Migration as a Determinant in the Development of Children Emotional and Behavior Problems: A Quantitative Study for Lisbon Region, Portugal

[The Relationship between Social and Family Structures and Behavioral Problems in Preschool Children]

BACKGROUND

Behavioral problems in children are indicators of compromised mental health. Their development is influenced by family and social factors, with limited understanding of interactions among family structure, educational status, migration background, and parental employment concerning behavioral problems. These associations were investigated in children between 5-6 years of age.

METHODS

Data (n=15,271) were collected between 09/2018 and 08/2019 in the federal state of Schleswig-Holstein as part of school entry examinations. Children's behavioral problems were assessed using the Strengths and Difficulties Questionnaire (SDQ). Statistical analyses included descriptive assessments and the calculation of a bivariate logistic regression model, with SDQ's outcomes "problematic" and "non-problematic" as dependent variables, and social and family factors as independent variables (gender, family structure, number of siblings, language proficiency, migration background, parental education level, parental employment, and sports participation in a sports club).

RESULTS

Logistic regression analyses revealed that children living with single parents had a 2.1-fold (odds ratio; OR) higher likelihood [95% confidence interval (CI): 1.7-2.6] of displaying behavioral problems compared to children living with both biological parents. Only children had a 1.4-fold higher likelihood [95% CI: 1.2-1.8] compared to children with one or two siblings. Children with a unilateral migration background exhibited a lower likelihood of behavioral problems [OR: 0.58; 95% CI: 0.38-0.87] than children without a migration background. Children from families with low educational attainment had a 3-fold higher likelihood of behavioral problems [95% CI: 2.3-3.8] compared to those from high educational attainment families. When both parents (or the single parent) were employed at least part-time, there was a lower likelihood of behavioral problems [OR: 0.58; 95% CI: 0.47-0.71] in the child compared to situations where at least one parent was unemployed.

CONCLUSIONS

This study identified sociodemographic factors associated with manifestation of behavioral problems. Particularly, single parents, families with lower educational levels and families with at least one unemployed parent should be targeted for intervention.

Patterns of mental health problems and well-being in children with disabilities in Sweden: A cross-sectional survey and cluster analysis

BACKGROUND

Children with disabilities have an increased risk of mental health problems. Patterns of mental health problems and well-being may vary.

AIMS

To identify patterns of mental health problems and well-being in children with disabilities in Sweden, and investigate the influence of parental background (migration, education), and child cognitive level.

METHOD

In this cross-sectional study, cluster analysis was used to analyse parents' ratings of conduct problems, emotional symptoms, and prosocial behaviour on the Strengths and Difficulties Questionnaire (SDQ) in children with disabilities (n = 136). The influence of parental background (migration, education) and child cognitive level on cluster membership was explored through multinomial logistic regression.

RESULTS

Five clusters of mental health patterns emerged. Three clusters had mean ratings near or past clinical cut-off for one each of the SDQ-subscales. One cluster had difficulties on all three subscales. Greater child cognitive difficulties increased the likelihood of low prosocial behaviour (OR 2.501, p < .001) and of difficulties on all three subscales (OR 2.155, p = .006). Parental background did not influence cluster membership.

CONCLUSION

Children with disabilities display varying mental health patterns. Awareness of the complexity of mental health patterns among children with disabilities is important. Screening and support for emotional symptoms and prosocial behaviour deficits should be considered for children with conduct problems.

Assessing Quality of Life in First- and Second-Generation Immigrant Children and Adolescents; Highlights from the DIATROFI Food Aid and Healthy Nutrition Promotion Program

To compare first- and second-immigrant pediatric populations with a non-immigrant pediatric population in terms of quality-of-life metrics, a cross-sectional analysis using data from the DIATROFI Program was implemented. In total, n = 2277 students (mean age: 9(4) years) from public schools in Greece participating in the 2020-2021 school year were analyzed. The students' immigration status (first-generation/second-generation) was defined as per the standard definition. The students' health related-quality of life (HRQoL) was assessed using a parental-perceived quality of life questionnaire. The sample included 4.8% first-generation and 21.2% second-generation immigrant students. Compared with non-immigrants, the first-generation immigrant students were more likely to have poor HRQoL (odds ratio (OR) = 2.82; 95% confidence interval (95%CI) = 11.75, 4.53), physical (OR = 1.91; 95%CI = 1.18, 3.10), social (OR = 1.94; 95%CI = 1.16, 3.22) and school function (OR = 2.52; 95%CI = 1.54, 4.13). Similar results were observed for second-generation immigrant students regarding HRQoL (OR = 1.68; 95%CI = 1.28, 2.21), physical (OR = 1.60; 95%CI = 1.23, 2.10) and school function (OR = 2.09; 95%CI = 1.58, 2.77). Children with one parent having a country of origin different that the country of residence had elevated odds of having poor emotional health (OR = 1.19; 95%CI = 0.87, 1.64). The family's affluency level was interrelated with the connection of poor HRQoL and immigration status. The immigrant students have a poorer quality of life depending on their immigration generation and irrespective of their socioeconomic background.

Cohort profile: Health trajectories of Immigrant Children (CRIAS)-a prospective cohort study in the metropolitan area of Lisbon, Portugal

PURPOSE

The CRIAS (Health trajectories of Immigrant Children in Amadora) cohort study was created to explore whether children exposed to a migratory process experience different health risks over time, including physical health, cognitive, socioemotional and behavioural challenges and different healthcare utilisation patterns.

PARTICIPANTS

The original CRIAS was set up to include 604 children born in 2015, of whom 50% were immigrants, and their parents. Recruitment of 420 children took place between June 2019 and March 2020 at age 4/5 years, with follow-up carried out at age 5/6 years, at age 6/7 years currently under way.

FINDINGS TO DATE

Baseline data at age 4/5 years (2019-2020) suggested immigrant children to be more likely to belong to families with less income, compared with non-immigrant children. Being a first-generation immigrant child increased the odds of emotional and behavioural difficulties (adjusted OR 2.2; 95% CI: 1.06 to 4.76); more immigrant children required monitoring of items in the psychomotor development test (38.5% vs 28.3%). The prevalence of primary care utilisation was slightly higher among immigrant children (78.0% vs 73.8%), yet they received less health monitoring assessments for age 4 years. Utilisation of the hospital emergency department was higher among immigrants (53.2% vs 40.6%). Age 5 years follow-up (2020-2021) confirmed more immigrant children requiring monitoring of psychomotor development, compared with non-immigrant children (33.9% vs 21.6%). Economic inequalities exacerbated by post-COVID-19 pandemic confinement with parents of immigrant children 3.2 times more likely to have their household income decreased.

FUTURE PLANS

Further follow-up will take place at 8, 10, 12/13 and 15 years of age. Funds awarded by the National Science Foundation will allow 900 more children from four other Lisbon area municipalities to be included in the cohort (cohort-sequential design).

Are immigrants more vulnerable to the socioeconomic impact of COVID-19? A cross-sectional study in Amadora Municipality, Lisbon metropolitan area

Introduction

Immigrants carry an extra burden of morbidities and mortalities since the beginning of the coronavirus disease 2019 (COVID-19) pandemic. Pre-existing inequalities among immigrants may threaten their economic wellbeing during the pandemic. This study analyzed the socioeconomic impact of COVID-19 on immigrants and natives living in Amadora, Metropolitan Region of Lisbon and the extent to which preexisting inequalities had been exacerbated during the pandemic.

Materials and methods

This cross-sectional study was conducted in Amadora Municipality, Lisbon Region, through phone interviews and using a structured questionnaire. Data collected in July 2020, included information on a cohort of 420 households, of which 51% were immigrants. To evaluate the socioeconomic position and economic wellbeing changes occurring during the pandemic we estimate crude and adjusted odds ratio (OR) and 95% CI, using Portuguese natives as the reference group.

Results

Overall, 287 (70%) participants responded to the questionnaire, of which 47% are immigrants. Preexisting socioeconomic inequalities were exacerbated during the pandemic. Compared with natives, immigrants were more likely to experience job loss, temporary lay-off, and income loss during the COVID-19 pandemic. Immigrants were also more likely to face several kinds of financial hardship during the pandemic, such as difficulties in buying food, hygiene products, and paying bills.

Conclusion

To the best of our knowledge, this study is the first to capture the direct socioeconomic impact of COVID-19 among immigrants and natives in Portugal. It highlights the bidirectional relation between inequalities deeply rooted among immigrants and COVID-19. Socioeconomic inequalities affect local patterns of COVID-19 burden, as confirmed in previous studies, but COVID-19 also has an impact on the economic wellbeing of Amadora immigrants during the pandemic. Urgent policies must be implemented to mitigate the economic burden of COVID-19 among immigrants, namely in Amadora, Lisbon Region.