Mental health and current issues of migrant workers in Japan: A cross-sectional study of Vietnamese workers

BACKGROUND

Over the past 5 years, the number of Vietnamese migrant workers in Japan has grown rapidly to become the largest group of migrant workers in the country. They hold various statuses of residence and are subjected to multifactorial stressors.

AIMS

The current study's aim is to investigate the association between psychological distress experienced by Vietnamese workers and their work environment. Another aim is to discuss issues involving migrant workers by comparing the characteristics of workers in the major statuses of residence.

METHODS

The study applied a cross-sectional design, and included a nationwide self-administered online questionnaire that was conducted in Vietnamese in 2022. The questionnaire included the Kessler Psychological Distress Scale (K10), workplace interpersonal factors as well as factors related to work and health. A multiple logistic regression analysis was conducted to investigate factors associated with psychological distress.

RESULTS

Of 933 Vietnamese workers, 37% were grouped as distressed under the K10 cutoff. Fewer opportunities to speak with Japanese co-workers, lower welfare and workload ratings, and the visa statuses including 'Technical Intern Training' were significantly associated with psychological distress. Unexpectedly, those in 'Engineer/Specialist in Humanities/International Services (ESI)' category who are deemed to hold better conditions demonstrated the highest amounts of distress.

CONCLUSION

Outside of unsatisfactory working environments, differing situations depending on status of residence could produce various sources of distress. The difficult aspects of Japan's distinct culture seem to contribute to their distress, especially for those who have more interactions with Japanese co-workers. A push for a multicultural society, where migrant workers can pursue proactive life designs of their own choosing, is warranted.

Nostrana, frustra, fiorata: migration patterns and the semantics of consumption in the Alps, mid-17th to late 18th centuries

Labour migrants were a widespread phenomenon in the Alps during the early modern period and impacted the materiality of everyday life in the mountains. This article investigates traces of these movements in linguistic usage by exploring the way in which goods were described by actors from the Three Leagues, in present-day Switzerland and Italy. Provenances of goods were given by using toponyms that indicated the place of origin the more precise, the closer the location was to the Alps. These geographical terms informed about specific visual and tactile qualities and were introduced together with other technical vocabulary via specialized merchants and spread via shops to customers of the upper echelons. Small-scale retailers and occasional dealers made use of less detailed descriptions that can also be found in the accounts of their clients which resembled the language used in informal correspondences. These channels could be activated to gain more detailed information and thanks to the wide-spread networks of migrant labourers, knowledge was exchanged with and via the Alps. This exchange of information appears, however, to have become less intense when migration patterns changed in the aftermath of the French Revolutionary Wars.

Challenges of Plasmodium vivax and Plasmodium knowlesi co-infection

A Burmese man was diagnosed with severe Plasmodium vivax (P. vivax) malaria infection admitted to a hospital in Thailand. Interestingly, following RT-PCR analysis, infections with both P. vivax and Plasmodium knowlesi were identified, potentially contributing to severe manifestation. Co-infection risk, especially in severe P. vivax cases, warrants vigilant consideration.

Betel Nut Consumption and the Reasons for Its Rise among Chinese Migrant Workers

Background: In China, betel nut users were initially concentrated in specific regions and ethnic groups. However, in recent years, public health concerns have been raised because betel nuts, addictive substances, have become largely used by Chinese migrant workers. Methods: This study adopts an anthropological fieldwork research methodology to investigate the rise in betel nut consumption among Chinese migrant workers. We observe the everyday lives of migrant workers in the rural-urban area of Wuhan. We use in-depth interviews to understand their psychology and behaviors toward betel nut consumption. Discussion: The study's results indicate that the observed increase in betel nut consumption among migrant workers is not only the result of the spread of betel nuts across regions and groups, but more importantly, it is related to the working and living conditions, social interaction, consumption culture, and masculinity image of migrant workers. The consumption of betel nuts reflects the political-economic structure and socio-cultural background to which Chinese migrant workers belong. Conclusion: The increasing consumption of betel nuts is a social issue that requires thorough research and government engagement. We contend that anthropology research may help identify the social mechanisms incentivizing betel nut consumption and solve the related public health issues among Chinese migrant workers from public policy and social governance perspectives.

Social support and quality of life in migrant workers: Focusing on the mediating effect of healthy lifestyle

Objective

To investigate the relationship between social support and quality of life of Chinese migrant workers and to explore the mediating role of healthy lifestyles in social support and quality of life.

Methods

Using a stratified multi-stage sampling method, 1, 298 migrant workers and 983 urban workers across 110 neighborhood committees in five economic development zones in eastern China were surveyed. The social support level of participants was quantified using the Social Support Rating Scale, and quality of life was evaluated using the SF-8. Healthy lifestyle was evaluated based on a combination of sleep, smoking, alcohol consumption, and exercise. Multiple linear regression analysis was used to assess the relationship between quality of life and social support. Stepwise regression was used to analyze the mediating effect of healthy lifestyle, social support, and quality of life among migrant workers.

Results

Total SSRS and total SF-8 scores of migrant workers were significantly higher than those of urban workers (P < 0.001). After controlling for confounders, social support showed an independent positive association with quality of life for both migrant (β = 0.50, P < 0.05) and urban workers (β = 0.62, P < 0.05). Mediation effect analysis revealed that healthy lifestyle partially mediated the relation between social support and quality of life of migrant workers with a mediation effect of 0.07, accounting for 11.70% of the total effect.

Conclusions

This study showed a significant correlation between social support and quality of life of Chinese migrant workers, with healthy lifestyle playing a mediating role. Improving the social support and health literacy of migrant workers and developing a healthy lifestyle are key to improving their quality of life.

Indonesian Nurses' Journey in Passing the Japan National Nursing Licensure Examination

Background

Despite the significant number of Indonesian nurses joining the Japanese National Nursing Licensure Examination (JNNLE), only a few of those were successful. Indonesian nurses as one of active migration player to Japan's market remain a critical support in supporting human resources for health in Japan. However, the successful nurses' perspectives have yet to be understood entirely. This study aimed to explore the experiences of Indonesian nurses who successfully passed the JNNLE.

Methods

This study used a descriptive qualitative approach. The participants were twenty Indonesian nurses who have passed the licensure examination. This study was carried out by semi-structured interviews conducted virtually. The data were analyzed using thematic content analysis.

Results

Five themes were discovered in this study: language ability as the key to succeeding in the exam, strategies to passing the exam, supporting resources as factors to increase the passing rate, understanding the nature of nursing exam, and internal motivation to be recognized as a professional nurse in a foreign country.

Conclusion

Indonesian nurses who passed the Japanese national nursing licensure examination tend to deploy planned strategies. Honing the language skills while working and living in Japan is very important, while structured support systems in the hospital, government, and social network are imperative to learning the new knowledge in the area of nursing care in Japan.

The Impact of Public Health Education on Migrant Workers' Medical Service Utilization

Based on the dynamic monitoring survey data of China's migrant population (CMDS) in 2017, this study analyzes the impact of public health education on migrant workers' medical service utilization. The study found that public health education can significantly promote the utilization of migrant workers' medical services and has a greater effect on the older generation groups, those who received secondary and higher education, and those working in first-tier cities. By distinguishing different types of public health education, it is found that smoking control education has the most obvious effect. Further differentiating disease types, the study found that the promotion effect of receiving occupational disease education is the highest, while the effect of receiving STD/AIDS education is relatively low. The mechanism test indicates that public health education has significantly improved migrant workers' utilization of medical services by influencing their health literacy, social network, and psychological integration.

Overqualification at work and risk of hospitalization for psychiatric and somatic diseases among immigrants in Sweden - a prospective register-based study

OBJECTIVES

This study aimed to (i) describe the prevalence of overqualification at work among immigrants in Sweden and (ii) analyze any association between overqualification and the risk of hospitalization for somatic and psychiatric disease among refugees and labor immigrants.

METHODS

We performed a prospective register study in a cohort of 120 339 adults who immigrated to Sweden in 1991-2005 and were employed in 2006. Education-occupation status was defined as the combination of an individual's highest level of education and their occupation skill level. Individuals were followed from 2007 to 2016 with regard to hospitalization for a psychiatric, cardiovascular, respiratory or musculoskeletal disease or diabetes. Hazard ratios (HR) with 95% confidence intervals (CI) were calculated in a multivariate Cox regression analysis adjusted for age, gender, reason for residence and duration of residence.

RESULTS

The overall prevalence of overqualification among immigrants with an academic education was 39%. Overqualified individuals had an increased risk of hospitalization for any disease (HR 1.33, 95% CI 1.21-1.46) compared to "job-matched with an academic education". However, the risk estimates were lower than that of "job-matched with no academic education" (HR 1.56, 1.46-1.68). The increased risk of hospitalization for a psychiatric disease of overqualified individuals did not differ from that of job-matched with no academic education.

CONCLUSION

Our study showed that being overqualified was associated with poorer health outcomes than job-matched individuals with an academic education. Considering the high prevalence of overqualification in immigrants, this constitutes a concern, for both society and individuals.

Exploring low-income migrant workers' health information-seeking behavior during COVID-19 in Taiwan: A qualitative study

Background

COVID-19 pandemic is reported to exacerbate existing vulnerabilities of marginalized groups, and the lack of self-care can lead to the spread of the virus across society. Therefore, effective responses to the challenges imposed by the health crisis should consider the health information needs of migrant workers.

Objective

We aimed to explore how migrant low-income workers seek health information and how their health-related information needs were met during a health crisis. We also investigated migrant workers’ preferred information sources and types of content with the theoretical concept of health literacy to understand the development of health competencies among migrant workers.

Methods

We conducted semi-structured interviews with Thai low-income migrant workers. A total of 13 Thai migrant workers participated in the study, among whom five were undocumented. The interviews were audio-taped, transcribed, and analyzed with the thematic analysis approach.

Results

Our findings indicated that migrant workers’ health literacy and health information behavior could be improved through technology when facing a health crisis. We found that participants sought health information proactively to reduce their perceived risks. However, there is still space for design to support the ability to process jargon information and apply local policy, such as providing easy-to-understand, accurate, and timely information. The findings of this study provide some insights for the authority and technological design to respond to migrant workers’ health information needs.

Conclusions

This study acknowledges and understands the needs of vulnerable migrant workers in society. The findings of this study provide insights for the authority and technological design to respond to migrant workers’ health information needs. We also outline the areas worth further investigation, such as the communication between information seekers and providers, and the navigation of the healthcare system for migrants in the host country.

COVID-19 Vaccine Acceptance and Its Determinants among Myanmar Migrant Workers in Southern Thailand

Success in eradicating COVID-19 will rely on the rate of vaccination adoption worldwide. Vaccine acceptance among vulnerable groups is critical for preventing the spread of COVID-19 and decreasing unnecessary deaths. The purpose of this study was to report on the willingness to obtain COVID-19 immunization and the factors related to its acceptance among Myanmar migrant workers in southern Thailand. This cross-sectional study consisted of 301 samples collected between October and November 2021 and analyzed using multiple logistic regression. Thirty-nine percent of workers intended to receive the COVID-19 vaccine within a year. The following factors were associated with obtaining the COVID-19 vaccine: a high level of perception of COVID-19 (AOR = 5.43), income less than or equal to 10,000 baht/month (AOR = 6.98), financial status at a sufficient level (AOR = 7.79), wearing a face mask in the previous month almost all the time (AOR =4.26), maintaining 1-2 m of distance from anyone in the last month (AOR =2.51), and measuring temperature in the previous month (AOR = 5.24). High reluctance to accept the COVID-19 vaccine among Myanmar migrant workers can influence efforts to eliminate COVID-19. Collaboration with all stakeholders is critical to helping Myanmar workers understand COVID-19, social measures, and preventive beliefs to increase vaccine uptake.

Acculturation, Work-Related Stressors, and Respective Coping Strategies among Male Indonesian Migrant Workers in the Manufacturing Industry in Taiwan: A Post-COVID Investigation

Globalization has prompted cross-cultural migration in search of employment opportunities, and poor adaptation during acculturation is widely known to cause additional psychosocial stress. Hence, the objective of this study was to investigate migrant workers' perceptions of acculturation, identify work-related stressors, and understand the respective coping strategies among male Indonesians in the manufacturing industry, particularly during the COVID-19 pandemic. Fifteen workers were recruited and interviewed on their acculturation experiences. We found that the workers were susceptible to forced adaptation to stressful conditions relating to work organization, economic distress, interaction with the manpower agencies, language barriers, and so on. During the pandemic, workers experienced overload, economic hardship, suspended home visits, isolation, discrimination, and fear of cluster infection in the crowded dormitory. We also found that workers were able to adopt coping strategies by capitalizing on resources at the individual, institutional, and governmental policy levels to actively solve problems, increase emotional support, and fortify self-appraisals. The identified coping strategies could inform policy development to assist with positive adaptation and promote the well-being of the migrant worker population.

Heat exertion precipitating shock and death in a case of previously undiagnosed sickle-cell disease

Sickle cell disease (SCD) is an autosomal recessive genetic condition characterized by the presence of a mutated form of haemoglobin (HbS). HbS polymerises into long needle-like fibres under low oxygen conditions, leading to the erythrocytes forming sickle shaped red blood cells. With repeated sickling, the red blood cells become irreversibly sickled and trapped within the circulation, and this leads to vaso-occlusive crisis. The patient, a 25-year-old female, previously undiagnosed with SCD, presented with high grade fever, splenomegaly and succumbed due to heat exertion precipitating sickling crisis, multiorgan failure and shock.

Time trends in occupational exposure to chemicals in Sweden: proportion exposed, distribution across demographic and labor market strata, and exposure levels

OBJECTIVE

This study investigated time trends in occupational exposure to various chemicals in Sweden and the distribution across demographic and labor market sectors.

METHODS

Exposure to six chemicals was investigated from 1980 to 2013 by application of a job exposure matrix to national population registers. Respirable crystalline silica (RCS), diesel engine exhaust, welding fumes, wood dust, chlorinated hydrocarbon solvents, and lead were selected to represent different groups of chemicals. Trends in exposure prevalence were investigated by linear regression and compared to the occupationally active population. Confidence intervals for the rate of change over time were obtained by bootstrapping.

RESULTS

The proportion of workers born outside the Nordic countries increased over time in those exposed to RCS, diesel exhaust and wood dust. There was a shift of exposed jobs to small companies (<50 employees), especially for RCS, welding fumes, wood dust, and chlorinated hydrocarbon solvents. For RCS and welding fumes, there was a marked drop in exposure levels from 1980 to 1990 but small changes thereafter. Exposure to lead diminished, both in terms of prevalence and intensity.

CONCLUSIONS

Over time, several exposures tended to shift to small companies, the construction sector, and migrant workers, all factors being indicative of less well-controlled working conditions. Occupational exposure to chlorinated organic solvents and lead diminished, while exposure levels to RCS and welding fumes have changed little since 1990. In view of the serious and well-established negative health effects, increased efforts to reduce exposure to RCS and welding fumes are needed.

Demographic Control Measure Implications of Tuberculosis Infection for Migrant Workers across Taiwan Regions

A sharp increase in migrant workers has raised concerns for TB epidemics, yet optimal TB control strategies remain unclear in Taiwan regions. This study assessed intervention efforts on reducing tuberculosis (TB) infection among migrant workers. We performed large-scale data analyses and used them to develop a control-based migrant worker-associated susceptible-latently infected-infectious-recovered (SLTR) model. We used the SLTR model to assess potential intervention strategies such as social distancing, early screening, and directly observed treatment, short-course (DOTS) for TB transmission among migrant workers and locals in three major hotspot cities from 2018 to 2023. We showed that social distancing was the best single strategy, while the best dual measure was social distancing coupled with early screening. However, the effectiveness of the triple strategy was marginally (1-3%) better than that of the dual measure. Our study provides a mechanistic framework to facilitate understanding of TB transmission dynamics between locals and migrant workers and to recommend better prevention strategies in anticipation of achieving WHO's milestones by the next decade. Our work has implications for migrant worker-associated TB infection prevention on a global scale and provides a knowledge base for exploring how outcomes can be best implemented by alternative control measure approaches.

The Prevalence of Non-infectious Diseases Among Overseas Chinese Workers in 2018

Background

With the "Belt and Road" initiative, more Chinese citizens have gone abroad to engage in overseas labor activities. Few studies have investigated the prevalence of non-infectious diseases among Chinese overseas workers. This study seeks to fill the gap and illustrate the relevant diseases in a population of Chinese overseas workers.

Methods

The health records of 13,529 Chinese migrant workers (12,917 males, mean age 41.3 ± 8.7 years, and 612 females, mean age 33.1 ± 10.2 years) who visited the International Travel Health Care Center in Anhui province were obtained. Chi-square test and binary logistic regression models were used to analyze the associations between the prevalence of non-infectious diseases and sex, as well as the association between non-infectious diseases and length of stay abroad.

Results

In this study, 34.6% of overseas workers were found to have one or more types of non-infectious diseases. Hypertension had the highest prevalence (9.58%). Hypertension, fatty liver, renal disease and abnormal liver function tests were more prevalent among male workers than among female workers, while anemia and abnormal urinalysis were more prevalent among female workers. The prevalence of hypertension, renal diseases, liver diseases and gallbladder diseases increased with the length of stay abroad.

Conclusion

Non-infectious diseases including cardiovascular diseases, diabetes, and chronic respiratory diseases were highly prevalent among Chinese overseas workers. Hence the monitoring of non-infectious diseases needs to be enhanced to reduce China's overall disease burden in the future.

Depressive Symptoms Among Migrant Workers in South Korea Amid COVID-19 Pandemic

Background

The purpose of this study was to investigate the depressive symptoms among migrant workers in South Korea amid the coronavirus disease 2019 pandemic.

Methods

This web-based cross-sectional survey involved migrant workers in South Korea to examine their depression levels using the Patient Health Questionnaire-9 scale. Logistic regression was used to find out the factors associated with depression.

Results

Migrant workers exhibited mild to severe depressive symptoms (98.4%) of which 41.7% had severe depression (n = 161). Migrant workers aged above 25 years were shown to have a significantly higher level of depression (odds ratio = 2.13, 95% CI: 1.084-4.193). Male workers (71.1%) had a higher depression level than females (28.9%). Losing a job during the coronavirus disease 2019 pandemic (odds ratio = 3.89, 95% CI = 1.705-8.906) and not having any social relief support (odds ratio = 1.92, 95% CI: 1.109-3.351) were significantly associated with depression.

Conclusion

Migrants workers were found to be experiencing a severe level of depression. Mental healthcare should be prioritized and made accessible to vulnerable and risk groups.

Does City Public Service Distance Increase Sense of Gain to Public Health Service? Evidence from 1394 Migrant Workers in Six Provinces

Increasing the well-being of migrant workers is one of the key objectives of promoting equality and safe, people-oriented, and sustainable social development, as well as inclusive globalization. With the equalization reform of the public health system and the reduction of frictions between cities, the well-being of the sense of gain to public health service (SGPHS) of migrant workers has attracted widespread attention. Based on the migrant worker thematic survey data in 2017 and the city statistical data in six destination cities, this study constructed and measured the sense of gain to public health service index and city public service distance index, and then studied the effects of city public service distance on the SGPHS of migrant workers and the heterogeneous effect. The results showed that the SGPHS of Chinese migrant workers is at a moderate level and presents spatial differences. Under the dual mechanism of preference reinforcement effect and public service discount effect, the effect of city public service distance on the SGPHS of migrant works shows an inverted U-shaped relationship, and the results of the endogeneity test by the generalized propensity score matching model are robust. The city public service distance has a significant non-linear effect on the public health service accessibility and provision for migrant workers, as well as on second-generation, low-income migrant workers, and migrant workers in central and western regions. The results provide beneficial insights for the formulation of rational public service policies.

To Stay or to Leave? Migrant Workers' Decisions During Urban Village Redevelopment in Hangzhou, China

As a vital source of the demographic dividend, migrant workers living in urban villages have positively contributed to urban economic development and the improvement of urbanization. Although urban villages have had a great impact on public health due to the shabby environments and poor public safety, the large-scale demolition of the urban villages, the supply of affordable housing for migrant workers has decreased drastically, which may lead to the outflow of many migrant workers and consequently affects the sustainable operations of cities. Therefore, this paper takes Hangzhou as an example to study the impact of urban village redevelopment on migrant workers and their migration decisions during urban village redevelopment process. The finding indicates that migrant workers are significantly impacted by large-scale demolition. (1) The number of affected migrant workers is huge. For example, 657,000 migrant workers who lived in around 178 urban villages are affected in Hangzhou (34,468 households). (2) The increase in rent is obvious. (3) Strong expulsion effect: nearly 1/3 migrant workers will decide to leave the city because of the demolition. Furthermore, our binary logistic regression model suggests that the commuting time, living satisfactory, and the rent affordability are factors significantly affecting migration workers' decision to leave and stay in the city. The housing quality and comfort indicators are not significant. This indicates that convenience for employment and high rent avoidance are the major characteristics of migrant workers' housing choice. Hence, in addition to considering whether the harsh environment is harmful to the public health of urban and residents, the interest and characteristics of migrant workers should be considered during the current urban village demolition process. While simply demolishing urban villages, government needs to provide a relatively sufficient amount of low-cost and affordable housing for migrant workers in case migrant workers leave the city in large numbers due to lack of suitable housing in the city.

Social Network Correlates of Mental Health among Rural-to-Urban Migrants in China

Internal rural-to-urban migrants in China are facing a high risk of mental disorders. Previous research on mental health correlates and predictors among this population focused on individual-level characteristics, neglecting network-level indicators, and migrant–urbanite intergroup relationship. A cross-sectional survey was conducted in Beijing, China from December 2018 to January 2019. A convenience sample of 420 rural-to-urban migrants completed the Chinese 12-item General Health Questionnaire and reported their relationship with urbanites in the past six months. Multivariate linear regression models were used to test the association of the inter-hukou network with migrant mental health. Two indicators of the inter-hukou network were significantly associated with migrant mental health. Migrants were more mentally healthy if their proportion of weak ties in the inter-hukou network was no less than 50%. The more social support migrants received from the inter-hukou network, the better their mental health was. Meanwhile, there was a significant interaction effect between social support and sex, indicating that the same level of social support better protected the mental health of female migrants. Results suggest the importance of social network factors and migrant–urbanite ties for migrant mental health. Future efforts may need to mobilize and facilitate the inter-hukou network to improve migrant mental health.

Social measures for reducing exposure to secondhand smoke in migrant workers of sugarcane harvest in the lower northern region of Thailand

INTRODUCTION

The sugarcane harvest migrant workers are an underprivileged group in Thailand and have a high risk of exposure to secondhand smoke but are potentially neglected in health promotion interventions.

METHODS

This three-phase study applied a mixed-method research approach. The data were collected from February to December 2019 from the Sukhothai province of Thailand. In Phase 1, the level of secondhand smoke exposure of the sugarcane harvest migrant workers at the worker camp was explored. The data were collected from 462 workers by questionnaires and from 24 sample participants in the group discussions about the factors leading to the exposure to secondhand smoke. Phase 2 was the provision and implementation of social measures for the health protection of migrant workers and families from exposure to secondhand smoke. In Phase 3, an evaluation of the health protection model for the migrant workers and families from secondhand smoke exposure was explored.

RESULTS

Workers aged ≤40 years had 1.9 times higher exposure to secondhand smoke than workers aged ≥41 years (OR=1.93; 95% CI: 1.24–3.01). Those who worked overtime had 1.7 times higher exposure to secondhand smoke than those who did not work overtime (OR=1.71; 95% CI: 1.10–2.66). Social measures to prevent secondhand smoke were: given a warning, no rewards for cigarettes, designated smoking area, not asking the children to buy cigarettes, stop displaying cigarettes at grocery shops, and empowering woman to go against the smoking husband in the camp and the sugarcane field when the women, children, and nonsmokers are present. After implementing the measures, there was no exposure to secondhand smoke inside the room, cooking area, and at the quad in the camp center.

CONCLUSIONS

Appropriate social measures for health protection can help to reduce exposure to secondhand smoke.

The Association of Residence Permits on Utilization of Health Care Services by Migrant Workers in China

Due to the limitations in the verifiability of individual identity, migrant workers have encountered some obstacles in access to public health care services. Residence permits issued by the Chinese government are a solution to address the health care access inequality faced by migrant workers. In principle, migrant workers with residence permits have similar rights as urban locals. However, the validity of residence permits is still controversial. This study aimed to examine the impact of residence permits on public health care services. Data were taken from the China Migrants Dynamic Survey (CMDS). Our results showed that the utilization of health care services of migrant workers with residence permits was significantly better than others. However, although statistically significant, the substantive significance is modest. In addition, megacities had significant negative moderating effects between residence permits and health care services utilization. Our research results emphasized that reforms of the household registration system, taking the residence permit system as a breakthrough, cannot wholly address the health care access inequality in China. For developing countries with uneven regional development, the health care access inequality faced by migrant workers is a structural issue.

A Culture-Centered Approach to Experiences of the Coronavirus Pandemic Lockdown Among Internal Migrants in India

India's coronavirus lockdown forced low-wage migrant workers to return from the city to the home towns and villages from which they came. Pre-pandemic living and working conditions were already stressful and difficult for these migrants. The lockdown became an additional burden, since it shut down sources of income with no assurance about when, or if, work and earning to support families could be resumed. This article draws on the lens of the Culture-Centered Approach (CCA) to understand how workers engaged with and navigated these difficult times. A total of 54 migrant workers locked-down at home across the Indian states of Bihar, Uttar Pradesh, and West Bengal were interviewed for this qualitative study. Financial worries were found to be endemic, with rising debt a major source of stress, and educational qualifications becoming an obstacle to earning. Returning migrants were suspected of bringing the virus from the city, and so stigmatized in their home towns and villages. However, the pandemic lockdown also showed some unexpected healthful consequences. It provided these marginalized, and always busy workers the time and space to stop working for a while, to stay home, eat home food, and take walks in the comparatively green and clean spaces of their home environments. In this, the pandemic lockdown may be seen to have enabled a measure of agency and health in the lives of these workers, an oasis albeit temporary, and ultimately subject to the demands of the globalized cities of India.

Experiences of Healthcare Worker Returnees in Their Home Countries: A Scoping Review

Background

International migration of healthcare workers is a global phenomenon driven by growing demand in developed countries and expectations of healthcare workers from developing countries to have improved employment and lives. This migration has been understood to impact both the individuals and countries involved, with positive and negative consequences. However, little is known about returnees' experiences that could be used to address challenges and optimize benefits. The aim of this review was to understand what is known about experiences of migrant health workers after returning to their home countries.

Methods

A scoping review of primary research addressing experiences of migrant health workers upon their return to their homelands. A range of database were searched including Career and Technical Education Database via ProQuest, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Education database via ProQuest, Excerpta Medica Care (EMCare) via Ovid, Education Resources Information Center (ERIC), Excerpta Medica database (EMBASE) via Ovid, MEDLINE and Scopus. A systematic process was performed guided by the work of Arksey and O'Malley. Eight databases were searched and 226 articles were retrieved. After screening articles and abstracts, 15 full-texts were assessed for eligibility, and finally seven studies were further analyzed and synthesized.

Results

Five qualitative studies, one quantitative study and one mixed methods study met inclusion criteria. Five themes emerged: (1) reasons to return, (2) upskilling and deskilling, (3) impact on human, financial, and social capital, (4) challenges and opportunities in the home country, and (5) facilitation supports.

Conclusion

Return migration is portrayed as a complex situation experienced by returnees. Structured policy and supports are required to help healthcare worker returnees prepare, and to adjust to life after their return. This study highlights the importance of comprehensive approach in return migration stage. Return migration policy should support healthcare worker returnees in their home country and facilitate utilization of their skills. Multi-stakeholder partnerships are vital to develop platforms for helping and facilitating returnees in the reintegration process at their home countries.

Work Resumption Rate and Migrant Workers' Income During the COVID-19 Pandemic

The COVID-19 public health crisis has quickly led to an economic crisis, impacting many people and businesses in the world. This study examines how the pandemic affects workforces and workers' income. We quantify the impact of staggered resumption of work, after the coronavirus lockdowns, on the migrant workers' income. Using data on population movements of 366 Chinese cities at the daily level from the Baidu Maps-Migration Big Data Platform and historical data on the average monthly income of migrant workers, we find that the average work resumption rate (WRR) during the period of the Chinese Lantern Festival was 25.25%, which was only 30.67% of that in the same matched lunar calendar period in 2019. We then apply Gray Model First Order One Variable [GM (1, 1)] to predict the monthly income of migrant workers during the period of the COVID-19 pandemic. We show that, if without the influence of the COVID-19 pandemic, the average monthly income of migrant workers in 2020 will be expected to increase by 12% compared with 2019. We further conduct scenario analysis and show that the average monthly income of migrant workers in 2020 under the conservative scenario (COS), medium scenario (MES), and worse scenario (WOS) will be predicted to decrease by 2, 21, and 44%, respectively. Through testing, our prediction error is <5%. Our findings will help policymakers to decide when and how they implement a plan to ease the coronavirus lockdown and related financial support policies.

Prevalence of Depression, Anxiety, and Stress Among Repatriated Indonesian Migrant Workers During the COVID-19 Pandemic

Introduction: Repatriated Indonesian migrant workers are vulnerable to developing serious mental health problems during the COVID-19 pandemic. This study aimed to assess the prevalence and associated factors of depression, anxiety, and stress among these populations during the COVID-19 pandemic.

Methods: Guided by the health belief model, a cross-sectional study design was employed among 335 participants, and primary data were collected through an online survey. Measured using DASS-21, anxiety, depression, and stress were the dependent variables. We performed descriptive and inferential statistical analyses—logistic regression was used to predict independently associated variables. STATA was used to execute all data analyses.

Results: The prevalence of depression, anxiety, and stress among repatriated Indonesian migrant workers were 10.15, 9.25, and 2.39%, respectively. The risk of anxiety and depression was low among those aged 21–30 years old, who had completed a university degree, were married, and had quarantined for 14 days. Conversely, the risk of anxiety and depression was high among those who had bad perceived health status, high perceived susceptibility, and negative stigma perception.

Conclusion: The prevalence of depression, anxiety, and stress among repatriated Indonesian migrant workers was relatively low compared to the general population. The risk of anxiety and depression was low among young people, educated people, and those under effective quarantine, but the risk was high among those who had negative perceptions about their health, stigma, and susceptibility to the disease.

Differences in injury and trauma management between migrant workers and citizens

In Taiwan, legal migrant workers and almost all citizens are covered under the National Health Insurance program. Work-related injuries and various traumatic events constitute 2 major reasons for seeking medical care among migrant workers. Therefore, we conducted this retrospective study to delineate the clinical features of migrant workers with trauma and determine differences in trauma management between migrant workers and citizens under the current medical care and insurance system.We retrospectively reviewed the data of all patients with trauma who were discharged from adult wards between January 1, 2015 and December 31, 2016. We identified 5854 citizens and 110 migrant workers during the chart review. Data related to the prehospital period, emergency department, hospital course, and prognosis were collected and compared between migrant workers and citizens.More than half of the traumatic events among migrant workers occurred at factory, farm, or mine locations (migrant workers vs all citizens: 57.3% vs 11.5%), whereas most traumatic events among citizens occurred at street and home or dormitory locations (street: migrant workers vs all citizens: 17.3% vs 52.5%; home or dormitory: migrant workers vs all citizens: 0.9% vs 14.3%). Compared with citizens, migrant workers had lower scores in injury severity scores and new injury severity scores, but higher scores in revised trauma score and trauma and injury severity scores. The hospital course and prognosis were similar between migrant workers and citizens.Compared with citizens, migrant workers had a higher incidence of work-related injury and sustained less severe injuries. Under the coverage of the current health care and insurance system in Taiwan, migrant workers with trauma and work-related injuries receive comparable medical care and prognoses to citizens.

Agricultural Safety Comic Book for Latinx Migrant Families: Development and Evaluation

INTRODUCTION

Comic books and graphic novels have been used in health education. The youth of migrant and seasonal agricultural workers are highly vulnerable to the health hazards associated with agricultural work and the migrant workers' itinerant home environment.

METHOD

The purpose of the study was to create a bilingual, culturally specific educational comic book to inform families of safety issues in youth hand-harvesting agricultural work and provide anticipatory guidance safety tips for agricultural work camp residence. In a mixed-methods design, a multistate and multidisciplinary team used focus groups to obtain the voice of potential users regarding the strengths and weaknesses of the comic book prototype and scales on satisfaction, helpfulness, and usability.

RESULTS

Focus group participants contributed constructive criticism to modify the prototype. Quantitative surveys found the comic book to be satisfactory, helpful, and highly usable.

DISCUSSION

This report describes the steps in the creation of the comic book that can be used for health promotion education.

Does the Conversion of Household Registration Actually Improve the Happiness of Migrant Workers in China?

Migrant workers are an important human resource for economic and social development. Considering the government’s goal of serving and improving people’s livelihoods, improving the happiness of migrant workers is necessary. This study investigates in-depth the impact of the conversion of household registration on migrant workers’ happiness, which is represented by a multi-dimensional comprehensive index based on the propensity matching score model and data from the China Migrants Dynamic Survey (CMDS) in 2017. Moreover, this study explores the different effects of conversion among the groups divided by the characteristics of migrant workers. The results show that from an overall perspective, although the conversion of household registration could improve the happiness of migrant workers, the degree of this improvement is minor. Further, the characteristics of the different groups, including age, educational background, contracted land, collective dividends, and income significantly affect the improvement of happiness. The conversion of household registration has obviously improved the happiness of migrant workers with low educational backgrounds, low income, and contracted land. Based on these findings, the government should take more targeted actions to improve the positive effects of household registration among different migrant worker groups due to the different characteristics in the process of household registration system reform.

Effect of Health Education on Healthcare-Seeking Behavior of Migrant Workers in China

Health education is considered to be an effective way to improve the healthcare-seeking behavior of migrant workers. This study examined the impact of health education on healthcare-seeking behavior of migrant workers in China and explored the differences in different health education methods. This paper used the 2017 China Migrants Dynamic Survey (CMDS) to analyze the relationship between health education and healthcare-seeking behavior. Our results indicated that health education could significantly improve the healthcare-seeking behavior of migrant workers, but there was still ample space for improvement. From the perspective of different health education methods, lectures, public consultation, and online education were positively correlated to healthcare-seeking behavior, while publicity materials and bulletin boards were not. Although the effects of publicity materials and bulletins were limited, these two health education methods were still the most widely used. Our results emphasized the necessity of increasing investment in lectures, public consultation, online education, and other similar health education methods. This change in health education methods can play an effective role in the spread of health education to improve the healthcare-seeking behavior of migrant workers.

Association between sleep duration and hypertension of migrant workers in China: a national cross-sectional surveillance study

OBJECTIVES

To examine the relationship between sleep duration and hypertension of migrant workers aged 18-59 years in China.

DESIGN

Population-based cross-sectional study using a complex survey sampling design.

PARTICIPANTS

There were 43 655 subjects in our analysis, after excluding people with missing information for key exposure and outcome variables and abnormal values for sleep duration (≤2 or ≥17 hours).

PRIMARY OUTCOME MEASURE

Hypertension was defined as systolic blood pressure (BP) ≥140 mm Hg and/or diastolic BP ≥90 mm Hg, or self-reported history of hypertension diagnosis in hospitals at the township (community) level or above and use of hypertensive medicine in the last 2 weeks.

RESULTS

Of 43 655 subjects, 15.6% (95% CI 15.1% to 16.1%) of migrant workers had hypertension. The prevalence of hypertension decreased with the increased sleep duration, both in males and females. Logistic regression models, using 7-8 hours sleep/day as the reference, showed a greater odds for hypertension among men and women who reported <6 hours of sleep after adjusting for sociodemographic characteristics, behavioural risk factors, body mass index, diabetes, stroke and myocardial infarction (men: OR 1.26; 95% CI 1.03 to 1.54, women: OR 1.55; 95% CI 1.13 to 2.06, p_interaction=0.096). Further stratified by age and migration time, it revealed that among adults less than 45 years old, those sleeping 9 or more hours had adjusted odds for hypertension of 0.82 (95% CI 0.72 to 0.93, p_interaction=0.020),while there was no evidence of an association between sleep duration and hypertension among adults aged 45-59 years. Among adults whose migration time was less than 4.5 years, those sleeping 9 or more hours had adjusted odds for hypertension of 0.80 (95% CI 0.68 to 0.94, p_interaction=0.097).

CONCLUSION

The association between sleep duration and hypertension varies by age. Short sleep duration (<6 hours) is associated with an increased prevalence of hypertension in both genders.

Prohibition on Changing Workplaces and Fatal Occupational Injuries among Chinese Migrant Workers in South Korea

We assessed the risk of fatal occupational injuries among migrant workers with two different types of employment permits in South Korea. This observational study used national data from January 2007 to September 2018 and analyzed 42,089 cases of occupationally injured migrant workers of Chinese nationality. Fatality rates were analyzed according to year, sex, age, occupation, industry, and type of employment permit. Chinese workers were permitted to work for one employer and prohibited from changing employers, whereas Korean-Chinese workers were permitted to change their employer. The adjusted fatality rate of occupational injuries of Chinese migrant workers was significantly higher (1.80-fold, 95% confidence interval 1.31-2.46) than that of Korean-Chinese migrant workers. The prohibition on changing workplaces; male sex; age ≥ 45 years; machine operator; construction industry; and agriculture, livestock, and fisheries industry were risk factors for fatal occupational injuries. The results imply a need for revision of the migrant-worker employment permit systems and implementation of occupational safety and health policies for all workers to promote health equity.

Depressive symptoms in Chinese assembly-line migrant workers: A case study in the shoe-making industry

INTRODUCTION

Assembly-line migrant workers (AMWs), as a major workforce in China, may be at particularly high risk of depression due to their relative low social economic status and particular job characteristics. However, little is known about the frequency and characteristics of depression among Chinese AMWs. This study investigated the prevalence and correlates of depressive symptoms in Chinese AMWs.

METHODS

In this cross-sectional survey, 915 Chinese AMWs from two shoe-making factories completed a standardized questionnaire to report their socio-demographics, physical health, migration, and work. They also reported their depressive symptoms by completing the Beck Depression Inventory-Short Form (BDI-SF). We conducted multiple logistic regression analysis to identify factors related to depression.

RESULTS

We found that 31.7% of AMWs were clinically depressed (BDI-SF ≥ 8). The multiple regression model included age, self-rated physical health, pain, family relationships, having no good friends at the same factory, and working under high pressure.

DISCUSSION

Our findings suggest that depression is common among Chinese AMWs. We argue that there is an urgent need for health care providers and factory managers to work on the early identification of AMWs, who are at high risk for depression. Psychological and psychiatric treatments are necessary in the Chinese labor-intensive industries.

Migrant Workers from the Eastern-Mediterranean Region and Occupational Injuries: A Retrospective Database-Based Analysis from North-Eastern Italy

The month of Ramadan is the ninth month of the Islamic lunar calendar, and, according to the Islamic tradition, it coincides with the month when the Noble Koran/Qur'an began to be revealed. In recent years, concerns about the potentially negative health effects of Ramadan fasting and the risks of work-related injuries have increased in Western European (EURO) countries. In the present study, we performed a retrospective database-based analysis assessing the impact of Ramadan fasting on occupational injuries (OIs) in North-Eastern Italy among migrant workers from the Eastern-Mediterranean Region (EMRO). Our results suggest that EMRO workers exhibit a significantly increased risk for OIs during Ramadan in periods characterized by heat-waves, while their frequency was somehow reduced for days associated with Ramadan characterized by increased but not extreme temperatures. However, these results may be attributable to an explanatory causation in the specific differences between EMRO and EURO workers in the job tasks performed at the workplace. Not coincidentally, no significant differences were found regarding industrial settings, mechanisms of OIs and final prognosis. Despite the obvious practical implications for health decision- and policy-makers, due to the limitations of the present investigation, further studies are warranted.

Active screening of gastrointestinal helminth infection in migrant workers in Thailand

Objective

This study aimed to detect gastrointestinal helminth infection in migrant workers in Thailand.

Methods

A cross-sectional survey study was conducted in 403 migrant workers in the factories of Nakhon Ratchasima Province, northeastern Thailand during October 2016 to June 2017. Gastrointestinal helminth infections were detected by the formalin ether acetate concentration technique and microscopy. The data were analyzed using the χ²-test and logistic regression.

Results

The rate of gastrointestinal helminth infection was 24.07%. The most common species involved in infection was Opisthorchis viverrini (11.91%), followed by hookworm (5.46%), Trichuris trichiura (5.21%), Strongyloides stercoralis (0.5%), Ascaris lumbricoides (0.5%), and Taenia spp. (0.5%). The majority of infections were found in men aged ≥40 years, married participants, uneducated participants, laborers, those who worked for 1 year, and those who had an income of 9000 to 12,000 THB.

Conclusions

Gastrointestinal helminth infection is still found in migrant workers. Therefore, active surveillance is required in this large group for investigating and eradicating this type of infection.

On-the-farm cardiovascular risk screening among migrant agricultural workers in Southeast Minnesota: a pilot prospective study

INTRODUCTION

Accessibility to healthcare services is a major concern facing migrant agricultural workers (MAWs) in the USA. We aimed to test the feasibility of implementing cardiovascular risk screening at farm sites.

METHODS

This was a pilot prospective cohort study providing on-site monthly screenings of cardiovascular risk factors. We estimated the prevalence of cardiovascular risk factors and evaluated the success of this approach via modified validated satisfaction surveys.

RESULTS

We enrolled 38 MAWs and diagnosed 18 cases of pre-diabetes, diabetes, hypertension and hyperlipidaemia in 15 subjects (39.4%). Mean scores of workers' satisfaction were high (≥4) on a 5-point scale except 'Time spent with provider'. Over 80% of workers were likely to use this model if it was permanently available on the farm. Only 8.7% of workers were able to follow up after referral to a clinic.

CONCLUSIONS

Cardiovascular risk factors are highly prevalent in MAWs. On-the-farm screening is a feasible and satisfactory model of healthcare delivery; however, other barriers continue to hinder MAWs from receiving follow-up care.

TRIAL REGISTRATION NUMBER

NCT02418637.

Mental health of the old- and new-generation migrant workers in China: who are at greater risk for psychological distress?

Rural-to-urban migrant workers (MWs) are a large vulnerable population in China and, recently, the new-generation MWs (those born in 1980 or later) have become the majority of this population. Examining difference in the epidemiology of poor mental health between the new- and old-generation (those born before 1980) MWs would facilitate mental health promotion efforts. However, very few related studies are available and they produced conflicting findings. This study investigated intergenerational difference in prevalence and correlates of psychological distress (PD) in MWs. A total of 3031 MWs (691 old- and 2340 new-generation MWs) completed a standardized questionnaire containing socio-demographic, migration-related, and work-related variables and the Chinese 12-item General Health Questionnaire (GHQ-12). A GHQ-12 score of 3 or higher was used to denote PD. PD was more prevalent in the new- than old-generation MWs (36.2% versus 28.2%, P < 0.001). The elevated risk of PD in the new- versus old-generation remained significant after controlling for potential confounders (OR=1.51, P < 0.001). For the new-generation, correlates for PD included low monthly income, recent two-week physical morbidity, migrating alone, poor Mandarin proficiency and long working hours; while for the old-generation, correlates for PD included low education, recent two-week physical morbidity, and having worked in many cities. The new-generation MWs are at higher risk for PD than the old-generation MWs. Mental health services for addressing the generation-specific needs may be an effective way to prevent or reduce PD of MWs.

Evaluating a Culturally Tailored HIV Risk Reduction Intervention Among Latina Immigrants in the Farmworker Community

Latina immigrants in the farmworker community are a vulnerable and understudied population at risk of acquiring HIV. Employing a CBPR framework, this pilot study was the first to evaluate the efficacy of SEPA, a CDC evidenced-based and culturally tailored HIV risk reduction intervention on a cohort of N = 110 predominantly undocumented Latina immigrants in a farmworker community. Findings revealed SEPA was effective in increasing HIV knowledge and decreasing HIV risk behaviors. However, no changes in self-efficacy were found in the present sample. We posit specific socio-cultural and structural barriers specific to the farmworker community not targeted in the original intervention may have hindered the program's capacity to influence changes in self-efficacy among this less acculturated population. Possible socio-cultural adaptations of the intervention to the target population and policy implications are discussed.

Dairy Tool Box Talks: A Comprehensive Worker Training in Dairy Farming

Today's dairies are growing rapidly, with increasing dependence on Latino immigrant workers. This requires new educational strategies for improving milk quality and introduction to state-of-the-art dairy farming practices. It also creates knowledge gaps pertaining to the health of animals and workers, mainly due to the lack of time and language barriers. Owners, managers, and herdsmen assign training duties to more experienced employees, which may not promote "best practices" and may perpetuate bad habits. A comprehensive and periodic training program administered by qualified personnel is currently needed and will enhance the sustainability of the dairy industry. Strategic management and employee satisfaction will be achieved through proper training in the employee's language, typically Spanish. The training needs to address not only current industry standards but also social and cultural differences. An innovative training course was developed following the same structure used by the engineering and construction industries, giving farm workers basic understanding of animal care and handling, cow comfort, and personal safety. The "Dairy Tool Box Talks" program was conducted over a 10-week period with nine sessions according to farm's various employee work shifts. Bulk milk bacterial counts and somatic cell counts were used to evaluate milk quality on the three dairy farms participating in the program. "Dairy Tool Box Talks" resulted in a general sense of employee satisfaction, significant learning outcomes, and enthusiasm about the topics covered. We conclude this article by highlighting the importance of educational programs aimed at improving overall cross-cultural training.

Effectiveness of a multifaceted intervention on improving the hand-washing skills and behaviors of migrant workers in Beijing

This study explores the effectiveness of a multifaceted intervention featuring a combination of tailored print and video (TPV) and peer education on improving the hand-washing skills and behaviors of migrant workers in the capital city of China. In the control group, supportive measures in both policy and environment were adopted. In addition, the intervention group received TPV and peer education. A total of 1496 participants were involved in the baseline and evaluation survey. The results showed that the participants experienced significant changes in developing health behaviors and skills as a whole after the intervention. The intervention effectiveness of hand-washing skills on vendors was relatively small compared with those on restaurant waiters and waitresses (44.3% and 87.2%, respectively). About 81.2 percent of the participants always forgot to carefully wash their thumbs and 81.8 percent failed to properly clean the back of their hands. The multifaceted intervention of this study has helped in improving the hand-washing skills and behaviors of migrant workers. Key steps should be strengthened to enhance the intervention effect. Moreover, the elderly should be given more attention with regards to hand-washing skills.

User Perceptions of ¡Protéjase!: An Intervention Designed to Increase Protective Equipment Use Among Mexican Immigrant and Mexican American Farmworkers

BACKGROUND

Farmworkers' exposures to pesticides are reduced when they wear personal protective equipment (PPE), and mobile health (mHealth) platforms can potentially deliver information to farmworkers to help promote PPE use. However, little is known about the feasibility of using mHealth platforms to promote farmworkers' use of PPE.

OBJECTIVE

The objective of the study was to describe the development and feasibility-testing of Protect Yourself! (¡Protéjase!), an intervention designed to increase PPE use. As the vast majority of farmworkers in the United States are from Mexico, we examined the intervention in a primarily Mexican-origin farmworker population.

METHODS

¡Protéjase was developed in several steps. First, we performed ethnographic observations to understand what prevents PPE use. Next, we developed program components that met the challenges uncovered in the ethnographic observations, seeking direct feedback from farmworkers on each component. Feasibility was assessed using surveys and focus groups. Material was provided in Spanish or English at the preference of the participant. Finally, we pilot tested each component of the intervention, including: (1) PPE that was provided to each worker for their personal use during the intervention trial, and (2) delivery of an application-based tool that promoted the use of PPE through daily individualized messaging.

RESULTS

55 farmworkers enrolled in the study, but only 41 of 55 (75%) completed the entire pilot intervention trial. Results focus on the evaluation of the intervention, and include only those who completed the entire trial. Among farmworkers who completed the entire intervention trial, all but two farmworkers were born in Mexico and were Spanish speaking. Still, all study participants self-identified as Mexican or Mexican-American. When asked what changes were needed in the intervention's messaging or delivery to increase user satisfaction, 22 out of 41 participants (54%) felt that no changes were needed. However, 16 of 41 participants (39%) suggested small changes to messaging (eg, refer to long pants as pants only) to improve their understanding of the messages. Finally, a small number (3 of 41 participants, 7%) felt that messages were difficult to read, primarily due to low literacy.

CONCLUSIONS

The ¡Protéjase! mHealth program demonstrated very good feasibility, satisfaction, and acceptance; potential improvements (eg, small modifications in messaging to increase farmworkers' use) were noted. Overall, the PPE provided to workers as well as the mHealth platform were both perceived as useful for promoting PPE use.

Retirement and health benefits for Mexican migrant workers returning from the United States

In the absence of a bilateral agreement for the portability and totalization of social security contributions between the United States and Mexico, this article examines the access to pension and health insurance benefits and employment status of older Mexican return migrants. We find that return migrants who have spent less than a year in the United States have a similar level of access to social security benefits as non-migrants. Return migrants who have spent at least a year in the United States are less likely to have public health insurance or social security benefits, and could be more vulnerable to poverty in old age. These results inform the debate on a bilateral social security agreement between the United States and Mexico to improve return migrants' social security.

Depression and associated factors in internal migrant workers in China

BACKGROUND

Internal migrant workers are a large population in China. Current health related studies among this population mainly focused on infectious disease, maternal health and occupational diseases and injuries. However, very limited studies were paid attention to mental health of migrant workers though it is an important public health issue.

AIMS

The current study aims to understand prevalence of depression symptoms and factors associated with depression among Chinese migrant workers using novel methods to develop a comprehensive sample.

METHODS

Respondent-driven sampling (RDS) was employed to recruit the target population, who are required 1) not to hold a hukou indicative of living in central areas or near suburbs of Chengdu city; 2) to be 16 years or older; 3) not to be a student. The Center for Epidemiologic Depression Scale (CES-D) was used to measure depression symptoms of migrant workers. And then Structural Equation Model (SEM) was applied to explore factors associated with depression among Chinese migrant workers.

RESULTS

Among 1180 migrant workers, 23.7% of them had clinically relevant depression symptoms (CES-D score >= 16), and 12.8% were consistent with a clinical diagnosis of depression (CES-D score >= 21). Self-rated economic status, city adaptation status, and self-rated health had negative effects on depression. Social economic status (SES) affected depression, and was mediated by self-rated economic status and self-rated health. City adaptation status was affected by length of residence in the city, satisfaction with one's job, and the social support that one could obtain while living in the city.

CONCLUSIONS

The findings indicated a higher prevalence of depression symptoms among migrant workers comparing to general population reported by previous studies, identified possible factors associated with depression symptoms, and also explored relationships between these factors. Our study provides a model to understand mental health of Chinese internal migrant workers and to generate important research questions for the future.

HIV and syphilis in migrant workers in eastern China

OBJECTIVE

To measure the prevalence of HIV and syphilis in migrant and urban workers in eastern China, and to determine their knowledge and attitudes towards HIV.

METHODS

A cross sectional survey involving dried blood spot testing and self completion questionnaires. Migrants and urban workers in 39 work units in two districts of Hangzhou, Zhejiang Province, were recruited. Respondents completed a questionnaire about knowledge and attitudes towards HIV. Testing for antibodies to HIV-1 and syphilis was carried out on dried blood spots using a gelatin particle agglutination technique.

RESULTS

Data were obtained from 4148 migrants and 2197 urban workers. There were no HIV infections detected in either the migrant or urban populations. Syphilis was detected, but the prevalence was not significantly different between urban workers (0.68%, 95% CI: 0.35 to 1.02) and migrant workers (0.48%, 95% CI 0.26 to 0.66, p = 0.07). 36% of the migrants had migrated with a partner, and 7% had also migrated with children. Urban workers were consistently more knowledgeable than migrants about HIV, but knowledge of the major modes of transmission was good in both groups. Traditional attitudes to sexual behaviour were still pervasive in both groups and attitudes towards individuals with HIV were generally intolerant. The use of sex workers appears rare and no more common in migrants than urban workers.

CONCLUSION

At present HIV is probably not spreading in the internal migrant population in eastern China. Syphilis is a problem in both the migrant and urban populations. The tendency to migrate with partners makes migrants relatively low risk for engaging in casual sex.