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Han G, Liu P, Zhao Y, Liang Y, Wang X. The Influence of Foreign Direct Investment on Physical Health of Rural-Urban Migrants-Empirical Evidence from China Migrants Dynamic Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4268. [PMID: 36901279 PMCID: PMC10002161 DOI: 10.3390/ijerph20054268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 02/13/2023] [Accepted: 02/22/2023] [Indexed: 06/18/2023]
Abstract
The purpose of this study is to explore the influence of Foreign Direct Investment (FDI) on rural-urban migrants' physical health and its influencing mechanism. A total of 134,920 rural-urban migrant samples are matched based on the China Migrants Dynamic Survey in 2017 and the China Urban Statistical Yearbook in 2016. On the basis of the samples, a Binary Probit Model is used to explore the relationship between the degree of FDI and rural-urban migrants' physical health. The results show that compared with migrants who lived in cities with a lower FDI level, rural-urban migrants who lived in cities with a higher FDI level are better in physical health. The results of the mediation effect model show that the degree of FDI has a significant positive impact on employment rights and benefits the protection of rural-urban migrants, improving rural-urban migrants' physical health, which means employment rights and benefits protection plays an intermediary role in the process of FDI affecting rural-urban migrants' physical health. Therefore, when formulating public policies such as plans to improve the physical health of rural-urban migrants, not only the availability of medical services for rural-urban migrants needs to be improved, but the positive spillover effect of FDI should be taken into account. By doing so, FDI can positively affect the physical health of rural-urban migrants.
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Affiliation(s)
- Guixin Han
- School of Management, Shandong University, Jinan 250100, China
| | - Pengcheng Liu
- School of Economics, Qingdao University, Qingdao 266100, China
| | - Yihang Zhao
- School of Management, Ocean University of China, Qingdao 266100, China
| | - Yinyin Liang
- Nottingham University Business School China, University of Nottingham Ningbo China, Ningbo 315100, China
| | - Xiaojie Wang
- School of Management, Ocean University of China, Qingdao 266100, China
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Huang L, Said R, Goh HC, Cao Y. The Residential Environment and Health and Well-Being of Chinese Migrant Populations: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2968. [PMID: 36833663 PMCID: PMC9957064 DOI: 10.3390/ijerph20042968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 02/02/2023] [Accepted: 02/03/2023] [Indexed: 06/18/2023]
Abstract
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.
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Affiliation(s)
- Liyan Huang
- Centre for Sustainable Urban Planning and Real Estate (SUPRE), Faculty of Built Environment, Universiti Malaya, Kuala Lumpur 50603, Malaysia
- School of Management, University of Suzhou, Suzhou 234000, China
| | - Rosli Said
- Centre for Sustainable Urban Planning and Real Estate (SUPRE), Faculty of Built Environment, Universiti Malaya, Kuala Lumpur 50603, Malaysia
| | - Hong Ching Goh
- Centre for Sustainable Urban Planning and Real Estate (SUPRE), Faculty of Built Environment, Universiti Malaya, Kuala Lumpur 50603, Malaysia
| | - Yu Cao
- Faculty of Built Environment, Universiti Malaya, Kuala Lumpur 50603, Malaysia
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Singh N, Thiagalingam P, Hussain J, Shah V, Edwards N, Lui E, Nesrallah G, Lok CE, Walele AA, Novak M, James CE, Mucsi I. Psychosocial Distress in Patients With Advanced CKD by Racial Group and Immigrant Status: A Canadian Cross-sectional Study. Am J Kidney Dis 2023; 81:67-78.e1. [PMID: 35948116 DOI: 10.1053/j.ajkd.2022.06.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 06/02/2022] [Indexed: 12/24/2022]
Abstract
RATIONALE & OBJECTIVE Patients with advanced chronic kidney disease (CKD) have been reported to experience profound psychosocial distress. Other work has established that patients with CKD from marginalized populations (including individuals who on the basis of race often face racism and related discrimination, termed "racialization") experience health care inequities. Given limited information on the intersection of these 2 phenomena, we assessed the association of psychosocial distress with racialized status and immigrant status in Canadians with advanced CKD. STUDY DESIGN Secondary analysis of cross-sectional data. SETTING & PARTICIPANTS 536 patients with advanced CKD (estimated glomerular filtration rate<30mL/min/1.73m2, with or without kidney replacement therapy) from multiple clinical centers in Toronto. EXPOSURE Racialized status (individuals who identify as Asian or as African, Caribbean, or Black Canadian), immigrant status, and combined immigrant-racialized status. OUTCOME Psychosocial distress, defined as the presence of depression, anxiety, or social difficulties (ie, a score of≥10 points on the Patient Health Questionnaire 9, Generalized Anxiety Disorder 7, or Social Distress 16 scales, respectively). ANALYTICAL APPROACH The independent associations of racialized status and immigrant status with psychosocial distress, depression, anxiety, and social difficulties were examined using univariable- and multivariable-adjusted logistic regression. RESULTS Mean age of the 536 participants was 57±16 (SD) years, 62% were male, and 45% were immigrants. Of the sample, 58% were White, 22% were African, Caribbean, or Black Canadian, and 20% were Asian. Psychosocial distress was present in 36% of participants (depression in 19%, anxiety in 12%, and social difficulties in 31%). To assess the combined impact of racialized and immigrant status, we created a variable with mutually exclusive categories: White nonimmigrant, racialized nonimmigrant, White immigrant, and racialized immigrant participants. In our final multivariable-adjusted model, compared with White nonimmigrant participants, racialized immigrant participants were more likely to have psychosocial distress (OR, 2.96 [95% CI, 1.81-4.81]), depression (OR, 1.87 [95% CI, 1.05-3.34]), and social difficulties (OR, 3.36 [95% CI, 2.03-5.57]). Overall similar associations were seen for racialized nonimmigrants and for White immigrants. LIMITATIONS Convenience sample; small subgroups; combined exposure variable grouping Asian and African, Caribbean, and Black participants together; lack of data about mechanisms. CONCLUSIONS Both racialized and immigrant status based on self-report of demographic characteristics were associated with psychosocial distress among patients with advanced CKD. These patients may benefit from culturally competent psychosocial support. PLAIN-LANGUAGE SUMMARY Psychosocial distress is frequent in patients with advanced chronic kidney disease and impacts quality of life and clinical outcomes. Psychosocial distress may be especially scarring in people who are racialized (marginalized on account of their membership in a particular racial group) and/or who are immigrants. We assessed the association of psychosocial distress with racialized and immigrant status in Canadians with advanced chronic kidney disease. Among 536 participants from multiple medical centers in Toronto, we found that racialized and immigrant participants were more likely to have psychosocial distress, depression, and social difficulties compared with White nonimmigrant participants. This is likely related to the multiple intersectional challenges, including experience with racism and discrimination that racialized immigrant patients may face. Further studies are needed to elucidate the specific factors that contribute to more distress. The potential impact of culturally competent and safe support for these patients will also need to be studied.
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Affiliation(s)
- Navneet Singh
- Ajmera Transplant Center, University Health Network and Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Division of Nephrology, University Health Network and Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Punithan Thiagalingam
- Ajmera Transplant Center, University Health Network and Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Division of Nephrology, University Health Network and Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Junayd Hussain
- Ajmera Transplant Center, University Health Network and Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Division of Nephrology, University Health Network and Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Vishva Shah
- Ajmera Transplant Center, University Health Network and Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Division of Nephrology, University Health Network and Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Nathaniel Edwards
- Ajmera Transplant Center, University Health Network and Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Division of Nephrology, University Health Network and Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Eric Lui
- Ajmera Transplant Center, University Health Network and Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Division of Nephrology, University Health Network and Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Gihad Nesrallah
- Department of Nephrology, Humber River Hospital, Toronto, Ontario, Canada
| | - Charmaine E Lok
- Division of Nephrology, University Health Network and Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Abdul Aziz Walele
- Department of Nephrology, William Osler Health System, Toronto, Ontario, Canada
| | - Marta Novak
- Centre for Mental Health, University Health Network and Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Carl E James
- Jean Augustine Chair in Education, Community & Diaspora, Faculty of Education, York University, Toronto, Ontario, Canada
| | - Istvan Mucsi
- Ajmera Transplant Center, University Health Network and Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Division of Nephrology, University Health Network and Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
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Mao AL, Tian YK, Li YN. Can community health centers improve the self-rated health of migrants? Evidence from China. Front Public Health 2022; 10:986201. [PMID: 36211663 PMCID: PMC9541740 DOI: 10.3389/fpubh.2022.986201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 08/31/2022] [Indexed: 01/26/2023] Open
Abstract
Background Due to the "epidemiological paradox," migrants face the risk of health attrition during their migration. Meanwhile, institutional constraints cause a health gap between migrants and non-migrants. To narrow this gap and maintain equity, scholars have studied the role and impact mechanism of medical insurance participation in improving the health of migrants. However, due to the provision of China's basic medical insurance system, the proportion of migrants participating in employee medical insurance is still relatively low, while the community health center (CHC) is a more accessible medical resource for this group. Therefore, this study attempts to explore the impact of CHCs on the self-rated health (SRH) of migrants and identify the factors and mechanisms associated with such an impact. This study addresses the hypotheses whether (a) CHCs can significantly improve the SRH of migrants in China and (b) CHCs improve the SRH of migrants by promoting both their health knowledge and health behavior. Methods Data was obtained from the 2017 China Migrants Dynamic Survey (CMDS). From the survey, 127,687 migrants were identified, and a series of logit regressions were conducted to explore the correlation between CHCs and the SRH of migrants. Propensity score matching (PSM) logit was also used for the robustness tests. Results Logit estimations revealed that CHC is positively related to the SRH of migrants (OR = 1.095, p < 0.001). Compared to others, males (OR = 1.156, p < 0.001), younger people with higher education (OR = 1.027, p < 0.001), more stable employment (OR = 1.544, p < 0.001), and people with a lower proportion of elderly (> 65 years) household family members (OR = 0.842, p < 0.001) tended to have better SRH. The results also showed that the impact of CHCs on migrants' SRH varied by gender, age, and income (p < 0.001). A possible mechanism is that CHCs can improve migrants' SRH by promoting both their health knowledge and health behaviors. Conclusion Programs that strengthen health knowledge and policies to enhance access to healthcare could be prioritized to improve the SRH of migrants in China.
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Understanding the Healthy Immigrant Effect in the Context of Mental Health Challenges: A Systematic Critical Review. J Immigr Minor Health 2021; 24:1564-1579. [PMID: 34807354 PMCID: PMC8606270 DOI: 10.1007/s10903-021-01313-5] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2021] [Indexed: 01/10/2023]
Abstract
The "Healthy Immigrant Effect" (HIE) suggests that immigrants have a health advantage over the domestic-born which vanishes with increased length of residency. Most HIE research focuses on physical health, with less attention given to mental health (MH). This systematic review of 58 MH studies examines whether there is a MH advantage among immigrants and explores changes in immigrants' MH, besides critically assessing the use of HIE theory. Inconsistent evidence was detected regarding the presence of MH advantage, whereas consistent, convincing evidence was revealed for a decline in immigrants' MH over years. Although the HIE theory can help reveal MH disparities, this theory alone does not explain the reasons for these disparities nor inform about potential avenues to improve immigrants' MH. A paradigm shift is needed to incorporate other potential theoretical concepts/frameworks, including the "Health Inequalities Action" framework, for a broader understanding of MH issues and to inform effective, culturally-sensitive interventions.
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Adhikari M, Kaphle S, Dhakal Y, Duwadi S, Subedi R, Shakya S, Tamang S, Khadka M. Too long to wait: South Asian migrants' experiences of accessing health care in Australia. BMC Public Health 2021; 21:2107. [PMID: 34789215 PMCID: PMC8596381 DOI: 10.1186/s12889-021-12132-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 10/29/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Migrants settling in a new country experience multiple complexities in navigating health care systems and adapting to a new way of life in the host country. In South Asia, migrating to another country for better life opportunities has been an ongoing trend and migration to Australia has significantly increased in recent years. Lower utilisation of health services and higher risks of chronic diseases among South Asian migrants poses a continuing challenge for the Australian health care system and little is known about why this demographic group does not access health services at the same rate. This study aimed to explore factors influencing access to health care by South Asian migrants in Australia. METHODS Using a mixed-method design, we conducted 62 online survey and 14 in-depth interviews with participants from four South Asian countries: Nepal, India, Bhutan, and Sri Lanka. Participants were recruited using a purposive snowball sampling approach following a standard ethical approval process. Survey data were analysed descriptively in SPSS and interview data were recorded, transcribed, and analysed thematically. RESULTS South Asian migrants experienced various complexities while accessing health services in Australia. The findings of this study highlighted a number of negative factors influencing their experiences of accessing health care: long waiting times for public health care, the expense of private health care, and communication problems due to socio-cultural differences. South Asian migrants also expressed their concern for a greater investment of resources into public health care to enable them to access quality and affordable care in these settings. CONCLUSIONS Given limited evidence available to help understand factors leading to the lower utilisation of health care and higher risks of chronic diseases among South Asian migrants, this study plays an important role in highlighting social, cultural, financial, and institutional factors that are critical to designing appropriate health-care strategies. This study recommends incorporating a collaborative and culturally competent model of care to increase access to health care and thereby help reduce existing disparities in health outcomes among South Asian migrant populations.
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Affiliation(s)
- Manju Adhikari
- LA GRANDEE International College, Pokhara Metropolitan City, Province 4 Nepal
| | | | - Yamuna Dhakal
- Central Queensland University, Melbourne, VIC Australia
| | - Sabina Duwadi
- Central Queensland University, Melbourne, VIC Australia
| | - Rajan Subedi
- Central Queensland University, Melbourne, VIC Australia
| | - Sonu Shakya
- Central Queensland University, Melbourne, VIC Australia
| | - Sunil Tamang
- Central Queensland University, Melbourne, VIC Australia
| | - Mukesh Khadka
- Central Queensland University, Melbourne, VIC Australia
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Maskileyson D, Seddig D, Davidov E. The Comparability of Perceived Physical and Mental Health Measures Across Immigrants and Natives in the United States. Demography 2021; 58:1423-1443. [PMID: 33970238 DOI: 10.1215/00703370-9304855] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The comparative study of perceived physical and mental health in general-and the comparative study of health between the native-born and immigrants, in particular-requires that the groups understand survey questions inquiring about their health in the same way and display similar response patterns. After all, observed differences in perceived health may not reflect true differences but rather cultural bias in the health measures. Research on cross-country measurement equivalence between immigrants and natives on self-reported health measures has received very limited attention to date, resulting in a growing demand for the validation of existing perceived health measures using samples of natives and immigrants and establishing measurement equivalence of health-related assessment tools. This study, therefore, aims to examine measurement equivalence of self-reported physical and mental health indicators between immigrants and natives in the United States. Using pooled data from the 2015-2017 IPUMS Health Surveys, we examine the cross-group measurement equivalence properties of five concepts that are measured by multiple indicators: (1) perceived limitations in activities of daily life; (2) self-reported disability; (3) perceived functional limitations; (4) perceived financial stress; and (5) nonspecific psychological distress. Furthermore, we examine the comparability of these data among respondents of different ethnoracial origins and from different regions of birth, who report few versus many years since migration, their age, gender, and the language used to respond to the interview (e.g., English vs. Spanish). We test for measurement equivalence using multigroup confirmatory factor analysis. The results reveal that health scales are comparable across the examined groups. This finding allows drawing meaningful conclusions about similarities and differences among natives and immigrants on measures of perceived health in these data.
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Affiliation(s)
- Dina Maskileyson
- University of Cologne, Faculty of Management, Economics and Social Sciences, Institute of Sociology and Social Psychology, Cologne, Germany
| | - Daniel Seddig
- University of Cologne, Faculty of Management, Economics and Social Sciences, Institute of Sociology and Social Psychology, Cologne, Germany
| | - Eldad Davidov
- University of Cologne, Faculty of Management, Economics and Social Sciences, Institute of Sociology and Social Psychology, Cologne, Germany.,Department of Sociology, and URPP Social Networks, University of Zurich, Zurich, Switzerland
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Zghal A, El-Masri M, McMurphy S, Pfaff K. Exploring the Impact of Health Care Provider Cultural Competence on New Immigrant Health-Related Quality of Life: A Cross-Sectional Study of Canadian Newcomers. J Transcult Nurs 2020; 32:508-517. [PMID: 33095098 PMCID: PMC8404719 DOI: 10.1177/1043659620967441] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction: New immigrants underutilize health care because of multiple barriers. Although culturally competent health care improves access, it is typically assessed by providers, not newcomers whose perceptions matter most. Methodology: Surveys that included measures of cultural competence and health-related quality of life (QOL) were completed by 117 new immigrants in Windsor, Ontario, Canada. A series of stepwise linear regression analyses were conducted to identify independent predictors of QOL and its four domains: physical health, psychological, social relationships, and environment. Results: Our adjusted results suggest that experiences of discrimination was negatively associated with overall QOL (β = −.313; p < .001) and its psychological (β = −.318; p < .001), social (β = −.177; p = .048), and environmental (β = −.408; p < .001) domains. Discussion: Discrimination negatively influences new immigrant QOL. Provider cultural competency training should emphasize the influence of provider discrimination on immigrant health and explore learners’ values and biases.
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Affiliation(s)
- Afef Zghal
- University of Windsor, Windsor, Ontario, Canada
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Giwa O, Salami BO, O’Rourke T. A Scoping Review of Nurse Practitioner Roles in Immigrant Health. J Nurse Pract 2020. [DOI: 10.1016/j.nurpra.2020.03.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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10
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Development and pilot testing of a health education program to improve immigrants' access to Canadian health services. BMC Health Serv Res 2020; 20:321. [PMID: 32303224 PMCID: PMC7164356 DOI: 10.1186/s12913-020-05180-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 04/01/2020] [Indexed: 11/14/2022] Open
Abstract
Background In Canada’s increasing immigrant population, a phenomenon called the “healthy immigrant effect” has arisen in which health declines after four years of settling. Access to healthcare is an important consideration. There is strong evidence that immigrants lack confidence and knowledge for navigating health services. The aim of this study was to develop and pilot test the Accessing Canadian Healthcare for Immigrants: Empowerment, Voice & Enablement (ACHIEVE) program. Method The study employed an exploratory sequential mixed methods design. A qualitative study was completed. Program content was developed based on a scoping review and refined in a formative evaluation. Then, a pilot test of the program measured participants’ perceived efficacy in improving confidence in healthcare navigation, program satisfaction, and learning in individual sessions. Results Researchers found significantly higher rates of health navigation and an increase in knowledge about the Canadian health system post-program. Conclusions Results provide promising evidence that ACHIEVE may improve confidence in healthcare access among immigrants, demonstrating potential for dispersion on a larger scale.
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Kaitelidou D, Galanis P, Economou C, Mladovsky P, Siskou O, Sourtzi P. Inequalities Between Migrants and Non-Migrants in Accessing and Using Health Services in Greece During an Era of Economic Hardship. INTERNATIONAL JOURNAL OF HEALTH SERVICES 2020; 50:444-457. [PMID: 32028832 DOI: 10.1177/0020731420902604] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A cross-sectional study was conducted from April 2013 until March 2014 to explore the existence of inequalities in access to and utilization of health services by migrants compared to non-migrants in Greece and to test the influence of various factors on these disparities. Also, we investigated the influence of several socioeconomic and demographic characteristics. Study population included 1,152 migrants and 702 non-migrants. Migrants, participants suffering from a chronic disease, those without health insurance, and patients who assessed their health status as not at all good/a little good/moderate were statistically more likely to report unmet needs in getting their medication. Uninsured participants, females, those unemployed or without a permanent occupational status, and those who assessed their health status as not at all good/a little good/moderate were statistically more likely to report unmet needs in access to health services during the last year. Regarding the use of health services, those with health coverage, non-migrants, and females were statistically more likely to go for a blood test as a hospital outpatient. Greece, despite administrative delays and barriers, provided full coverage to the uninsured, asylum seekers, and migrants, even many groups of undocumented migrants.
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Affiliation(s)
- Daphne Kaitelidou
- Department of Nursing, Center for Health Services Management and Evaluation, National and Kapodistrian University of Athens, Athens, Greece
| | - Petros Galanis
- Department of Nursing, Center for Health Services Management and Evaluation, National and Kapodistrian University of Athens, Athens, Greece
| | - Charalambos Economou
- Department of Sociology, Panteion University of Social and Political Sciences, Athens, Greece
| | - Philipa Mladovsky
- Department of International Development, London School of Economics and Political Science, London, UK
| | - Olga Siskou
- Department of Nursing, Center for Health Services Management and Evaluation, National and Kapodistrian University of Athens, Athens, Greece
| | - Panayota Sourtzi
- Department of Nursing, Sector of Public Health, Occupational Health Nursing, National and Kapodistrian University of Athens, Athens, Greece
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Abdulla D. Immigrant Usage Patterns of Natural Health Products: Role in Pharmacoeconomics. CURRENT NUTRITION & FOOD SCIENCE 2020. [DOI: 10.2174/1573401315666181206120420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
Understanding patterns and drivers for natural health product (NHP) usage
among immigrants is essential in the provision of appropriate health care; many studies have elucidated
NHP utilization among immigrants; however, few have considered impacts of concurrent NHP
and prescription medication usage.
Objective:
The study aims to determine new immigrant NHP usage patterns (including concurrent
usage with prescription medications) and to discern economic impacts driving concurrent usage.
Methods:
A survey questionnaire was administered to local new immigrants during English Language
Training classes.
Results:
Most participants understood the NHP definition and would take an NHP for the same disease
or condition they would normally take a prescription medication for. Many participants agreed
that NHPs are not safe however were unable to provide robust examples of unsafe NHP usage. With
regard to purchases of medicines for short and long term illnesses, a high percentage of participants
would purchase the prescription medication for a short term illness over the NHP; however this percentage
decreases in the event of a long term illness, with more participants relying on NHPs to remedy
their long term illness symptoms.
Conclusion:
Pharmacoeconomics tends to be a major driver for immigrant utilization of NHPs, and
is a stronger influencer of use compared to ethnicity or parenteral usage of such products. This pharmacoeconomic
correlation in the preference to use NHPs over prescription medications tends to be
more observable for chronic and long term conditions (compared to short term illnesses).
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Affiliation(s)
- Dalya Abdulla
- Pharmacy Technician Program, Sheridan College Institute of Technology and Advanced Learning, 7899 McLaughlin Road, Brampton, ON, L6Y 5H9, Canada
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Panagiotopoulos C, Apostolou M, Zachariades A. Assessing migrants’ satisfaction from health care services in Cyprus: a nationwide study. INTERNATIONAL JOURNAL OF MIGRATION, HEALTH AND SOCIAL CARE 2019. [DOI: 10.1108/ijmhsc-10-2016-0037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
As long as migration is recognized as a public health concern, policies exist to address migrants’ health, and provide comprehensive information on how public and private health care system operates, health rights and what their health care plan does or does not cover. Thereby, responding to patients’ expectations significantly affects overall satisfaction with health care services because this dimension is most strongly associated with patient satisfaction. The purpose of this paper is to constitute the first quantitative large-scale study (n=1,512) in Cyprus and Greece exploring the level of satisfaction among third-country nationals (TCN) in relation to their health care needs.
Design/methodology/approach
The questionnaire used in this study has been developed and measured (Cronbach α =0.7) in a similar study in Greece (Galanis et al., 2013) and it has been used by other studies too (Vozikis, 2015).
Findings
The authors can conclude that participants’ knowledge of the health system is not good as 70.2 percent that they do not have a good knowledge. The findings suggest that nearly one in two TCN faced problems in accessing clinics or communicating due to various factors.
Practical implications
The findings of this study provide the context for further exploration of different means to improve cultural awareness amongst health and social care professionals, including multicultural training of health and social service providers and medical pluralist approaches that may be closer to migrants’ cultural and health background. Overall, types of interventions to improve cultural competency included training/workshops/programs for health practitioners (e.g. doctors, nurses and community health workers), culturally specific/tailored education or programs for patients/clients, interpreter services, peer education, patient navigators and exchange programs (Truong, 2014). To the above, practices can also be added as multicultural education to all health professionals in order to develop enthusiasm and be able to acknowledge immigrants’ difficulties. Adding to the above recommendation, interdisciplinary education with allied health professionals (psychologists, social workers and nurses) may lead to a more holistic approach of this group’s needs, especially in the forthcoming health system where primary care will play a vital role.
Social implications
Access to the health system may lead to social inclusion of TCN in the local society and improve their quality of life. It is also important for TCN to feel that the current health system is aware of issues related to their social and cultural background; thus, it will make the health system and those who work look more friendly and approachable.
Originality/value
In an era of crisis and of great debate around a forthcoming National Health System, these findings indicate that healthcare providers in Cyprus will need to address several challenges in managing care for migrants. In order for that to happen, assessing patient satisfaction is thereby important in the process of quality evaluation, especially when dealing with population subgroups at higher risk of inequalities such as immigrants or ethnic minorities. Such studies help systems to develop by measuring their weaknesses and enhancing their strengths. Voicing clients/patients feedback is always helpful to minimize risks.
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Double Burden of Rural Migration in Canada? Considering the Social Determinants of Health Related to Immigrant Settlement Outside the Cosmopolis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16050678. [PMID: 30813529 PMCID: PMC6427738 DOI: 10.3390/ijerph16050678] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 02/17/2019] [Accepted: 02/18/2019] [Indexed: 11/26/2022]
Abstract
There is a large and growing body of research acknowledging the existence of health disparities between foreign-born and native-born populations in many high immigrant-receiving countries. Significant attention has been paid to the role of physical and social environments in the changing health status of immigrants over time. However, very limited attention has been given to these issues within the context of rural geographies, despite global evidence that immigrants are increasingly settling outside of traditional gateway cities and into rural communities. This paper presents the results of a scoping review aimed at assessing the state of knowledge on the health impacts of immigrant migration into rural communities in Canada. Guided by Arksey and O’Malley’s scoping protocol, we conduct a review of academic literature in Canada related to rural migration. A total of 25 articles met inclusion criteria which included access to the social determinants of health. Findings identified a paucity of research directly connecting rural settlement to health but the literature did emphasize five distinct social determinants of health for rural residing immigrants: social inclusion, culturally-appropriate services, gender, employment, and housing. This paper concludes with an identification of research gaps and opportunities for future research into whether rural-residing immigrants face a double burden with respect to health inequity.
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Abstract
RÉSUMÉLe vieillissement et l’immigration ont significativement transformé la composition démographique au Canada, et les immigrants y représentent une proportion croissante de la population adulte plus âgée. L’accès adéquat aux services de santé est essentiel au bien-être et à l’inclusion sociale de cette population. Cet examen de la portée porte sur les connaissances actuelles concernant l’accès des immigrants d’âge avancé aux médecins omnipraticiens et à leur consultation, considérant que ces médecins jouent un rôle central dans la prestation de soins de première ligne, dans les soins préventifs et les soins de santé mentale. Le modèle en 5 étapes d’Arksey et O’Malley a été utilisé pour effectuer des recherches dans une grande variété de bases de données pour des articles publiés en anglais dans des revues avec comité de pairs concernant ce sujet dans le contexte canadien. Un total de 31 articles répondant aux critères d’inclusion ont été examinés en détail. Ces articles ont été classés en fonction de l’information disponible sur leurs auteurs, la population à l’étude, la méthodologie, le domaine de la santé et les obstacles mentionnés. Trois thèmes principaux ont émergé de cet examen de portée : l’accès et l’utilisation des soins de première ligne, la promotion de la santé et le dépistage du cancer, ainsi que l’utilisation des services de santé mentale. Les immigrants d’âge avancé font face à des obstacles en termes d’accès aux soins et ceux-ci seraient liés à la littératie en santé, à la langue, à la culture, aux croyances en matière de santé, aux inégalités spatiales et à des circonstances structurelles. L’examen de la portée présente de manière détaillée l’accès aux soins des personnes âgées immigrantes au Canada, et permet de dériver des implications sur les politiques qui permettraient de répondre à leurs besoins qui sont non comblés dans le domaine de la santé.
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The Experience of Food Insecurity Among Immigrants: a Scoping Review. JOURNAL OF INTERNATIONAL MIGRATION AND INTEGRATION 2018. [DOI: 10.1007/s12134-018-0613-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Crăciun IC, Rasche S, Flick U, Hirseland A. Too Old to Work: Views on Reemployment in Older Unemployed Immigrants in Germany. AGEING INTERNATIONAL 2018. [DOI: 10.1007/s12126-018-9328-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Affiliation(s)
- Jonathan Crush
- Balsillie School of International Affairs Waterloo Canada
| | - Mary Caesar
- Balsillie School of International Affairs Waterloo Canada
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Subedi RP, Rosenberg MW. “I am from nowhere”: identity and self-perceived health status of skilled immigrants employed in low-skilled service sector jobs. INTERNATIONAL JOURNAL OF MIGRATION, HEALTH AND SOCIAL CARE 2017. [DOI: 10.1108/ijmhsc-09-2015-0035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The foreign-born skilled immigrant population is growing rapidly in Canada but finding a job that utilizes immigrants’ skills, knowledge and experience is challenging for them. The purpose of this paper is to understand the self-perceived health and social status of skilled immigrants who were working in low-skilled jobs in the service sector in Ottawa, Canada.
Design/methodology/approach
In this qualitative study, semi-structured interviews with 19 high-skilled immigrants working as taxi drivers and convenience store workers in the city of Ottawa, Canada were analysed using a grounded theory approach.
Findings
Five major themes emerged from the data: high expectations but low achievements; credential devaluation, deskilling and wasted skills; discrimination and loss of identity; lifestyle change and poor health behaviour; and poor mental and physical health status.
Social implications
The study demonstrates the knowledge between what skilled immigrants expect when they arrive in Canada and the reality of finding meaningful employment in a country where international credentials are less likely to be recognized. The study therefore contributes to immigration policy reform which would reduce barriers to meaningful employment among immigrants reducing the impacts on health resulting from employment in low-skilled jobs.
Originality/value
This study provides unique insights into the experience and perceptions of skilled immigrants working in low-skilled jobs. It also sheds light on the “healthy worker effect” hypothesis which is a highly discussed and debated issue in the occupational health literature.
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Woodgate RL, Busolo DS, Crockett M, Dean RA, Amaladas MR, Plourde PJ. A qualitative study on African immigrant and refugee families' experiences of accessing primary health care services in Manitoba, Canada: it's not easy! Int J Equity Health 2017; 16:5. [PMID: 28068998 PMCID: PMC5223444 DOI: 10.1186/s12939-016-0510-x] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 12/28/2016] [Indexed: 11/10/2022] Open
Abstract
Background Immigrant and refugee families form a growing proportion of the Canadian population and experience barriers in accessing primary health care services. The aim of this study was to examine the experiences of access to primary health care by African immigrant and refugee families. Methods Eighty-three families originating from 15 African countries took part in multiple open ended interviews in western Canada. Qualitative data was collected in six different languages between 2013 and 2015. Data analysis involved delineating units of meaning from the data, clustering units of meaning to form thematic statements, and extracting themes. Results African immigrant and refugee families experienced challenges in their quest to access primary health care that were represented by three themes: Expectations not quite met, facing a new life, and let’s buddy up to improve access. On the theme of expectations not quite met, families struggled to understand and become familiar with a new health system that presented with a number of barriers including lengthy wait times, a shortage of health care providers, high cost of medication and non-basic health care, and less than ideal care. On the theme of facing a new life, immigrant and refugee families talked of the difficulties of getting used to their new and unfamiliar environments and the barriers that impact their access to health care services. They talked of challenges related to transportation, weather, employment, language and cultural differences, and lack of social support in their quest to access health care services. Additionally, families expressed their lack of social support in accessing care. Privately sponsored families and families with children experienced even less social support. Importantly, in the theme of let’s buddy up to improve access, families recommended utilizing networking approaches to engage and improve their access to primary health care services. Conclusions African immigrant and refugee families experience barriers to accessing primary health care. To improve access, culturally relevant programs, collaborative networking approaches, and policies that focus on addressing social determinants of health are needed.
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Affiliation(s)
- Roberta Lynn Woodgate
- Rady Faculty of Health Sciences, College of Nursing, University of Manitoba, Winnipeg, MB, R3T 2N2, Canada.
| | - David Shiyokha Busolo
- Rady Faculty of Health Sciences, College of Nursing, University of Manitoba, Winnipeg, MB, R3T 2N2, Canada
| | - Maryanne Crockett
- Departments of Pediatrics and Child Health, Rady Faculty of Health Sciences, Max Rady College of Medicine, Medical Microbiology and Community Health Sciences, University of Manitoba, Winnipeg, MB, R3E 3P5, Canada
| | - Ruth Anne Dean
- Rady Faculty of Health Sciences, College of Nursing, University of Manitoba, Winnipeg, MB, R3T 2N2, Canada
| | - Miriam R Amaladas
- Nor-West Co-op Access Center, 785 Keewatin Street, Winnipeg, MB, Canada
| | - Pierre J Plourde
- Medical Officer of Health, Winnipeg Regional Health Authority, 490 Hargrave Street, Winnipeg, MB, R3A 0X7, Canada
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Rodriguez PI, Dean J, Kirkpatrick S, Berbary L, Scott S. Exploring experiences of the food environment among immigrants living in the Region of Waterloo, Ontario. Canadian Journal of Public Health 2016; 107:5310. [PMID: 27281516 DOI: 10.17269/cjph.107.5310] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Revised: 03/02/2016] [Accepted: 03/06/2016] [Indexed: 11/17/2022]
Abstract
OBJECTIVES This exploratory study aimed to shed light on the role of the food environment in shaping food access among immigrants living in the Region of Waterloo, Ontario. METHODS In this qualitative case study, in-depth interviews aided by photovoice were conducted with nine immigrants, and key informant (KI) interviews were conducted with nine community stakeholders (e.g., settlement workers, planners) who held expert knowledge of the local context with respect to both the food system and experiences of immigrants in interacting with this system. In this paper, we focus specifically on insights related to the food environment, applying the Analysis Grid for Environments Linked to Obesity Framework to assess economic, physical, socio-cultural and political aspects. RESULTS Economic features of the food environment, including food prices and differential costs of different types of food, emerged as factors related to food access. However, interactions with the food environment were shaped by broader economic factors, such as limited employment opportunities and low income. Most immigrants felt that they had good geographic access to food, though KIs expressed concerns about the types of outlet and food that were most accessible. Immigrants discussed social networks and cultural food practices, whereas KIs discussed political issues related to supporting food security in the Region. CONCLUSION This exploratory case study is consistent with prior research in highlighting the economic constraints within which food access exists but suggests that there may be a need to further dissect food environments.
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Lum ID, Swartz RH, Kwan MYW. Accessibility and use of primary healthcare for immigrants living in the Niagara Region. Soc Sci Med 2016; 156:73-9. [PMID: 27017093 DOI: 10.1016/j.socscimed.2016.03.024] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 01/19/2016] [Accepted: 03/16/2016] [Indexed: 11/26/2022]
Abstract
Although the challenges of accessing and using primary healthcare for new immigrants to Canada have been fairly well documented, the focus has primarily been on large cities with significant immigrant populations. The experiences of immigrants living in smaller, less diverse urban centres remain largely unknown. The purpose of this study was to examine the lived experiences of immigrants living in a small urban centre with regards to the primary healthcare system. A total of 13 immigrants living in the Greater Niagara Region participated in semi-structured interviews. All interviews were recorded, transcribed, and then coded and analyzed for emergent themes using NVivo. Five factors were found to impact primary care access and use: lack of social contacts, lack of universal healthcare coverage during their initial arrival, language as a barrier, treatment preferences, and geographic distance to primary care. Overall findings suggest that immigrants moving to smaller areas such as the Niagara Region face similar barriers to primary care as those moving into large cities. Some barriers, however, appear to be specific to the context of smaller urban centres, further exacerbated by living in a small city due to a smaller immigrant population, fewer services for immigrants, and less diversity in practicing physicians. More research is required to understand the contextual factors inhibiting primary care access and use among immigrants moving to smaller urban centres, and determine effective strategies to overcome these barriers.
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Affiliation(s)
- Irene D Lum
- McMaster University, Michael G. DeGroote School of Medicine, Niagara Regional Campus, 500 Glenridge Avenue, St. Catharines, Ontario L2S 3A1, Canada.
| | - Rebecca H Swartz
- McMaster University, Michael G. DeGroote School of Medicine, Niagara Regional Campus, 500 Glenridge Avenue, St. Catharines, Ontario L2S 3A1, Canada.
| | - Matthew Y W Kwan
- McMaster University, Michael G. DeGroote School of Medicine, Niagara Regional Campus, 500 Glenridge Avenue, St. Catharines, Ontario L2S 3A1, Canada; McMaster University, Department of Family Medicine, 5th Floor - 100 Main Street West, Hamilton, Ontario L8P 1H6, Canada.
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Development of an Interview Guide Identifying the Rehabilitation Needs of Women from the Middle East Living with Chronic Pain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:12043-56. [PMID: 26404332 PMCID: PMC4626954 DOI: 10.3390/ijerph121012043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Revised: 09/09/2015] [Accepted: 09/18/2015] [Indexed: 11/16/2022]
Abstract
The purpose of this study was to develop an interview guide for use by primary healthcare professionals to support them in identifying the rehabilitation needs of forced resettled women from the Middle East living with chronic pain. Previous findings together with the existing literature were used as the basis for developing the interview guide in three steps: item generation, cognitive interviews, and a pilot study. The study resulted in a 16-item interview guide focusing on patients' concerns and expectations, with consideration of pre-migration, migration, and post-migration factors that might affect their health. With the help of the guide, patients were also invited to identify difficulties in their daily activities and to take part in setting goals and planning their rehabilitation. The current interview guide provides professional guidance to caretakers, taking a person-centered participative point of departure when meeting and planning care, for and together, with representatives from dispersed ethnic populations in Sweden. It can be used together with the patient by all staff members working in primary healthcare, with the aim of contributing to continuity of care and multi-professional collaboration.
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Snyder M, Wilson K. “Too much moving…there's always a reason”: Understanding urban Aboriginal peoples' experiences of mobility and its impact on holistic health. Health Place 2015; 34:181-9. [DOI: 10.1016/j.healthplace.2015.05.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 05/12/2015] [Accepted: 05/18/2015] [Indexed: 10/23/2022]
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Terry DR, Quynh L. Social capital among migrating doctors: the "bridge" over troubled water. J Health Organ Manag 2014; 28:315-26. [PMID: 25080647 DOI: 10.1108/jhom-09-2012-0178] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The purpose of this paper is to examine the concept of social capital among International Medical Graduates (IMGs). It will specifically examine bridging social capital and greater intercultural communication which provides IMGs access to the wider community and plays a key role in cross-cultural adaptation and acculturation. DESIGN/METHODOLOGY/APPROACH A review of the literature. FINDINGS An Australian wide shortage of doctors has led to an increased reliance on the recruitment of IMGs. As IMGs migrate, they may encounter different meanings of illness, models of care and a number of social challenges. Nevertheless, greater cross-cultural adaptation and acculturation occurs through bridging social capital, where intercultural communication, new social networks and identity aids integration. This process produces more opportunities for economic capital growth and upward mobility than bonding social capital. PRACTICAL IMPLICATIONS Concerns regarding immigration, appropriate support and on-going examination processes have been expressed by IMGs in a number of studies and policy papers. However, there is very little insight into what contributes cross-cultural adaptation of IMGs. ORIGINALITY/VALUE As IMGs migrate to not only a new country, but also a new health system and workplace they arrive with different cultural meanings of illness and models of care. These differences may be in contrast to the dominant western medical model, but often bring positive contributions to patient care in the new environment. In addition, improving bridging social capital provides IMGs access to the wider community and has been demonstrated to play a key role in cross-cultural adaptation and ultimately acculturation.
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Exploring socio-cultural factors that mediate, facilitate, & constrain the health and empowerment of refugee youth. Soc Sci Med 2014; 117:34-41. [DOI: 10.1016/j.socscimed.2014.07.025] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Revised: 04/07/2014] [Accepted: 07/10/2014] [Indexed: 11/22/2022]
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Subedi RP, Rosenberg MW. Determinants of the variations in self-reported health status among recent and more established immigrants in Canada. Soc Sci Med 2014; 115:103-10. [PMID: 24953500 DOI: 10.1016/j.socscimed.2014.06.021] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2013] [Revised: 01/31/2014] [Accepted: 06/12/2014] [Indexed: 11/19/2022]
Abstract
Studies have shown that immigrants are normally in better health on arrival compared to their Canadian-born counterparts. However, the health conditions of new immigrants deteriorate after a few years of their arrival in Canada. This phenomenon is popularly termed the "healthy immigrant effect" (HIE) in the immigrant health literature. Although different hypotheses have been proposed to understand HIE, the causes are subject to ongoing discussion. Unlike previous studies, this study explored the possible causes behind the variations in the health status of recent and more established immigrants comparing 2001 and 2010 Canadian Community Health Surveys (CCHS). Four different hypotheses - namely lifestyle change, barriers to health care services, poor social determinants of health, and work related stress - were tested to understand variations in health status. The study concludes that there is a statistically significant difference in the socioeconomic characteristics and health outcomes of immigrants having less than and more than 10 years of residency in Canada. Logistic regression models show that the health conditions of immigrants are associated with age, sex, ethnic origin, smoking habit, Body Mass Index (BMI), total household income, number of consultations made with a family doctor per year and work related stress.
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Galanis P, Sourtzi P, Bellali T, Theodorou M, Karamitri I, Siskou O, Charalambous G, Kaitelidou D. Public health services knowledge and utilization among immigrants in Greece: a cross-sectional study. BMC Health Serv Res 2013; 13:350. [PMID: 24034077 PMCID: PMC3847449 DOI: 10.1186/1472-6963-13-350] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2013] [Accepted: 09/10/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND During the 90s, Greece has been transformed to a host country for immigrants mostly from the Balkans and Eastern European Countries, who currently constitute approximately 9% of the total population. Despite the increasing number of the immigrants, little is known about their health status and their accessibility to healthcare services. This study aimed to explore the perceived barriers to access and utilization of healthcare services by immigrants in Greece. METHODS A pilot cross-sectional study was conducted from January to April 2012 in Athens, Greece. The study population consisted of 191 immigrants who were living in Greece for less than 10 years. We developed a questionnaire that included information about sociodemographic characteristics, health status, public health services knowledge and utilization and difficulties in health services access. Statistical analysis included Pearson's ×2 test, ×2 test for trend, Student's t-test, analysis of variance and Pearson's correlation coefficient. RESULTS Only 20.4% of the participants reported that they had a good/very good degree of knowledge about public health services in Greece. A considerable percentage (62.3%) of the participants needed at least once to use health services but they could not afford it, during the last year, while 49.7% used public health services in the last 12 months in Greece. Among the most important problems were long waiting times in hospitals, difficulties in communication with health professionals and high cost of health care. Increased ability to speak Greek was associated with increased health services knowledge (p<0.001). Increased family monthly income was also associated with less difficulties in accessing health services (p<0.001). CONCLUSIONS The empowerment and facilitation of health care access for immigrants in Greece is necessary. Depending on the needs of the migrant population, simple measures such as comprehensive information regarding the available health services and the terms for accessibility is an important step towards enabling better access to needed services.
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Affiliation(s)
- Petros Galanis
- Center for Health Services Management and Evaluation, Faculty of Nursing, University of Athens, Athens, Greece
| | - Panayiota Sourtzi
- Department of Public Health, Associate Professor, Faculty of Nursing, University of Athens, Athens, Greece
| | - Thalia Bellali
- Department of Nursing, Alexandreio Technological Educational Institute, Thessaloniki, Greece
| | - Mamas Theodorou
- Faculty of Economic Sciences and Management, Open University of Cyprus, Nicosia, Cyprus
| | - Ioanna Karamitri
- General Hospital of Kalamata, Messinia, Greece, Hellenic Open University, Patras, Greece
| | - Olga Siskou
- Center for Health Services Management and Evaluation, Faculty of Nursing, University of Athens, Athens, Greece
| | | | - Daphne Kaitelidou
- Emergency Department, Hippocratio Hospital of Athens, Athens, Greece
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Tarsitani L, Pasquini M, Maraone A, Zerella MP, Berardelli I, Giordani R, Polselli GM, Biondi M. Acute psychiatric treatment and the use of physical restraint in first-generation immigrants in Italy: a prospective concurrent study. Int J Soc Psychiatry 2013; 59:613-8. [PMID: 22751614 DOI: 10.1177/0020764012450985] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND and AIMS Immigrants in Europe appear at higher risk of psychiatric coercive interventions. No studies have investigated this issue in Italy. The aim of this study is to investigate whether the use of physical restraint, compulsory admission and other treatment characteristics differ in immigrated and Italian-born patients admitted to a psychiatric intensive care unit. METHODS One hundred first-generation immigrant patients were compared to 100 age-, gender- and diagnosis-matched Italian-born patients. Subjects were diagnosed according to DSM-IV-TR and rated on the Clinical Global Impression - Severity Scale and the Global Assessment of Functioning. Clinical data and treatment characteristics were collected. RESULTS Immigrant patients were more likely to be physically restrained as compared to Italian-born patients (11% vs 3%; χ (2) = 4.92; p = 0.027; RR = 3.67; 95% CI = 1.05-12.7). No differences in the proportion of involuntary treatment were found. Immigrant patients did not receive higher doses of antipsychotics or benzodiazepines, but they had a longer stay in the hospital. CONCLUSIONS The higher rate of physical restraint among migrants may reflect cultural, ethnic and language differences leading to communication problems between immigrant patients and mental health professionals. Since coercive interventions can be harmful, specific strategies to prevent this phenomenon in immigrants are needed.
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Affiliation(s)
- Lorenzo Tarsitani
- Department of Neurology and Psychiatry, Policlinico Umberto I, Sapienza University of Rome, Italy.
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Tracking the Emotional Cost of Immigration: Ethno-religious Differences and Women’s Mental Health. JOURNAL OF INTERNATIONAL MIGRATION AND INTEGRATION 2013. [DOI: 10.1007/s12134-013-0302-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Agudelo-Suárez AA, Gil-González D, Vives-Cases C, Love JG, Wimpenny P, Ronda-Pérez E. A metasynthesis of qualitative studies regarding opinions and perceptions about barriers and determinants of health services' accessibility in economic migrants. BMC Health Serv Res 2012; 12:461. [PMID: 23245431 PMCID: PMC3565901 DOI: 10.1186/1472-6963-12-461] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2012] [Accepted: 11/23/2012] [Indexed: 11/30/2022] Open
Abstract
Background Access to health services is an important health determinant. New research in health equity is required, especially amongst economic migrants from developing countries. Studies conducted on the use of health services by migrant populations highlight existing gaps in understanding which factors affect access to these services from a qualitative perspective. We aim to describe the views of the migrants regarding barriers and determinants of access to health services in the international literature (1997–2011). Methods A systematic review was conducted for Qualitative research papers (English/Spanish) published in 13 electronic databases. A selection of articles that accomplished the inclusion criteria and a quality evaluation of the studies were carried out. The findings of the selected studies were synthesised by means of metasynthesis using different analysis categories according to Andersen’s conceptual framework of access and use of health services and by incorporating other emergent categories. Results We located 3,025 titles, 36 studies achieved the inclusion criteria. After quality evaluation, 28 articles were definitively synthesised. 12 studies (46.2%) were carried out in the U.S and 11 studies (42.3%) dealt with primary care services. The participating population varied depending mainly on type of host country. Barriers were described, such as the lack of communication between health services providers and migrants, due to idiomatic difficulties and cultural differences. Other barriers were linked to the economic system, the health service characteristics and the legislation in each country. This situation has consequences for the lack of health control by migrants and their social vulnerability. Conclusions Economic migrants faced individual and structural barriers to the health services in host countries, especially those with undocumented situation and those experimented idiomatic difficulties. Strategies to improve the structures of health systems and social policies are needed.
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Affiliation(s)
- Andrés A Agudelo-Suárez
- Faculty of Dentistry, University of Antioquia, Calle 64 N° 52-59, Medellín, Antioquia, Colombia.
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Harrington DW, Elliott SJ, Clarke AE, Ben-Shoshan M, Godefroy S. Exploring the Determinants of the Perceived Risk of Food Allergies in Canada. HUMAN AND ECOLOGICAL RISK ASSESSMENT : HERA 2012; 18:1338-1358. [PMID: 23172987 PMCID: PMC3498839 DOI: 10.1080/10807039.2012.722857] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2011] [Accepted: 09/08/2011] [Indexed: 06/01/2023]
Abstract
Food allergies are emerging health risks in much of the Western world, and some evidence suggests prevalence is increasing. Despite lacking scientific consensus around prevalence and management, policies and regulations are being implemented in public spaces (e.g., schools). These policies have been criticized as extreme in the literature, in the media, and by the non-allergic population. Backlash appears to be resulting from different perceptions of risk between different groups. This article uses a recently assembled national dataset (n = 3,666) to explore how Canadians perceive the risks of food allergy. Analyses revealed that almost 20% self-report having an allergic person in the household, while the average respondent estimated the prevalence of food allergies in Canada to be 30%. Both of these measures overestimate the true clinically defined prevalence (7.5%), indicating an inflated public understanding of the risks of food allergies. Seventy percent reported food allergies to be substantial risks to the Canadian population. Multivariate logistic regression models revealed important determinants of risk perception including demographic, experience-based, attitudinal, and regional predictors. Results are discussed in terms of understanding emerging health risks in the post-industrial era, and implications for both policy and risk communication.
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Affiliation(s)
- Daniel W. Harrington
- School of Geography and Earth Sciences, McMaster University, Hamilton, ON, Canada
| | - Susan J. Elliott
- Geography and Environmental Management, University of Waterloo, Waterloo, ON, Canada
| | - Ann E. Clarke
- Division of Allergy and Clinical Immunology and Clinical Epidemiology, Department of Medicine, McGill University Health Center, Montreal, QB, Canada
| | - Moshe Ben-Shoshan
- Division of Pediatric Allergy and Clinical Immunology, Department of Pediatrics, McGill University Health Center, Montreal, QB, Canada
| | - Samuel Godefroy
- Food Directorate, Health Products and Food Branch, Health Canada, Ottawa, ON, Canada
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Ogilvie L, Higginbottom G, Burgess-Pinto E, Murray C. Fostering excellence: development of a course to prepare graduate students for research on migration and health. Nurs Inq 2012; 20:211-22. [PMID: 22631435 DOI: 10.1111/j.1440-1800.2012.00605.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Canada is an immigrant-receiving nation and many graduate students in nursing and other disciplines pursue immigrant health research. As these students often start with inadequate understanding of the policy, theoretical, and research contexts in which their work should be situated, we became concerned that the theses and dissertations were less sophisticated than were both possible and desirable. This led to development of a PhD-level course titled Migration and Health in the Canadian Context. In this study, we provide an analytic overview including course description, objectives, assignments, and specific class topics. Areas of focus include historical and theoretical considerations; determinants of immigrant health; refugee health; cultural competence and cultural safety; research challenges, approaches, and skills; policy-relevant research; and educational imperatives in the health and related disciplines. Salient research is introduced in each of these classes. While Canada is the main focus, comparative data are provided and there is relevance for nurse-researchers in other immigrant-receiving countries.
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Harrington DW, Wilson K, Bell S, Muhajarine N, Ruthart J. Realizing neighbourhood potential? The role of the availability of health care services on contact with a primary care physician. Health Place 2012; 18:814-23. [PMID: 22503325 DOI: 10.1016/j.healthplace.2012.03.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2012] [Revised: 03/02/2012] [Accepted: 03/26/2012] [Indexed: 11/16/2022]
Abstract
Access to health services research has traditionally focused on demographic, socioeconomic, and need-based factors, resulting in a relative lack of knowledge regarding place-based determinants. Further, much of what we know comes from international, national, and regional study. This study analyzes survey data (n=1635) to explore the relationship between neighbourhood-level potential access (i.e., availability) and realized access (i.e., use) in two Canadian cities. Controlling for predisposing, enabling and need factors, living in a well-served neighbourhood was a significant predictor of realized access, particularly in Saskatoon. This suggests that the relationship between potential and realized access may be modified by place-based factors.
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Affiliation(s)
- Daniel W Harrington
- Department of Geography, University of Toronto Mississauga, 3359 Mississauga Rd N, WG Davis Bldg, Mississauga, Ontario, Canada L5L 1C6.
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Boateng L, Nicolaou M, Dijkshoorn H, Stronks K, Agyemang C. An exploration of the enablers and barriers in access to the Dutch healthcare system among Ghanaians in Amsterdam. BMC Health Serv Res 2012; 12:75. [PMID: 22443162 PMCID: PMC3348030 DOI: 10.1186/1472-6963-12-75] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2011] [Accepted: 03/24/2012] [Indexed: 11/18/2022] Open
Abstract
Background Sub-Saharan African populations are growing in many European countries. Data on the health of these populations are rare. Additionally, many sub-Saharan African migrants are confronted with issues of low socio-economic status, acculturation and language difficulties, which may hamper their access to health care. Despite the identification of some of those barriers, little is known about the enabling factors. Knowledge about the enablers and barriers in access to healthcare experienced is important in addressing their health needs and promoting healthcare access. This study aimed to investigate the enabling factors as well as barriers in access to the Dutch healthcare system among the largest sub-Saharan African migrant group (Ghanaians) living in Amsterdam, the Netherlands. Methods Six focus groups were conducted from November 2009 to February 2010. A semi-structured interview guideline was used. Discussions were conducted in English or Twi (Ghanaian dialect), recorded and transcribed verbatim. Analysis was based on the Andersen model of healthcare utilisation using MAXQDA software. Results Knowledge and perceived quality of the health system, awareness of diseases, family and community support, community initiatives and availability of social support were the main enablers to the healthcare system. Difficulties with the Dutch language and mistrust in health care providers were major barriers in access to healthcare. Conclusions Access to healthcare is facilitated mainly by knowledge of and the perceived efficiency and quality of the Dutch healthcare system. However, poor Dutch language proficiency and mistrust in health care providers appear to be important barriers in accessing healthcare. The enablers and barriers identified by this study provide useful information for promoting healthcare access among this and similar Sub-Saharan African communities.
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Affiliation(s)
- Linda Boateng
- Department of Public Health, Academic Medical Centre, University of Amsterdam, The Netherlands.
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Hawthorne TL, Kwan MP. Using GIS and perceived distance to understand the unequal geographies of healthcare in lower-income urban neighbourhoods. THE GEOGRAPHICAL JOURNAL 2012; 178:18-30. [PMID: 22400154 DOI: 10.1111/j.1475-4959.2011.00411.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Geographers play important roles in public health research, particularly in understanding healthcare accessibility, utilisation, and individual healthcare experiences. Most accessibility studies have benefited from the increased sophistication of geographic information systems (GIS). Some studies have been enhanced with semi-structured in-depth interviews to understand individual experiences of people as they access healthcare. However, few accessibility studies have explicitly utilised individual in-depth interview data in the construction of new GIS accessibility measures. Using mixed methods including GIS analysis and individual data from semi-structured in-depth interviews, we offer satisfaction-adjusted distance as a new way of conceptualising accessibility in GIS. Based on fieldwork in a predominantly lower-income community in Columbus, Ohio (USA), we find many residents felt neighbourhood healthcare facilities offered low-quality care, which suggested an added perceived distance as they attempt to access high-quality healthcare facilities. The satisfaction-adjusted distance measure accounts for the perceived distance some residents feel as they search for high-quality healthcare in lower-income urban neighbourhoods. In moving beyond conventional GIS and re-conceptualising accessibility in this way, we offer a more realistic portrayal of the issues lower-income urban residents face as they attempt to access high-quality healthcare facilities. The work has theoretical implications for conceptualising healthcare accessibility, advances the mixed-methodologies literature, and argues for a more equitable distribution of high-quality healthcare in urban neighbourhoods.
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Wick JY. Immigrants: distinct differences, increasing insight. THE CONSULTANT PHARMACIST : THE JOURNAL OF THE AMERICAN SOCIETY OF CONSULTANT PHARMACISTS 2011; 26:350-354. [PMID: 21733816 DOI: 10.4140/tcp.n.2011.00.350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- Jeannette Y Wick
- National Cancer Institute, National Institutes of Health, Bethesda, Maryland
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Singh Setia M, Lynch J, Abrahamowicz M, Tousignant P, Quesnel-Vallee A. Self-rated health in Canadian immigrants: Analysis of the Longitudinal Survey of Immigrants to Canada. Health Place 2011; 17:658-70. [DOI: 10.1016/j.healthplace.2011.01.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2010] [Revised: 12/31/2010] [Accepted: 01/15/2011] [Indexed: 10/18/2022]
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