Migration and mental health: Evidence from a natural experiment

Mental health and wellbeing of international students in Australia: a systematic review

BACKGROUND

Concerns have been raised that international students are at high risk of poor mental health and wellbeing.

AIMS

The aim of this study was to systematically review the literature on the mental health and wellbeing of international students in Australia.

METHODS

A literature search was conducted using CINAHL, MEDLINE, PsycINFO, and Academic Search Complete using EBSCOhost interface for articles published from 2000. A pre-determined set of eligibility criteria was used to screen articles and eligible articles were quality appraised using the Mixed Methods Appraisal Tool. Due to considerable heterogeneity, the data was narratively analysed, considering the statistical significance and the text narratives. Nineteen studies (N = 19) met the inclusion criteria.

RESULTS

Mental health issues experienced by international students included anxiety (2.4-43%, N = 5), depression (3.6-38.3%, N = 6), psychological stress/distress (31.6-54%, N = 9) and gambling problems (3.3-50.7%, N = 3). Factors affecting student wellbeing included loneliness/isolation (60-65%, N = 4), work/financial difficulties (15.4-95%, N = 4) and discrimination/safety concerns (9-50%, N = 3). Other factors affecting students included cross-cultural transition experiences, language difficulties, social interaction, university belonging, technology difficulties, self-harm, use of counselling services and mental health literacy.

CONCLUSION

International students in Australia experience various issues affecting their mental health and wellbeing. More effort needs to be made to better support students.

Context, health and migration: a systematic review of natural experiments

Background

Migration health research pays little attention to the places into which people migrate. Studies on health effects of contextual factors are often limited because of the ability of individuals to self-select their environment, but natural experiments may allow for the causal effect of contexts to be examined. The objective was to synthesise the evidence on contextual health effects from natural experiments among migrant groups.

Methods

We performed a systematic review of natural experiments among migrant populations in PubMed/MEDLINE, The Cochrane Library, Web of Science, CINAHL and Google Scholar for literature published until 13 October 2022. 5870 articles were screened in duplicate using the following inclusion criteria: quantitative natural experiment design, migrant population, context factor as treatment variable and health or healthcare outcome variable. Synthesis without meta-analysis was performed following quality appraisal using the EPHPP tool for quantitative studies and data extraction (PROSPERO: CRD42020169236).

Findings

The 46 included articles provide evidence for negative effects of neighbourhood disadvantage on physical health and mortality, while finding mixed effects on mental health. Articles comparing migrants with those that stayed behind demonstrate detrimental effects of migration and adverse post-migratory contexts on physical health and mortality, while demonstrating favourable effects for mental and child health. Natural experiments of policy environments indicate the negative impacts of restrictive migration and social policies on healthcare utilization, mental health and mortality, as well as the positive health effects when restrictions are lifted.

Interpretation

Natural experiments complement observational studies and provide robust evidence to advocate for more inclusive migration, health and social policies as well as neighbourhood improvement programmes. In order to strengthen the methodological approach, future research utilising natural experiments should be more explicit in the mechanisms underlying the experiment and provide details on potential causal mechanisms for the observed effects.

Funding

German Science Foundation (FOR: 2928/GZ: BO5233/1-1).

Mental health penalties of having a child: findings from the China family panel studies

In recent years, the birth rate in China has rapidly declined. While much research has been done on the penalties in earnings that women incur when they fall behind men in the labor market due to childbirth, there has been little to no research on the mental health effects. This study addresses the gap in current literature by examining the mental health penalties that women experience after having a child in comparison to men. We applied econometric modeling to data collected from China Family Panel Studies (CFPS) and found that women experienced a significant, immediate, and long-run decline (4.3%) in life satisfaction after their first child, while men were unaffected. We also found that women experienced a significant increase in depression after their first child. This suggests mental health penalties since the mental health risk proxied by these two measurements is only significant for women. This is likely related to child penalties in labor market performance and childbirth-related physical health issues. When countries adopt multiple tools to stimulate the birth rate for economic growth, they must consider the implicit burden on women-especially the long-term negative effects on mental health.

The Residential Environment and Health and Well-Being of Chinese Migrant Populations: A Systematic Review

China's internal migrants suffer from marginalised housing conditions, poor neighbourhood environments and residential segregation, which may have significant implications on health and well-being. Echoing recent calls for interdisciplinary research on migrant health and well-being, this study examines the associations and mechanisms of the impact of the residential environment on the health and well-being of Chinese migrants. We found that most of the relevant studies supported the "healthy migration effect", but the phenomenon was only applicable to migrants' self-reported physical health rather than mental health. The subjective well-being of migrants is lower than that of urban migrants. There is a debate between the effectiveness of residential environmental improvements and the ineffectiveness of residential environmental improvements in terms of the impact of the neighbourhood environment on migrants' health and well-being. Housing conditions and the neighbourhood's physical and social environment can enhance migrants' health and well-being by strengthening place attachment and social cohesion, building localised social capital and gaining neighbourhood social support. Residential segregation on the neighbourhood scale affects the health outcomes of migrant populations through the mechanism of relative deprivation. Our studies build a vivid and comprehensive picture of research to understand migration, urban life and health and well-being.

Exploring the Effect of Health on Migrants' Social Integration in China

There are 376 million migrants, which account for more than 25% of the population in China according to the newest national demographic census, most of whom are from undeveloped areas to developed urban regions. Migrants’ social integration was one of the most important issues when the country aimed to build an inclusive society. As a form of human capital, the effect of migrants’ health status on social integration has rarely been explored until now, especially empirically. Previous studies have usually ignored health indicators when discussing the determinants of migrants’ social integration, and understanding the role of migrants’ physical health and mental health on their social integration is significant for efforts to ensure inclusive urbanization. For filling this research gap, the China Migrants Dynamic Survey dataset was used to uncover the role of migrants’ health status, including physical health and mental health, in their degree of social integration, and a further comparison of impact was conducted among rural–urban and urban–urban migrants. Through the empirical analysis, our results indicated the following. First, both better physical and mental health lead to higher social integration levels, and a one-point increase in physical and mental health improves the odds of good social integration by 33.27% and 5.98% for belonging and 66.05% and 6.35% for harmony, respectively. Second, health status is equally important for rural–urban and urban–urban migrants’ social integration, and the significant positive effect was consistent across groups, although some other impact factors may exhibit differences. Third, the effect of health status on social integration was moderated by social participation, which was more obvious for mental health than physical health. According to our findings, we discuss the measures to promote migrants’ health status and additional countermeasures to improve their social integration level.

Understanding Integration Experience and Wellbeing of Economic-Asylum Seekers in Italy: the Case of Nigerian Immigrants

The literature on migrants’ integration and wellbeing is ample, but the case of economic-asylum seekers in a protracted asylum application system is yet to receive sufficient attention. The economic-asylum seekers are a unique group who migrate with an economic motive but apply for asylum to achieve economic integration in the host country. We use the aspiration-capability framework and a mixed-method approach: participant observation, focus group discussion, and field survey, to study a group of economic-asylum seekers from Nigeria when they were waiting for their asylum decisions in Italy. We find that they evaluate their wellbeing by reflecting on their premigration aspirations, integration constraints, and capabilities. They report lower life satisfaction compared to their satisfaction in Nigeria, and were affected by several barriers including structural, psychological, economic, and social constraints. Our study generally describes what it is like to live in limbo and frustration, with a limited assurance for a better tomorrow. It gives voice to the economic-asylum seekers and contributes to the integration literature by examining their perceptions of integration constraints.

Environmental Displacement and Mental Well-Being in Banjarnegara, Indonesia

BACKGROUND

Residential moves (displacement) owing to climate- and weather-related disasters may significantly impact mental health. Despite the growing risk from climate change, health impacts of environmental-mobility remain understudied.

OBJECTIVES

We assessed the effects of displacement on the association between landslides and changes in perceived mental well-being in Banjarnegara, Indonesia. We also investigated whether sociodemographics (age, sex, level of education, household-level income, or employment in agriculture) and landslide characteristics (number and severity of landslides) were associated with differing odds of relocation after experiencing landslides.

METHODS

In this cross-sectional study, we surveyed 420 individuals who experienced landslides between 2014 and 2018 to assess perceived changes in mental well-being, comparing after landslide exposure to before landslide exposure. We used a novel six-item measure that was created in collaboration with the local community to compare perceived changes between those who were displaced by landslides and those who were not displaced, using logistic and multinomial regressions adjusted for sociodemographic characteristics. We then assessed whether the odds of displacement differed based on sociodemographic characteristics and landslide exposure characteristics, using logistic regressions.

RESULTS

Those who were displaced were more likely than those who were not displaced to report perceived increases in economic stability [odds ratio (OR)=3.06; 95% confidence interval (CI): 1.45, 6.46], optimism (OR=4.01; 95% CI: 1.87, 8.61), safety (OR=2.71; 95% CI: 1.44, 5.10), religiosity (OR=1.92; 95% CI: 1.03, 3.65), and closeness with community (OR=1.90; 95% CI: 1.10, 3.33) after landslides compared with before their first landslide during the study period. More frequent landslide exposures were associated with reduced odds of relocation, but more severe landslides were associated with increased odds of relocation.

DISCUSSION

These findings suggest that landslides affect the mental well-being not only of those who are displaced but also of those who are left behind. Further, this work supports the need for community-based participatory research to fully capture the health impacts of environmental mobility. https://doi.org/10.1289/EHP9391.

The worse the better? Quantile treatment effects of a conditional cash transfer programme on mental health

Poor mental health is a pressing global health problem, with high prevalence among poor populations from low-income countries. Existing studies of conditional cash transfer (CCT) effects on mental health have found positive effects. However, there is a gap in the literature on population-wide effects of cash transfers on mental health and if and how these vary by the severity of mental illness. We use the Malawian Longitudinal Study of Family and Health containing 790 adult participants in the Malawi Incentive Programme, a year-long randomized controlled trial. We estimate average and distributional quantile treatment effects and we examine how these effects vary by gender, HIV status and usage of the cash transfer. We find that the cash transfer improves mental health on average by 0.1 of a standard deviation. The effect varies strongly along the mental health distribution, with a positive effect for individuals with worst mental health of about four times the size of the average effect. These improvements in mental health are associated with increases in consumption expenditures and expenditures related to economic productivity. Our results show that CCTs can improve adult mental health for the poor living in low-income countries, particularly those with the worst mental health.

The Relationship Between Mental Health and Psychosocial Stress of Reservoir Migrants in the Middle Route of China's South-to-North Water Diversion Project (SNWDP): The Mediating Role of Social Support

BACKGROUND

South-North Water Diversion Project (SNWDP) migrants were vulnerable to developing mental health problems due to post-migration stresses and lack of social support. However, the evidence on the mental health, psychosocial stress and social support of SNWDP migrants and their interrelationships are limited and inconclusive. We aimed to explore the mechanism of influence of social support on the relationship between mental health and social psychosocial stress of SNWDP migrants.

METHODS

We performed a cross-sectional analysis of the data of 983 SNWDP migrants. The mental health status, psychosocial stress and social support of the participants were evaluated by Symptom Checklist-90-Revised (SCL-90-R), Psychosocial Stress Survey for Groups (PSSG) and Social Support Rating Scale (SSRS). Multiple stepwise regression model was used to analyze the data.

RESULTS

Among the 983 individuals, the average SCL-90-R score was 1.47, the PSSG score was 30.50, and the SSRS score was 40.30. The SCL-90-R was positively correlated with PSSG (r=0.483, P<0.001) and negatively correlated with SSRS (r=-0.257, P<0.001), PSSG was negatively correlated with SSRS (r=-0.516, P<0.001). Multiple regression analysis showed that PSSG and SSRS had significant effects on SCL-90-R prediction and that SSRS played a partial intermediary role in SCL-90-R and PSSG (46.87%).

CONCLUSION

The SNWDP migrants performed a strong correlation between social support, mental health and psychosocial stress. Social support plays a part role in mediating mental health and psychosocial stress.

A review of mental health and wellbeing under climate change in small island developing states (SIDS)

Small island developing states (SIDS) are often at the forefront of climate change impacts, including those related to health, but information on mental health and wellbeing is typically underreported. To help address this research lacuna, this paper reviews research about mental health and wellbeing under climate change in SIDS. Due to major differences in the literature's methodologies, results, and analyses, the method is an overview and qualitative evidence synthesis of peer-reviewed publications. The findings show that mental health and wellbeing in the context of climate change have yet to feature prominently and systematically in research covering SIDS. It seems likely that major adverse mental health and wellbeing impacts linked to climate change impacts will affect SIDS peoples. Similar outcomes might also emerge when discussing climate change related situations, scenarios, and responses, irrespective of what has actually happened thus far due to climate change. In the context of inadequate health systems and stigmatisation of mental health diagnoses and treatments, as tends to occur globally, climate change narratives might present an opening for conversations about addressing mental health and wellbeing issues for SIDS.

Do Public Pensions Improve Mental Wellbeing? Evidence from the New Rural Society Pension Insurance Program

The causal effect of public pensions on the mental wellbeing of the elderly in lower and middle-income countries deserves further investigation. This paper first constructed a theoretical framework for the impact of New Rural Society Pension Insurance pensions in China on the mental wellbeing of the rural elderly, and described potential channels through which pension income may affect mental wellbeing. We then used the fixed effect model and the instrument variable approach to estimate the casual effects of pension income on the mental wellbeing of the rural elderly. The results reveal that pension income improves mental wellbeing by relieving depression of the rural elderly; however, the beneficial effects of pension income are very limited. Pension income has no beneficial effects on the mental health of the rural elderly in the east region, whereas it slightly relieves depression of those in the middle and west regions. We also found that pension income produces small improvements in the mental health of older females, elderly persons living independently, and those with relatively poor economic conditions.

Mental and self-rated health of bakery workers in Lebanon: A national study

Objectives:

The relationship between poverty and health has been well addressed in public health research. The health effects of social and economic inequalities on working groups have also drawn the attention of occupational health scholars. Research addressing workers in low-paying jobs showed increased risks for poor health. This research examined the psychosocial factors associated with poor mental health and self-rated health among low-income bakery workers performing demanding tasks.

Methods:

Face-to-face interviews in 504 randomly selected bakeries in Lebanon provided data on socio-demographics, perception of the workplace environment, job security, job satisfaction, general health, and mental health.

Results:

In total, 16.5% of bakery workers reported poor self-rated health, and 45% reported poor mental health. Workers with a chronic illness were almost three times more likely to report poor self-rated health (OR = 2.86; 95% CI = 1.44–5.67), and those with musculoskeletal pain reported poor self-rated health five times as often (OR = 5.34; 95% CI = 2.9–9.80). Those with a chronic illness and musculoskeletal pain were twice as likely to report poor mental health (OR = 1.94; 95% CI = 1.07–3.50 and OR = 2.07; 95% CI = 1.32–3.23, respectively); and those dissatisfied with their job reported poorer self-rated health (OR = 2.18; 95% CI = 1.12–4.23) and mental health (OR = 2.57; 95% CI = 1.54–4.26). In addition, workers reporting job insecurity had poor mental health twice as often (OR = 1.93; 95% CI = 1.24–2.99). Low socioeconomic indicators showed a gradient association with both poor self-rated health and mental health.

Conclusion:

Reporting job dissatisfaction and insecurity, musculoskeletal pain, and chronic illness were associated with poor mental and self-rated health among bakery workers. Interventions to improve the working conditions of bakery workers are timely and essential. This research provided evidence for policy to guide occupational health practice and safeguard the health of bakery workers.

Pre-migration socioeconomic status and post-migration health satisfaction among Syrian refugees in Germany: A cross-sectional analysis

BACKGROUND

The large increase in numbers of refugees and asylum seekers in Germany and most of Europe has put the issue of migration itself, the integration of migrants, and also their health at the top of the political agenda. However, the dynamics of refugee health are not yet well understood. From a life-course perspective, migration experience is associated with various risks and changes, which might differ depending on the socioeconomic status (SES) of refugees in their home country. The aim of this paper was to analyze the relationship between pre-migration SES and self-reported health indicators after migration among Syrian refugees. Specifically, we wanted to find out how their SES affects the change in health satisfaction from pre- to post-migration.

METHODS AND FINDINGS

We used data from the 2016 refugee survey, which was part of the German Socio-Economic Panel (GSOEP). Although cross-sectional by design, this survey collected information referring to the current situation as a refugee in Germany as well as to their situation before migration. Using a sample of 2,209 adult Syrian refugees who had entered Germany between 2013 and 2016, we conducted a cross-sectional and a quasi-longitudinal (retrospective) analysis. The mean ± SD age was 35 ± 11 years, with 64% of the participants being male. Our results showed a positive association between pre-migration self-reported SES and several subjective health indicators (e.g., health satisfaction, self-reported health, mental health) in the cross-sectional analysis. However, the quasi-longitudinal analysis revealed that the socioeconomic gradient in health satisfaction before migration was strongly attenuated after migration (SES-by-time interaction: -0.48, 95% CI -0.61 to -0.35, p < 0.001; unstandardized regression coefficients, 5-point SES scale and 11-point health outcome scale). Similar results were produced after controlling for sociodemographic characteristics, experiences during the migration passage, and the current situation in Germany. A sex-stratified analysis showed that while there was some improvement in health satisfaction among men from the lowest SES over time, no improvement was found among women. A limitation of this study is that it considers only the first months or years after migration. Thus, we cannot preclude that the socioeconomic gradient regains importance in the longer run.

CONCLUSIONS

Our findings suggest that the pre-migration socioeconomic gradient in health satisfaction is strongly attenuated in the first years after migration among Syrian refugees. Hence, a high SES before crisis and migration provides limited protection against the adverse health effects of migration passage.

Revising ethical guidance for the evaluation of programmes and interventions not initiated by researchers

Public health and service delivery programmes, interventions and policies (collectively, 'programmes') are typically developed and implemented for the primary purpose of effecting change rather than generating knowledge. Nonetheless, evaluations of these programmes may produce valuable learning that helps determine effectiveness and costs as well as informing design and implementation of future programmes. Such studies might be termed 'opportunistic evaluations', since they are responsive to emergent opportunities rather than being studies of interventions that are initiated or designed by researchers. However, current ethical guidance and registration procedures make little allowance for scenarios where researchers have played no role in the development or implementation of a programme, but nevertheless plan to conduct a prospective evaluation. We explore the limitations of the guidance and procedures with respect to opportunistic evaluations, providing a number of examples. We propose that one key missing distinction in current guidance is moral responsibility: researchers can only be held accountable for those aspects of a study over which they have control. We argue that requiring researchers to justify an intervention, programme or policy that would occur regardless of their involvement prevents or hinders research in the public interest without providing any further protections to research participants. We recommend that trial consent and ethics procedures allow for a clear separation of responsibilities for the intervention and the evaluation.

Does money relieve depression? Evidence from social pension expansions in China

We estimate the impact of pension enrollment on mental well-being using China's New Rural Pension Scheme (NRPS), the largest existing pension program in the world. Since its launch in 2009, more than 400 million Chinese have enrolled in the NRPS. We first describe plausible pathways through which pension may affect mental health. We then use the national sample of China Family Panel Studies (CFPS) to examine the effect of pension enrollment on mental health, as measured by CES-D and self-reported depressive symptoms. To overcome the endogeneity of pension enrollment or of income change on mental health, we exploit geographic variation in pension program implementation. Results indicate modest to large reductions in depressive symptoms due to pension enrollment; this effect is more pronounced among individuals eligible to claim pension income, among populations with more financial constraints, and among those with worse baseline mental health. Our findings hold for a rich set of robustness checks and falsification tests.

Mental Health among Migrants in Shenzhen, China: Does it Matter Whether the Migrant Population is Identified by Hukou or Birthplace?

Massive rural–urban migration in China has drawn attention to the prevalence of mental health problems among migrants. Research on the mental health of Chinese migrants has a narrow focus on rural–urban migrants, emphasizing the institutional role of hukou in migrant mental health. We argue that the heterogeneity of migrants, including their place of origin and whether they are temporary or permanent migrants, should be taken into account when trying to understand the meaning of migration as an actual movement from one place to another. The data used for this study is from a cross-sectional survey (N = 855) conducted in Shenzhen to compare the differences in migrants’ mental health that arise when using the two definitions (e.g., hukou and birthplace). Binary logistic regression models were estimated to assess the associations between people’s mental health and migration, while controlling for settlement experiences, self-reported physical health, and sociodemographics. The results reveal inconsistent findings across both definitions: general migrants by birthplace were found to be unlikely to have mental problems compared to non-migrants, whereas temporary migrants were at higher risk of mental problems. The study provides important evidence that different migrant groups have different mental health outcomes. The choice of the definition used influences both migrant group selection and the actual linkage between migration and mental health.

Longitudinal associations between having an adult child migrant and depressive symptoms among older adults in the Mexican Health and Aging Study

Background

Migration may impact the mental health of family members who remain in places of origin. We examined longitudinal associations between having an adult child migrant and mental health, for middle-aged and older Mexican adults accounting for complex time-varying confounding.

Methods

Mexican Health and Aging Study cohort (N = 11 806) respondents ≥50 years completed a 9-item past-week depressive symptoms scale; scores of ≥5 reflected elevated depressive symptoms. Expected risk differences (RD) for elevated depressive symptoms at each wave due to having at least one (versus no) adult child migrant in the US or in another Mexican city were estimated with longitudinal targeted maximum likelihood estimation.

Results

Women with at least one adult child in the US had a higher adjusted baseline prevalence of elevated depressive symptoms (RD: 0.063, 95% CI: 0.035, 0.091) compared to women with no adult children in the US. Men with at least one child in another Mexican city at all three study waves had a lower adjusted prevalence of elevated depressive symptoms at 11-year follow-up (RD: -0.042, 95% CI: -0.082, -0.003) compared to those with no internal migrant children over those waves. For men and women with ≤3 total children, adverse associations between having an adult child in the US and depressive symptoms persisted beyond baseline.

Conclusions

Associations between having an adult child migrant and depressive symptoms varied by respondent gender, family size, and the location of the child migrant. Trends in population aging and migration bring new urgency to examining associations with other outcomes and in other settings.

The Healthy Immigrant Effect on Mental Health: Determinants and Implications for Mental Health Policy in Spain

Since the mid-1990s, Spain has started to receive a great number of migrant populations. The migration process can have a significantly negative impact on mental health of immigrant population and, consequently, generate implications for the delivery of mental health services. The aim of this article is to provide empirical evidence to demonstrate that the mental health of immigrants in Spain deteriorates the longer they are resident in the country. An empirical approach to this relationship is carried out with data from the National Survey of Health of Spain 2011-2012 and poisson and negative binomial models. Results show that immigrants who reside <10 years in Spain appear to be in a better state of mental health than that observed for the national population. Studying health disparities in the foreign population and its evolution are relevant to ensure the population's access to health services and care. The need for further research is especially true in the case of the immigrant population's mental health in Spain because there is scant evidence available on their situation.

Happiness in the Air: How Does a Dirty Sky Affect Mental Health and Subjective Well-being?

Previous studies evaluating the welfare cost of air pollution have not paid much attention to its potential effect on mental health and subjective well-being (SWB). This paper attempts to fill the gap by investigating the impact of air pollution on several key dimensions, including mental health status, depressive symptoms, moment-to-moment happiness, and evaluative happiness. We match a nationwide longitudinal survey in China with local air quality and rich weather conditions according to the exact time and place of survey. By making use of variations in exposure to air pollution for the same individuals over time, we show that air pollution reduces hedonic happiness and increases the rate of depressive symptoms, while life satisfaction has little to do with the immediate air quality. Our results shed light on air pollution as an important contributor to the Easterlin paradox that economic growth may not bring more happiness.

The centrality of social ties to climate migration and mental health

Climate change-related hazards and disasters, known to adversely impact physical and mental health outcomes, are also expected to result in human migration above current levels. Environmentally-motivated migration and displacement may lead to the disruption of existing social ties, with potentially adverse consequences for mobile populations as well as their family members who remain in places of origin. We propose that the disruption of social ties is a key mechanism by which climate-related migration may negatively impact mental health, in particular. Existing social ties may provide social and material resources that buffer mental health stressors related to both prolonged and acute climate events. Preparation for such events may also strengthen these same ties and protect mental health. Communities may leverage social ties, first to mitigate climate change, and second, to adapt and rebuild post-disaster in communities of origin. Additionally, social ties can inform migration decisions and destinations. For example, scholars have found that the drought-motivated adaptive migration of West African Fulbe herders only occurred because of the long-term development of social networks between migrants and non-migrants through trade and seasonal grazing. On the other hand, social ties do not always benefit mental health. Some migrants, including those from poor regions or communities with no formal safety net, may face considerable burden to provide financial and emotional resources to family members who remain in countries of origin. In destination communities, migrants often face significant social marginalization. Therefore, policies and programs that aim to maintain ongoing social ties among migrants and their family and community members may be critically important in efforts to enhance population resilience and adaptation to climate change and to improve mental health outcomes. Several online platforms, like Refugee Start Force, serve to integrate refugees by connecting migrants directly to people and services in destination communities. These efforts may increasingly draw upon novel technologies to support and maintain social networks in the context of population mobility due to climatic and other factors.

Prevalence and associated factors of common mental disorders among Ethiopian migrant returnees from the Middle East and South Africa

BACKGROUND

Ethiopian migrants to the Middle East and South Africa experience a range of problems at various stages of their migration including overwork, sleep deprivation, denial of food, emotional abuse, difficulty adapting to the host culture, salary denial, sexual abuse, labor exploitation, confiscation of their travel documents, confinement, denial of medication, lack of access to legal service and degrading attitude by employers, traffickers and smugglers. These experiences can be associated with different types of mental disorders. This study sought to determine the prevalence of common mental disorders (CMD) and socio-demographic and other migration related associated factors among Ethiopian migrant returnees from the Middle East and South Africa.

METHOD

A cross-sectional study was conducted using non-probability (i.e. purposive, availability and snowball) sampling techniques. Migrant returnees (n = 1036) were contacted individually at their homes in eight high prevalent immigrant returnee locations in Ethiopia. Common mental disorders were assessed using the self-reporting questionnaire (SRQ-20) and a structured questionnaire was employed to collect data on socio-demographic and migration related characteristics. Data were analyzed using descriptive statistics, univariate logistic regression, and multivariable logistic regression.

RESULTS

The prevalence of CMD among migrant returnees was found to be 27.6%. Highly prevalent specific CMD symptoms included headaches, poor appetite, being tired, sleeping problems, and feeling unhappy or nervous. Being originally from Amhara and Oromia regions, being Christian, being divorced, not receiving salary on time, not being able to contact family, unable to prepare for domestic labor abroad, lack of cross- cultural awareness, and lack of knowledge and skills for work were all important risk factors for CMD. Migrants experienced adversities at different stages of their migration which are associated with psychological distress and even to long term mental illnesses.

CONCLUSIONS

CMD symptoms were found to be prevalent among Ethiopian migrant returnees. As pre-migration factors are associated with CMD symptoms, pre-departure training could be useful to mitigate the risk factors. Creating and routinely arranging mental health interventions and rehabilitation services are advisable for returnees who are screened for, or diagnosed with, mental health problems.

Health Consequences of Rural-to-Urban Migration: Evidence from Panel Data in China

This paper provides new empirical evidence on the health consequences of rural-to-urban migration in China. We use a panel dataset from 2003 to 2006 constructed by the Research Center on the Rural Economy at the Ministry of Agriculture in China to investigate the effects of short-term and medium-term migration on health status. By combining propensity-score matching and the difference-in-difference model, we attempt to overcome the migration endogeneity issue and estimate the average treatment effect on the treated. We find that the effect of short-term migration on health in China is significantly positive mostly because of the income effect. However, the effect of longer-term continuous migration on health is insignificant and close to zero. Our results are robust to several alternative estimation techniques and a series of robustness checks. Copyright © 2015 John Wiley & Sons, Ltd.

Substance Use and Cumulative Exposure to American Society: Findings From Both Sides of the US-Mexico Border Region

OBJECTIVES

We investigated whether Mexican immigration to the United States exerts transnational effects on substance use in Mexico and the United States.

METHODS

We performed a cross-sectional survey of 2336 Mexican Americans and 2460 Mexicans in 3 Texas border metropolitan areas and their sister cities in Mexico (the US-Mexico Study on Alcohol and Related Conditions, 2011-2013). We collected prevalence and risk factors for alcohol and drug use; Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, alcohol-use disorders; and 2 symptoms (hazardous use and quit or control) of drug use disorder across a continuum of migration experiences in the Mexican and Mexican American populations.

RESULTS

Compared with Mexicans with no migrant experience, the adjusted odds ratios for this continuum of migration experiences ranged from 1.10 to 8.85 for 12-month drug use, 1.09 to 5.07 for 12-month alcohol use disorder, and 1.13 to 9.95 for 12-month drug-use disorder. Odds ratios increased with longer exposure to US society. These findings are consistent with those of 3 previous studies.

CONCLUSIONS

People of Mexican origin have increased prevalence of substance use and disorders with cumulative exposure to US society.

The Impact of the Great Migration on Mortality of African Americans: Evidence from the Deep South

The Great Migration-the massive migration of African Americans out of the rural South to largely urban locations in the North, Midwest, and West-was a landmark event in U.S.

HISTORY

Our paper shows that this migration increased mortality of African Americans born in the early twentieth century South. This inference comes from an analysis that uses proximity of birthplace to railroad lines as an instrument for migration.

Associations between life conditions and multi-morbidity in marginalized populations: the case of Palestinian refugees

BACKGROUND

Evidence suggests that higher multi-morbidity rates among people with low socioeconomic status produces and maintains poverty. Our research explores the relationship between socioeconomic deprivation and multi-morbidity among Palestinian refugees in Lebanon, a marginalized and impoverished population.

METHODS

A representative sample of Palestinian refugees in Lebanon was surveyed, interviewing 2501 respondents (97% response rate). Multi-morbidity was measured by mental health, chronic and acute illnesses and disability. Multinomial logistic regression models assessed the association between indicators of poverty and multi-morbidities.

RESULTS

Findings showed that 14% of respondents never went to school, 41% of households reported water leakage and 10% suffered from severe food insecurity. Participants with an elementary education or less and those completing intermediate school were more than twice as likely to report two health problems than those with secondary education or more (OR: 2.60, CI: 1.73-3.91; OR: 2.47, CI: 1.62-3.77, respectively). Those living in households with water leakage were nearly twice as likely to have three or more health reports (OR = 1.88, CI = 1.45-2.44); this pattern was more pronounced for severely food insecure households (OR = 3.41, CI = 1.83-6.35).

CONCLUSION

We identified a positive gradient between socioeconomic status and multi-morbidity within a refugee population. These findings reflect inequalities produced by the health and social systems in Lebanon, a problem expected to worsen following the massive influx of refugees from Syria. Ending legal discrimination and funding infrastructural, housing and health service improvements may counteract the effects of deprivation. Addressing this problem requires providing a decent livelihood for refugees in Lebanon.

Migration and mental health: An interface

Migration is a universal phenomenon, which existed with the subsistence of the human beings on earth. People migrate from one place to another for several reasons, but the goal or main reason behind changing the residence would be improving their living conditions or to escape from debts and poverty. Migration is also a social phenomenon which influences human life and the environment around. Hence, migration has a great impact on any geographical area and it is known as one of the three basic components of population growth of any particular region (the other two are, mortality and fertility). Migration involves certain phases to go through; hence, it is a process. Many times, lack of preparedness, difficulties in adjusting to the new environment, the complexity of the local system, language difficulties, cultural disparities and adverse experiences would cause distress to the migrants. Moreover subsequently it has a negative impact on mental well-being of such population. Due to globalization, modernization, improved technologies and developments in all the sectors, the migration and its impact on human well-being is a contemporary issue; hence, here is an attempt to understand the migration and its impact on the mental health of the migrants based on the studies conducted around.

Natural experiment evidence on the effect of migration on blood pressure and hypertension

Over 200 million people worldwide live outside their country of birth and typically experience large gains in material well-being by moving to where wages are higher. But, the effect of this migration on other dimensions of well-being such as health are less clear and existing evidence is ambiguous because of potential for self-selection bias. In this paper, we use a natural experiment, comparing successful and unsuccessful applicants to a migration lottery to experimentally estimate the impact of migration on measured blood pressure and hypertension. Hypertension is a leading global health problem, as well as being an important health measure that responds quickly to migration. We use various econometric estimators to form bounds on the treatment effects because there appears to be selective non-compliance in the natural experiment. Even with these bounds, the results suggest significant and persistent increases in blood pressure and hypertension, which are likely to have implications for future health budgets given recent increases in developing to developed country migration.

Evaluating the satisfaction of immigrant women from a rural community regarding family functioning and health-related quality of life

Transnational marriages in Taiwan are largely mediated by marriage brokers. The present study was conducted to evaluate the satisfaction of immigrant women with their family function and health-related quality of life in a rural township in southern Taiwan. Data were collected from January 1, 2006 to November 31, 2006, and 157 immigrants agreed to participate in the study, with a 79.3% response rate. A structured questionnaire was used for data collection. The interviewers also collected information on the immigrants' and husbands' demographics, self-reported mental conditions, family function using a Family APGAR questionnaire (Adaptability, Partnership, Growth, Affection, and Resolve), and health-related quality of life. Marriage arranged through a marriage broker and having emotional distress were factors that were strongly associated with lower Family APGAR scores. Based on multiple regression models, higher Family APGAR scores were more positively related to vitality and mental health scales. Self-reported mental conditions, including feeling economic distress, emotional distress, loneliness, and having sleep problems, were negatively associated with most scales of the health-related quality of life. Female migrants' mental health was significantly related to their health-related quality of life. These findings suggest that migrant women must be educated regarding the importance of mental health by physicians and hygiene authorities in Taiwan.

Mental health of aging immigrants and native-born men across 11 European countries

OBJECTIVES

Though working-age immigrants exhibit lower mortality compared with those domestic-born immigrants, consequences of immigration for mental health remain unclear. We examine whether older immigrants exhibit a mental advantage and whether factors believed to underlie immigrant vulnerability explain disparities.

METHOD

The sample includes 12,247 noninstitutionalized men more than 50 years in 11 European countries. Multivariate logistic regression models estimated the impact of physical health, health behaviors, availability of social support, social participation, citizenship, time since immigration, socioeconomic status (SES), and employment on the mental health of immigrants.

RESULTS

Immigrants face 1.60 increased odds of depression despite a physical health advantage, evidenced by 0.74 lower odds of chronic illness. SES and availability of social support were predictive, though acculturation measures were not. Decomposition analysis revealed that only approximately 20% of the variation in depression rates between immigrants and native-born peers were explained by commonly cited risk factors.

CONCLUSIONS

Despite physical health advantages, older immigrants suffer substantially higher depression rates. Time since immigration does not appear to mitigate depressive symptoms.

Disentangling the effects of migration, selection and acculturation on weight and body fat distribution: results from a natural experiment involving Vietnamese Americans, returnees, and never-leavers

We distinguish between selection and true migration effects on weight and body fat for Vietnamese immigrants; and examine the role of acculturation on these outcomes. Data (n = 703) were collected among three population-based samples of working-age Vietnamese immigrants, repatriated emigrants and never-migrated Vietnamese nationals. This allows for a decomposition exercise to separate the effects of migration effects from selection effects on body mass index (BMI) and waist-hip ratio (WHR). Immigrants are more likely to be overweight and to have high WHR, relative to both never-leavers and returnees, a pattern reflecting the importance of migration over selection. Among immigrants, coming to the US at a younger age is associated with higher BMI and WHR levels. And longer length of residence in the US is related to higher BMI. While higher Vietnamese language proficiency is related to a lower BMI level, being bilingual (proficient in both English and Vietnamese) is associated with lower risks for being overweight. The distinct pattern of results suggests that more problematic weight status and fat distribution among Vietnamese immigrants relative to Vietnamese nationals are not artifacts of the types of persons choosing to emigrate, but rather are due to acculturation to American diet and lifestyles. While efforts to promote and maintain traditional patterns of diet and lifestyle are likely to help Vietnamese and other immigrants avoid the perils of American patterns, facilitating a bi-cultural orientation is perhaps the most realistic approach for preserving protective features of the culture of origin with regard to body weight and fat distribution.

Mental health consequences of international migration for Vietnamese Americans and the mediating effects of physical health and social networks: results from a natural experiment approach

Although the existing literature on immigrant mental health is extensive, major substantive and methodological gaps remain. Substantively, there is little population-based research that focuses on the mental health consequences of migration for Vietnamese Americans. More generally, although a wide range of mental health problems among immigrants has been identified, the potential causal or mediating mechanisms underlying these problems remain elusive. This latter substantive shortcoming is related to a key methodological challenge involving the potentially confounding effects of selection on migration-related outcomes. This article addresses these challenges by employing a "natural experiment" design, involving comparisons among three population-based samples of Vietnamese immigrants, never-leavers, and returnees (N=709). Data were collected in Ho Chi Minh City and in New Orleans between 2003 and 2005. The study investigates the long-term impact of international migration on Vietnamese mental health, and the potential mediating effects of social networks and physical health on these migration-related outcomes. The results reveal both mental health advantages and disadvantages among Vietnamese immigrants relative to the two groups of Vietnamese nationals. Selection can be ruled out for some of these differences, and both social networks and physical health are found to play important explanatory roles.