES. Our results suggest a relative health advantage of early-life compared to later-life migration, albeit with worse outcomes with longer residence in Sweden. The predominance of integration opportunities in childhood strengthens calls for supportive policies to assist older migrants' integration directly upon arrival, which may ultimately improve their psychological wellbeing.
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Affiliation(s)
- Helena Honkaniemi
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden; Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Stockholm, Sweden.
| | - Sol Pía Juárez
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden; Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Stockholm, Sweden
| | | | - Mikael Rostila
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden; Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Stockholm, Sweden
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Chen Y, Freedman ND, Rodriquez EJ, Shiels MS, Napoles AM, Withrow DR, Spillane S, Sigel B, Perez-Stable EJ, Berrington de González A. Trends in Premature Deaths Among Adults in the United States and Latin America. JAMA Netw Open 2020; 3:e1921085. [PMID: 32049297 PMCID: PMC8268086 DOI: 10.1001/jamanetworkopen.2019.21085] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
IMPORTANCE Premature death rates vary in the United States by race/ethnicity. Despite their socioeconomic disadvantages, US Latino populations have lower premature mortality rates than do US white populations, a phenomenon termed the "Latino or Hispanic paradox." OBJECTIVE To investigate whether there is a broader Latin American paradox by comparing premature mortality rates in the United States according to race/ethnicity with rates in Latin America and Puerto Rico from 2001 to 2015. DESIGN, SETTING, AND PARTICIPANTS This descriptive cross-sectional study used mortality data from the World Health Organization Mortality Database. All deaths occurring in individuals aged 20 to 64 years among US Latino, African American, white, and Puerto Rican and 12 other Latin American populations from January 2001 to December 2015 were selected. The data analysis began in October 2018. EXPOSURES Age, sex, race/ethnicity, and country. MAIN OUTCOMES AND MEASURES All-cause mortality, cause-specific mortality, age-standardized mortality rates (AMSRs), and average annual percentage change in mortality rates during 2001 to 2015. RESULTS During 2001 to 2015, 22 million deaths (8 million women and 14 million men) occurred among individuals aged 20 to 64 years in the selected populations. Among women, US Latina individuals had the lowest premature mortality rates (ASMR for 2015, 144 deaths per 100 000 population) and US African American women had the highest premature mortality rate (ASMR for 2015, 340 deaths per 100 000 population) of the 16 populations studied. Rates among US white women shifted from the sixth lowest in 2001 (ASMR, 231 deaths per 100 000 population) to the 12th lowest in 2015 (ASMR, 235 deaths per 100 000 population). Among men, Peru had the lowest premature mortality rates (ASMR for 2015, 219 deaths per 100 000 population), and Belize had the highest premature mortality rates (ASMR for 2015, 702 deaths per 100 000 population). White men in the United States shifted from the fifth lowest rates in 2001 (ASMR, 396 deaths per 100 000 population) to the eighth lowest rates in 2015 (ASMR, 394 deaths per 100 000 population). Rates for both women and men decreased in all the populations studied from 2001 to 2015 (average annual percentage change range, 0.4% to 3.8% per year) except among US white populations, for which the rate plateaued (average annual percentage change, 0.02% per year [95% CI, -0.3% to 0.2% per year] for women; -0.2% per year [95% CI, -0.4% to 0.0% per year] for men) and among Nicaraguan men, for whom the rates increased (0.6% per year [95% CI, 0.2% to 1.0% per year]). The populations with the lowest mortality rates in 2015 had lower rates from all major causes, but rates were particularly lower for heart disease (21 deaths per 100 000 population) and cancer (50 deaths per 100 000 population). CONCLUSIONS AND RELEVANCE Premature mortality rates are lower for US Latino populations and several Latin American countries than for US white populations, suggesting that there may be a broader Latin American paradox. This analysis also highlights the high premature mortality rates among US African American populations, especially women, compared with many Latin American populations.
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Affiliation(s)
- Yingxi Chen
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Neal D Freedman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Erik J Rodriquez
- Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Meredith S Shiels
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Anna M Napoles
- National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland
| | - Diana R Withrow
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Susan Spillane
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Byron Sigel
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Eliseo J Perez-Stable
- National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland
| | - Amy Berrington de González
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
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136
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Piao H, Yun JM, Shin A, Cho B. Longitudinal Study of Diabetic Differences between International Migrants and Natives among the Asian Population. Biomol Ther (Seoul) 2020; 28:110-118. [PMID: 31739384 PMCID: PMC6939688 DOI: 10.4062/biomolther.2019.163] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 10/15/2019] [Accepted: 10/15/2019] [Indexed: 01/25/2023] Open
Abstract
Migration presents a substantial social and public health issue. However, it is unclear whether diabetes is worse among Asian migrants than natives of South Korea over time. This longitudinal study investigated the nationwide population, including 2,680,495 adults aged 20 years and older (987,214 Asian migrants and 1,693,281 natives), who received health check-ups, using the Korean National Health Insurance Service data (2009-2015). Joinpoint regression was used to estimate the annual percentage change of diabetes, and multivariable logistic regression was used to examine differences in incident type 2 diabetes between Asian migrants and natives adjusting for age, sex, economic status, body mass index, smoking status, any alcohol use, and physical activity. The age-adjusted prevalence of diabetes increased among native men (from 8.8% in 2009 to 9.7% in 2015, APC=1.64, p<0.05) compared to Asian migrant men, and the age-adjusted prevalence of diabetes increased among native women (from 6.0% in 2009 to 6.7% in 2015, APC=1.88, p<0.05) compared to Asian migrant women. In the multivariate analyses, Asian migrants were less likely to get type 2 diabetes than natives (odds ratio, 0.82; 95% CI, 0.78 to 0.86) between the first and last health check-ups. However, the odds ratio for developing type 2 diabetes was 1.15 (95% CI, 1.10 to 1.20) among low-income levels compared to high-income levels, regardless of whether they were Asian migrants or natives. The results could help to establish a new strategy for prevention, treatment, and management of diabetes among the Asian population.
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Affiliation(s)
- Heng Piao
- Department of Family Medicine, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
| | - Jae Moon Yun
- Department of Family Medicine, Seoul National University College of Medicine, Seoul 03080, Republic of Korea.,Department of Family Medicine & Health Promotion Center, Seoul National University Hospital, Seoul 03080, Republic of Korea
| | - Aesun Shin
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
| | - Belong Cho
- Department of Family Medicine, Seoul National University College of Medicine, Seoul 03080, Republic of Korea.,Department of Family Medicine & Health Promotion Center, Seoul National University Hospital, Seoul 03080, Republic of Korea
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137
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Affiliation(s)
- Baltica Cabieses
- Instituto de Ciencias e Innovación en Salud, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile.
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138
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Yi Y, Liao Y, Zheng L, Li M, Gu J, Hao C, Hao Y. Health Selectivity and Rural-Urban Migration in China: A Nationwide Multiple Cross-Sectional Study in 2012, 2014, 2016. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16091596. [PMID: 31067684 PMCID: PMC6540158 DOI: 10.3390/ijerph16091596] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 05/02/2019] [Accepted: 05/04/2019] [Indexed: 12/27/2022]
Abstract
Background: China is undergoing an unprecedented rural-urban migration, which may deeply influence the health of internal migrants. Previous studies suggested that migrants are a selectively healthier population. This paper examines the evidence for and the changes of health selectivity among Chinese internal migrants. Methods: We use data from the China Labor-force Dynamics Survey (CLDS), a nationally representative survey conducted in 2012, 2014, and 2016, respectively. The health statuses of four groups of research subjects (out-migrants, returned migrants, rural residents, and urban residents) are measured by general health, physical health, and emotional health. Results: By comparing the health status of migrants with that of rural residents, we find supportive evidence for the Healthy Migrant Hypothesis that migrants exhibit better health than rural residents in their hometown. We also add strength to the Salmon Bias Hypothesis that migrants returning to their hometowns are less healthy than those still being outside. However, migrants present worse emotional health in both comparisons. The general and physical health gaps between migrants, rural residents, and returnees widened in all three rounds of the survey, which implies a possibly increasing trend of health selectivity. This study also suggests that bringing family to the destination requires better general and physical health, but not emotional health. Conclusions: Migrants are positively selected on general and physical health. The health selectivity in 2012–2016 is highly likely to increase, which means that there are increasing number of obstacles for migrants to overcome. Family migration’s high requirement for health might also contribute to it. It is urgent to establish and improve primary health care service systems in rural areas in current circumstances.
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Affiliation(s)
- Yao Yi
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhong Shan 2nd Road, Guangzhou 510080, China.
| | - Yu Liao
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhong Shan 2nd Road, Guangzhou 510080, China.
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China.
| | - Lingling Zheng
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhong Shan 2nd Road, Guangzhou 510080, China.
| | - Mengjie Li
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhong Shan 2nd Road, Guangzhou 510080, China.
| | - Jing Gu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhong Shan 2nd Road, Guangzhou 510080, China.
| | - Chun Hao
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhong Shan 2nd Road, Guangzhou 510080, China.
| | - Yuantao Hao
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhong Shan 2nd Road, Guangzhou 510080, China.
- Guangdong Key Laboratory of Health Informatics, Sun Yat-sen Global Health Institute, Sun Yat-sen University, 74 Zhong Shan 2nd Road, Guangzhou 510080, China.
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Bozorgmehr K, Jahn R. Adverse health effects of restrictive migration policies: building the evidence base to change practice. LANCET GLOBAL HEALTH 2019; 7:e386-e387. [PMID: 30852189 DOI: 10.1016/s2214-109x(19)30042-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Accepted: 01/11/2019] [Indexed: 01/04/2023]
Affiliation(s)
- Kayvan Bozorgmehr
- Department of Population Medicine and Health Services Research, School of Public Health, Bielefeld University, Bielefeld, Germany; Department of General Practice and Health Services Research, University Hospital Heidelberg, 69120 Heidelberg, Germany.
| | - Rosa Jahn
- Department of General Practice and Health Services Research, University Hospital Heidelberg, 69120 Heidelberg, Germany
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140
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Canevelli M, Bruno G, Valletta M, Fabbrini A, Vanacore N, Berardelli A, Fabbrini G. Parkinson's disease among migrants in Europe: estimating the magnitude of an emerging phenomenon. J Neurol 2019; 266:1120-1126. [PMID: 30762103 DOI: 10.1007/s00415-019-09241-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 02/07/2019] [Accepted: 02/09/2019] [Indexed: 10/27/2022]
Abstract
INTRODUCTION The occurrence of age-related pathological conditions among subjects with a migration background and composing ethnic minorities is an emerging challenge for Western countries. Specifically, the onset of neurodegenerative diseases in these populations of individuals might assume special relevance and generate additional complexities for our healthcare systems. The aim of the present study was to estimate the number of Parkinson's disease (PD) cases in migrant subjects living in Europe. METHODS The estimated cases of PD among ≥ 50-year-old migrants living in Europe, and in each of the 32 considered countries, were calculated by multiplying the number of migrants (derived by the Eurostat data) with the age-specific prevalence rates of PD (obtained by a recent meta-analysis). RESULTS Nearly 20 million migrants ≥ 50 years lived in Europe in 2017. The application of the age-specific prevalence rates led to the estimation of 129,645 overall PD cases in this population, accounting for the 8% of overall PD cases in Europe. National estimates widely ranged from 36 cases in Iceland to 29,390 cases in France. CONCLUSION The present findings suggest that the occurrence of PD in migrants and minority groups already constitutes an important issue for European healthcare systems and will assume further relevance given the rapidly evolving sociodemographic scenario. Characterizing the phenomenon at the "real world" level and implementing coordinated initiatives and strategies represent novel but pressing needs for our countries.
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Affiliation(s)
- Marco Canevelli
- Department of Human Neuroscience, Sapienza University, Viale dell'Università 30, 00185, Rome, Italy. .,National Center for Disease Prevention and Health Promotion, National Institute of Health, Rome, Italy.
| | - Giuseppe Bruno
- Department of Human Neuroscience, Sapienza University, Viale dell'Università 30, 00185, Rome, Italy
| | - Martina Valletta
- Department of Human Neuroscience, Sapienza University, Viale dell'Università 30, 00185, Rome, Italy
| | - Andrea Fabbrini
- Department of Human Neuroscience, Sapienza University, Viale dell'Università 30, 00185, Rome, Italy
| | - Nicola Vanacore
- National Center for Disease Prevention and Health Promotion, National Institute of Health, Rome, Italy
| | - Alfredo Berardelli
- Department of Human Neuroscience, Sapienza University, Viale dell'Università 30, 00185, Rome, Italy.,IRCCS NEUROMED, Pozzilli, IS, Italy
| | - Giovanni Fabbrini
- Department of Human Neuroscience, Sapienza University, Viale dell'Università 30, 00185, Rome, Italy.,IRCCS NEUROMED, Pozzilli, IS, Italy
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Burns R, Pathak N, Campos-Matos I, Zenner D, Katikireddi SV, Muzyamba MC, Miranda JJ, Gilbert R, Rutter H, Jones L, Williamson E, Hayward AC, Smeeth L, Abubakar I, Hemingway H, Aldridge RW. Million Migrants study of healthcare and mortality outcomes in non-EU migrants and refugees to England: Analysis protocol for a linked population-based cohort study of 1.5 million migrants. Wellcome Open Res 2019; 4:4. [PMID: 30801036 PMCID: PMC6381442 DOI: 10.12688/wellcomeopenres.15007.1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2019] [Indexed: 12/13/2022] Open
Abstract
Background: In 2017, 15.6% of the people living in England were born abroad, yet we have a limited understanding of their use of health services and subsequent health conditions. This linked population-based cohort study aims to describe the hospital-based healthcare and mortality outcomes of 1.5 million non-European Union (EU) migrants and refugees in England. Methods and analysis: We will link four data sources: first, non-EU migrant tuberculosis pre-entry screening data; second, refugee pre-entry health assessment data; third, national hospital episode statistics; and fourth, Office of National Statistics death records. Using this linked dataset, we will then generate a population-based cohort to examine hospital-based events and mortality outcomes in England between Jan 1, 2006, and Dec 31, 2017. We will compare outcomes across three groups in our analyses: 1) non-EU international migrants, 2) refugees, and 3) general population of England. Ethics and dissemination: We will obtain approval to use unconsented patient identifiable data from the Secretary of State for Health through the Confidentiality Advisory Group and the National Health Service Research Ethics Committee. After data linkage, we will destroy identifying data and undertake all analyses using the pseudonymised dataset. The results will provide policy makers and civil society with detailed information about the health needs of non-EU international migrants and refugees in England.
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Affiliation(s)
- Rachel Burns
- Centre for Public Health Data Science, University College London, London, UK
| | - Neha Pathak
- Centre for Public Health Data Science, University College London, London, UK
- Institute of Epidemiology and Healthcare, University College London, London, UK
| | | | - Dominik Zenner
- Migration Health Division, International Organization for Migration, Brussels, Belgium
- Institute for Global Health, University College London, London, UK
| | - Srinivasa Vittal Katikireddi
- MRC/CSO Social and Public Health Sciences Unit, Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | | | - J. Jaime Miranda
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Ruth Gilbert
- Institute of Epidemiology and Healthcare, University College London, London, UK
- Administrative Data Research Centre for England, University College London, London, UK
| | - Harry Rutter
- Faculty of Humanities and Social Sciences, University of Bath, Bath, UK
| | - Lucy Jones
- UK programme manager, Doctors of the World, London, UK
| | - Elizabeth Williamson
- Faculty of Epidemiology & Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Andrew C. Hayward
- Institute of Epidemiology and Healthcare, University College London, London, UK
| | - Liam Smeeth
- Department of Non-Communicable Diseases Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Ibrahim Abubakar
- Institute for Global Health, University College London, London, UK
| | - Harry Hemingway
- Institute of Health Informatics Research, Faculty of Population Health Sciences, University College London, London, UK
| | - Robert W. Aldridge
- Centre for Public Health Data Science, University College London, London, UK
- Public Health England, London, UK
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