1
|
Kuru Alici N, Öztürk Çopur E. Nurses' Experiences as Care Providers for Syrian Refugees With Noncommunicable Diseases: A Qualitative Study. J Transcult Nurs 2023; 34:24-31. [PMID: 36172801 DOI: 10.1177/10436596221125888] [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] [Indexed: 02/02/2023] Open
Abstract
INTRODUCTION Noncommunicable diseases (NCDs) are the leading cause of disability and death in the world. In Syria, the incidence of NCDs in refugees is 45%. Cardiovascular diseases, cancers, chronic respiratory diseases, diabetes, and other NCDs are the most common causes of morbidity in Syria. Nurses have challenges caring for Syrian refugees with NCDs. The purpose of the study was to explore nurses' experiences of caring for Syrian refugees with NCDs in Turkey. METHODOLOGY A phenomenology design was used. Inclusion criteria were nurses working experience of more than 1 year, caring for Syrian refugees with NCDs, and willingness and ability to participate in an individual interview. The participants were 20 nurses who worked with Syrian refugees at a public hospital in Kilis Province the border with Syria. Data were collected using semistructured interviews and analyzed by the thematic analysis method of Braun and Clarke. RESULTS Three major themes and six subthemes were identified. Major themes included the communication experience, cultural differences, and Syrian refugees' lack of knowledge about NCDs. DISCUSSION The results provide insight related to nursing care in Turkey for Syrian refugees with NCDs. The study revealed that nurses encountered challenges when caring for Syrian refugees with NCDs. Culturally competent assessment and interventions for refugees with NCDs should be encouraged considering these three themes.
Collapse
|
2
|
Svensson P, Agardh A, Zdravkovic S, Asamoah BO. Investigating pathways for predisposing, enabling and need factors in predicting the use of STI/HIV-testing services among Syrian and Iraqi migrants in Scania, Sweden - a cross-sectional study with directed acyclic graphs for modelling pathways to testing. BMC Public Health 2022; 22:2177. [PMID: 36434617 PMCID: PMC9700979 DOI: 10.1186/s12889-022-14615-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 11/14/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Some groups of migrants have increased vulnerability to Sexually Transmitted Infections (STI) and Human Immunodeficiency Virus (HIV) transmission partly due to a lower uptake of disease preventive activities targeting the general population in receiving country. Limited access to economic and social resources and poor language skills may exacerbate exposure to sexual risks and utilization of health services. AIM To explore general and migrant specific predictors for STI/HIV-testing among Syrian and Iraqi migrants in Sweden and to investigate potential pathways that link predisposing, enabling and need- factors to STI/HIV-testing. METHOD Cross-sectional study design based on a migration specific framework for health care utilization. Directed acyclic graphs (DAGs) were used to model assumptions about factors associated with the uptake of STI/HIV-testing services. Bi-variable and multivariable logistic regression analyses assessed individual predictors while adjusting for covariates. The magnitude of the indirect effect of mediating variables were estimated with bootstrap analyses and a method for decomposing the total effect. RESULT The pathways between younger age, unmarried, and self-identifying as bi- or homosexual and testing were mainly indirect, mediated by experiences of sexual coercion and other risk behaviours. One third of the indirect mediating effect of the pathway between higher education and testing could be attributed to Swedish language skills. CONCLUSION Utilization of STI/HIV-testing services among Syrian and Iraqi migrants seemed to be motivated by sexual risk exposure and risk awareness. Interventions should focus on language-adapted information about available screening services and where to go for advice on sexual wellbeing and sexual rights. Such activities should be implemented within an integration promoting framework, addressing structures that increase STI/HIV risk exposure, specifically targeting vulnerable subgroups of migrants.
Collapse
Affiliation(s)
- Pia Svensson
- grid.4514.40000 0001 0930 2361Social Medicine and Global Health, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Anette Agardh
- grid.4514.40000 0001 0930 2361Social Medicine and Global Health, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Slobodan Zdravkovic
- grid.32995.340000 0000 9961 9487Department of Care Science, Faculty of Health and Society and Malmö Institute for Studies of Migration Diversity and Welfare (MIM), Malmö University, Malmö, Sweden
| | - Benedict Oppong Asamoah
- grid.4514.40000 0001 0930 2361Social Medicine and Global Health, Department of Clinical Sciences, Lund University, Malmö, Sweden
| |
Collapse
|
3
|
Aro T, Kantele A. Hospital admissions of refugees, asylum seekers and undocumented migrants: Ten-year retrospective study. Travel Med Infect Dis 2021; 44:102186. [PMID: 34688889 DOI: 10.1016/j.tmaid.2021.102186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 08/05/2021] [Accepted: 10/18/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The worldwide population of forcibly displaced people has increased over the past decade, approaching 80 million and encompassing more than 30 million refugees and asylum seekers. Research into refugee and migrant health has remained scarce, however. METHODS To investigate the reasons for hospital admissions of refugees, asylum seekers and undocumented migrants, we collected medical data from Helsinki University Hospital (HUH) records 2010-20. RESULTS The study population consisted of 647 patients originally from 54 different countries, mainly Iraq, Syria, and Afghanistan. Among adults, 40.9% of the admissions were related to pregnancy. For minors, the group comprising congenital malformations, deformations, and chromosomal abnormalities accounted for most hospitalizations, followed by diseases of the digestive or nervous system. Every fifth patient (19.3%) was admitted because of an infection: adults mostly for urinary tract infection (16.3%), pneumonia (14.1%), and tuberculosis (9.8%), and minors for acute gastroenteritis (15.2%). Infectious reason was more frequent within two months after immigration than later. CONCLUSIONS Our data reveal a unique admission profile for forced migrants: in addition to infectious diseases, a particularly high rate of obstetric diagnoses was recorded, the two ranking as the most common reasons for hospitalization.
Collapse
Affiliation(s)
- Tuomas Aro
- Department of Infectious Diseases, University of Helsinki and Helsinki University Hospital, Finland; Meilahti Infectious Diseases and Vaccine Research Center, MeiVac, Inflammation Center, University of Helsinki and Helsinki University Hospital, Finland
| | - Anu Kantele
- Department of Infectious Diseases, University of Helsinki and Helsinki University Hospital, Finland; Meilahti Infectious Diseases and Vaccine Research Center, MeiVac, Inflammation Center, University of Helsinki and Helsinki University Hospital, Finland.
| |
Collapse
|
4
|
Buch Mejsner S, Kristiansen M, Eklund Karlsson L. Civil Servants and Non-Western Migrants' Perceptions on Pathways to Health Care in Serbia-A Grounded Theory, Multi-Perspective Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10247. [PMID: 34639551 PMCID: PMC8547138 DOI: 10.3390/ijerph181910247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 09/15/2021] [Accepted: 09/26/2021] [Indexed: 11/16/2022]
Abstract
(1) Background: Informal patient payments continue to persist in the Serbian health care system, exposing vulnerable groups to private spending on health care. Migrants may in particular be subject to such payments, as they often experience barriers in access to health care. Little is known about migrants paying informally to access health care in Serbia. The study aims to explore pathways of accessing health care, including the role of informal patient payments, from the perspectives of civil servants and non-western migrants in Serbia. (2) Methods: Respondents (n = 8 civil servants and n = 6 migrants) were recruited in Belgrade in 2018, where semi-structured interviews were conducted. The interviews were analysed applying the grounded theory methodological steps. (3) Results: Data reveal different pathways to navigate the Serbian health care system, and ultimately whether paying informally occurs. Migrants appear less prone to paying informally and receive the same or better-quality health care. Locals experience the need to pay informal patient payments, quasi-formal payments and to bring medicine, materials or equipment when in health facilities. (4) Conclusions: Paying informally or using private care in Serbia appear to have become common. Despite a comprehensive health insurance coverage, high levels of out-of-pocket payments show barriers in accessing health care. It is highly important to not confuse the cultural beliefs with forced spending on health care and such private spending should be reduced to not push people into poverty.
Collapse
Affiliation(s)
- Sofie Buch Mejsner
- Unit for Health Promotion Research, University of Southern Denmark, Degnevej 14, 6705 Esbjerg, Denmark;
| | - Maria Kristiansen
- Department of Public Health, Center for Healthy Aging, University of Copenhagen, Øster Farimagsgade 5, 1353 Copenhagen, Denmark;
| | - Leena Eklund Karlsson
- Unit for Health Promotion Research, University of Southern Denmark, Degnevej 14, 6705 Esbjerg, Denmark;
| |
Collapse
|
5
|
Mundy SS, Foss SLW, Poulsen S, Hjorthøj C, Carlsson J. Sex differences in trauma exposure and symptomatology in trauma-affected refugees. Psychiatry Res 2020; 293:113445. [PMID: 32977049 DOI: 10.1016/j.psychres.2020.113445] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 09/12/2020] [Indexed: 10/23/2022]
Abstract
The aim of this cross-sectional study was to examine associations between sex, exposure to potentially traumatic events and pre-treatment symptomatology in trauma-affected refugees. We analyzed pre-treatment self-report questionnaires and clinical interviews from 318 refugees with post-traumatic stress disorder (PTSD) in a specialized mental health clinic. Results show that twice as many females reported exposure to family violence (p = .001) and sexual abuse (p = .004), whereas men were at least three times as likely to report exposure to torture (p <0.001), imprisonment (p < .001), and combat (p < .001). Men reported exposure to more trauma types (p < .001). Women reported more depression (p = .001), anxiety (p = .008) and somatization (p = 0.001), whereas men were diagnosed significantly more with enduring personality change after catastrophic experience (p < .001). Additionally, trauma burden was significantly associated with PTSD (p = .001) and depression (p = .039) scores for women but not men, and imprisonment was associated with a higher PTSD score in women (p = 0.037) but not men. Our findings highlight sex differences in trauma exposure and symptomatology in trauma-affected refugees in host countries, that should be considered when developing mental health interventions for this underserved population.
Collapse
Affiliation(s)
- Sara Skriver Mundy
- Competence Centre for Transcultural Psychiatry (CTP), Mental Health Centre Ballerup, Mental Health Services of the Capital Region of Denmark, Ballerup, Denmark; Department of Psychology, University of Copenhagen, Copenhagen, Denmark.
| | - Sara Louise Wilms Foss
- Competence Centre for Transcultural Psychiatry (CTP), Mental Health Centre Ballerup, Mental Health Services of the Capital Region of Denmark, Ballerup, Denmark; Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Stig Poulsen
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Carsten Hjorthøj
- Copenhagen Research Center for Mental Health (CORE), Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark; Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Jessica Carlsson
- Competence Centre for Transcultural Psychiatry (CTP), Mental Health Centre Ballerup, Mental Health Services of the Capital Region of Denmark, Ballerup, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
| |
Collapse
|
6
|
Lindberg LG, Mundy SS, Kristiansen M, Johansen KS, Carlsson J. Satisfaction with mental health treatment among patients with a non-Western migrant background: a survey in a Danish specialized outpatient mental health clinic. Eur J Public Health 2020; 29:700-705. [PMID: 31155672 DOI: 10.1093/eurpub/ckz090] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Global migration increases ethnic and cultural diversity and demands mental health services to adapt to provide all patients with equal access to good quality care. Patient satisfaction surveys can inform this service delivery, thus we explored patient satisfaction among non-Western migrants receiving treatment in a Danish specialized outpatient mental health clinic [Competence Centre for Transcultural Psychiatry (CTP)]. METHODS We used multivariate logistic regression models to estimate associations between 'Overall treatment satisfaction' and treatment-related items plus potential confounders from a cross-sectional patient satisfaction survey (n = 686). The satisfaction questionnaire was a self-report measurement tool developed locally at CTP. Participants were non-Western migrants above 18 years with Post-Traumatic Stress Disorder (PTSD) or depression diagnoses according to ICD-10. RESULTS Most participants (n = 497; 82.6%) reported overall satisfaction with their mental health treatment, but less than half (n = 311; 48.8%) reported an improvement in health and situation after end of treatment. Participants who experienced a subjective improvement in their health and situation had significantly higher odds of being satisfied with their mental health treatment [odds ratio (OR) = 8.5, 95% confidence interval (CI): 4.0-18.1]. Perceptions of influence on the treatment course (OR = 4.7, 95% CI: 2.4-9.2), and of understanding and respect for one's cultural background (OR = 3.4, 95% CI: 1.5-7.6) were significantly associated with treatment satisfaction. Age and sex were insignificant in the final regression model. CONCLUSIONS Implications for practice based on our findings are to enhance person-centred care and shared decision-making with all patients regardless of cultural background and to prioritize pre- and postgraduate training in cultural competences and cultural humility for healthcare providers.
Collapse
Affiliation(s)
- Laura Glahder Lindberg
- Competence Centre for Transcultural Psychiatry, Mental Health Centre Ballerup, Mental Health Services of the Capital Region of Denmark, Ballerup, Denmark.,Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Sara Skriver Mundy
- Competence Centre for Transcultural Psychiatry, Mental Health Centre Ballerup, Mental Health Services of the Capital Region of Denmark, Ballerup, Denmark
| | - Maria Kristiansen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
| | | | - Jessica Carlsson
- Competence Centre for Transcultural Psychiatry, Mental Health Centre Ballerup, Mental Health Services of the Capital Region of Denmark, Ballerup, Denmark
| |
Collapse
|
7
|
Tiittala P, Tuomisto K, Puumalainen T, Lyytikäinen O, Ollgren J, Snellman O, Helve O. Public health response to large influx of asylum seekers: implementation and timing of infectious disease screening. BMC Public Health 2018; 18:1139. [PMID: 30249224 PMCID: PMC6154941 DOI: 10.1186/s12889-018-6038-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 09/13/2018] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Infectious disease screening of migrants at increased risk is a feature of national infection prevention and control measures. Asylum seekers in Finland are offered screening of tuberculosis (TB), hepatitis B, human immunodeficiency virus infection (HIV) and syphilis based on individual risk assessment. We aimed to evaluate the public health response to a large influx of asylum seekers to Finland in 2015-2016 with respect to national guidelines on initial health services and infectious disease screening. METHODS We used immigration and healthcare procurement data for all 38,134 asylum seekers to Finland during 2015-2016 to assess the implementation, timing and yields of infectious disease screening. RESULTS The coverage of pulmonary TB screening was 71.6% [95% CI 71.1-72.0%] and that of hepatitis B, HIV or syphilis 60.6% [60.1-61.1%] among those eligible for screening. The estimated average delay from arrival to pulmonary TB screening was 74 days for adults and 43 days for children. Delay to hepatitis B, HIV and syphilis screening was 91 days for adults and 47 days for children. The seroprevalence of hepatitis B surface antigen positivity was 1.4% [95% CI 1.3-1.6%], HIV 0.3% [95% CI 0.1-0.4%] and Treponema pallidum specific antibodies 1.0% [95% CI 0.8-1.1%]. Data did not allow assessment of yields of pulmonary TB screening. CONCLUSIONS Up to one third of asylum seekers were not reached by screening and screenings were delayed from target timeframes. Children, as a vulnerable population, were screened earlier than adults. To ensure higher screening coverage, infectious disease risks should be reassessed and screening completed at contacts to healthcare during the post-asylum phase of integration. The large influx of asylum seekers to Finland in 2015-2016 tested the country's public health preparedness. After action reviews of the public health response to the large migrant influx such as screening implementation can be used for evidence-based improvement of public health preparedness and guidelines for initial health services and infectious disease screening.
Collapse
Affiliation(s)
- Paula Tiittala
- Doctoral Programme for Population Health, University of Helsinki, Helsinki, Finland. .,Department of Health Security, Infectious Disease Control and Vaccinations Unit, National Institute for Health and Welfare, P.O. Box 30, 00271, Helsinki, Finland.
| | - Karolina Tuomisto
- Department of Health Security, Infectious Disease Control and Vaccinations Unit, National Institute for Health and Welfare, P.O. Box 30, 00271, Helsinki, Finland
| | - Taneli Puumalainen
- Department of Health Security, Infectious Disease Control and Vaccinations Unit, National Institute for Health and Welfare, P.O. Box 30, 00271, Helsinki, Finland
| | - Outi Lyytikäinen
- Department of Health Security, Infectious Disease Control and Vaccinations Unit, National Institute for Health and Welfare, P.O. Box 30, 00271, Helsinki, Finland
| | - Jukka Ollgren
- Department of Health Security, Infectious Disease Control and Vaccinations Unit, National Institute for Health and Welfare, P.O. Box 30, 00271, Helsinki, Finland
| | | | - Otto Helve
- Department of Health Security, Infectious Disease Control and Vaccinations Unit, National Institute for Health and Welfare, P.O. Box 30, 00271, Helsinki, Finland
| |
Collapse
|
8
|
How effective are approaches to migrant screening for infectious diseases in Europe? A systematic review. THE LANCET. INFECTIOUS DISEASES 2018; 18:e259-e271. [PMID: 29778396 DOI: 10.1016/s1473-3099(18)30117-8] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 01/26/2018] [Accepted: 02/06/2018] [Indexed: 12/20/2022]
Abstract
Rates of migration to Europe, and within Europe, have increased in recent years, with considerable implications for health systems. Migrants in Europe face a disproportionate burden of tuberculosis, HIV, and hepatitis B and C, yet experience a large number of barriers to accessing statutory health care on arrival. A better understanding of how to deliver effective and cost-effective screening, vaccination, and health services to this group is now crucial. We did a systematic review to document and assess the effectiveness and cost-effectiveness of approaches used for infectious diseases screening, and to explore facilitators and barriers experienced by migrants to accessing screening programmes. Following PRISMA guidelines, we searched Embase, PubMed, PsychINFO, the Cochrane Library, and Web of Science (1989 to July 1, 2015, updated on Jan 1, 2018), with no language restrictions, and systematically approached experts across the European Union (EU) for grey literature. Inclusion criteria were primary research studies assessing screening interventions for any infectious disease in the migrant (foreign-born) population residing in EU or European Economic Area (EEA) countries. Primary outcomes were the following effectiveness indicators: uptake of screening, coverage, infections detected, and treatment outcomes. Of 4112 unique records, 47 studies met our inclusion criteria, from ten European countries (Belgium, Denmark, France, Italy, the Netherlands, Norway, Spain, Sweden, Switzerland, and the UK) encompassing 248 402 migrants. We found that most European countries screening migrants focus on single diseases only-predominantly active or latent tuberculosis infection-and specifically target asylum seekers and refugees, with 22 studies reporting on other infections (including HIV and hepatitis B and C). An infection was detected in 3·74% (range 0·00-95·16) of migrants. Latent tuberculosis had the highest prevalence across all infections (median 15·02% [0·35-31·81]). Uptake of screening by migrants was high (median 79·50% [18·62-100·00]), particularly in primary health-care settings (uptake 96·77% [76·00-100·00]). However, in 24·62% (0·12-78·99) of migrants screening was not completed and a final diagnosis was not made. Pooled data highlight high treatment completion in migrants (83·79%, range 0·00-100·00), yet data were highly heterogeneous for this outcome, masking important disparities between studies and infections, with only 54·45% (35·71-72·27) of migrants with latent tuberculosis ultimately completing treatment after screening. Coverage of the migrant population in Europe is low (39·29% [14·53-92·50]). Data on cost-effectiveness were scarce, but suggest moderate to high cost-effectiveness of migrant screening programmes depending on migrant group and disease targeted. European countries have adopted a variety of approaches to screening migrants for infections; however, these are limited in scope to single diseases and a narrow subset of migrants, with low coverage. More emphasis must be placed on developing innovative and sustainable strategies to facilitate screening and treatment completion and improve health outcomes, encompassing multiple key infections with consideration given to a wider group of high-risk migrants. Policy makers and researchers involved with global migration need to ensure a longer-term view on improving health outcomes in migrant populations as they integrate into health systems in host countries.
Collapse
|
9
|
Suurna MV, Myers EN, Roesch S. Workforce Considerations, Training, and Certification of Physicians in Europe. Otolaryngol Clin North Am 2018. [PMID: 29525389 DOI: 10.1016/j.otc.2018.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Following recent geopolitical events and unification of Europe, the European Union (EU) is currently confronted with health care workforce shortage and insufficient uniform access to quality care. Aging population, difficulties with physician retention, and mobility of health care professionals are thought to contribute to this problem. Because of the differences in medical education and residency curriculum across the European countries, there is a need for a standardized training and certification. Current government initiatives are geared toward developing common policies and programs across the EU countries to address health care access.
Collapse
Affiliation(s)
- Maria V Suurna
- Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medicine, 2315 Broadway, New York, NY 10024, USA.
| | - Eugene N Myers
- Department of Otolaryngology, University of Pittsburgh School of Medicine, 200 Lothrop Street, Pittsburgh, PA 15213, USA
| | - Sebastian Roesch
- Department of Otorhinolaryngology, Head and Neck Surgery, Paracelsus Medical University, Müllner Hauptstraße 48, Salzburg 5020, Austria
| |
Collapse
|
10
|
Refugee Crisis As a Potential Threat to Public Health. DEFENCE AGAINST BIOTERRORISM 2018. [PMCID: PMC7122854 DOI: 10.1007/978-94-024-1263-5_4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The refugee crisis in Europe continues to persist despite recent data, showing a drop in the number of refugees seeking asylum. The EU has called this as “an unprecedented displacement crisis” and has aimed at devising a comprehensive approach to tackle it, which has been widely criticized. Concerns about public healthcare aspects of the crisis have permanently entered the media and policy discourse even though no systematic association between migration and the importation of infectious diseases has been recorded. In this context, the literature has not filled the existing gap between discourse and evidence, and almost no publications with reliable empirical data exist, both thematic (epidemiology) and geographical (Eastern Europe and Bulgaria). Among the existing publications, the focus has been on TB and HIV (Odone et al., Euro J Public Health 25(3):506–512, 2015). In light of this, the aim of this research is to contribute to the debate by providing an overview of the refugee situation in Bulgaria, as a primary entry-point for refugees entering the EU. In order to achieve this, the article analyses the case of the refugee camp in city of Harmanly, close to the Bulgarian-Turkish border, and assesses the public health risks related to this specific situation. Based on a study of 128 patients with different symptoms we aim to draw wider implications about the linkages between public health and migration. The in-depth review of this specific case shows that both the probability and impact of migration on public health increases when the hosting country is relatively poor, the domestic public healthcare system is not efficient, and there is lack of trust in the government and public services. The study contributes to understanding better these risks in order to identify potential mitigation strategies in the region and the EU as a whole.
Collapse
|
11
|
McKee M, Stuckler D, Zeegers Paget D, Dorner T. The Vienna Declaration on Public Health. Eur J Public Health 2016; 26:897-898. [PMID: 27744344 DOI: 10.1093/eurpub/ckw194] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | | | | | - Thomas Dorner
- Chair, Austrian Public Health Association and 2016 European Public Health Conference
| |
Collapse
|
12
|
Zeegers Paget D, McKee M, Zeegers Paget D, Charpak Y, Jakab Z, Andriukaitis V, Zeegers Paget D, Lombrail P. European Public Health NewsEUPHA President’s ColumnEUPHA Office ColumnEUPHA members’ column: terrorists ‘activities’ in France from a public health perspectiveMessage from the WHO Regional Director for EuropeMessage by Vytenis Andriukaitis, EU commissioner for health and food safety on the commission’s draft scientific criteria to identify endocrine disruptors for regulating pesticides and biocides9th European Public Health Conference—‘all for health—health for all’. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
13
|
Elstad JI. Register study of migrants' hospitalization in Norway: world region origin, reason for migration, and length of stay. BMC Health Serv Res 2016; 16:306. [PMID: 27461121 PMCID: PMC4962451 DOI: 10.1186/s12913-016-1561-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 07/20/2016] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The proportion of migrants and refugees increase in many populations. Health planners have to consider how migration will influence demand for health care. This study explores how migrants' geographical origin, reason for migration, and duration of residence are associated with admission rates to somatic hospitals in Norway. METHODS Sociodemographic information on all individuals residing in Norway at the start of 2008 was linked to data on all admissions to somatic hospitals during 2008-2011. Migrants, age 30-69, who had come to Norway during 1970-2007 (N = 217,907), were classified into seven world region origins and compared with native Norwegians of the same age (N = 2,181,948). Any somatic hospital stay 2008-2011 and number of hospital admissions 2008-2011 per 1000 personyears for a set of somatic diagnoses were analyzed by age and gender standardized rates, linear probability models, and Poisson regression. RESULTS In the native Norwegian sample, 28.7 % had at least one admission 2008-2011, and there were 116 admissions per 1000 personyears. Corresponding age and gender adjusted figures for the migrant sample were 27.0 % and 103 admissions. Admission rates varied with migrants' geographical origin, with relatively many admissions among migrants from West and South Asia and relatively few admissions among migrants from Western, East European, and Other Asian countries. Hospitalization varied strongly with reason for migration, with low admission rates for recent work migrants and high admission rates for recent refugees. Admission rates tended to move towards the level among native Norwegians with increasing length of stay. Among longstanding migrants (arrival period 1970-1989), admission rates were close to the levels of native Norwegians for most analyzed migrant categories. CONCLUSION Both world region origin, reason for migration, and duration of residence are important sources for variations in migrants' utilization of somatic hospitals. Forecasts about migrants' use of hospital services have to take into account how the migrant population is composed as to these three determinants. High admission rates among recently arrived refugees should be a health policy concern.
Collapse
Affiliation(s)
- Jon Ivar Elstad
- NOVA, Centre for Welfare and Labour Research, Oslo and Akershus University College of Applied Sciences, P.O.B. 4, St. Olavs Plass, 0130, Oslo, Norway.
| |
Collapse
|