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Migrant Health Burden: Emerging Challenges and Future Solutions

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: closed (1 April 2020) | Viewed by 46107

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Dr. Pietro Ferrara

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Guest Editor

School of Hygiene and Preventive Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy
Interests: public health; global health; epidemiology; health policies
Special Issues, Collections and Topics in MDPI journals

Dr. Laura Spagnoli

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Guest Editor

School of Hygiene and Preventive Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy
Interests: global health, public health, epidemiology, travel and migrant health medicine

Prof. Dr. Antoine Flahault

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Guest Editor

1. Swiss School of Public Health (SSPH+), Hirschengraben 82, 8001 Zürich, Switzerland
2. Institute of Global Health, Faculty of Medicine, University of Geneva, CH-1202, 8001 Geneva, Switzerland
Interests: global health; public health; travel and migrant health medicine; biomathematics
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

We are arranging a Special Issue on the ‘’Migrant Health Burden’’ in the International Journal of Environmental Research and Public Health (IF 2.145).

Migration, constitutuing approximately 258 million international refugees and migrants worldwide (UN, International Migration Report 2017), is a social determinant of health.

Migrants face high barriers in accessing essential healthcare services due to multiple factors, ranging from difficulties in communication, irregular status, and lack of migrant-inclusive health policies to inaccessibility of services.

As a consequence of this geographic dispersion through the movement of people, growing challenges are emerging to health systems and policies that will require responses at national and international levels.

Thus, we would like to invite you to contribute to this Special Issue with qualitative or quantitative research that explores this particular topic, with the aim of promoting the discussion of challenges, opportunities, and solutions to overcome boundaries that affect the healthcare of migrants.

We look forward to hearing from you.

Dr. Pietro Ferrara
Dr. Laura Spagnoli
Prof. Antoine Flahault
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

Migrant health
Minority health
Health disparities
Access to care
Migrant
Refugees
Social determinants of health

Published Papers (11 papers)

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Editorial

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3 pages, 262 KiB

Open AccessEditorial

Migrant Health Burden: Where Do We Stand?

by Laura Spagnoli, Antoine Flahault and Pietro Ferrara

Int. J. Environ. Res. Public Health 2020, 17(9), 3004; https://doi.org/10.3390/ijerph17093004 - 26 Apr 2020

Cited by 3 | Viewed by 2580

Abstract

This Special Issue of the International Journal of Environmental Research and Public Health contains a collection of extended papers that describe many important aspects of the “migrant health burden” and focus on new realities and solutions in the healthcare of migrants and refugees. [...] Read more.

(This article belongs to the Special Issue Migrant Health Burden: Emerging Challenges and Future Solutions)

2 pages, 228 KiB

Open AccessEditorial

Assessing the Economic Burden of Disease in Migrants: The Diabetes Case in Northern Italy

by Pietro Ferrara

Int. J. Environ. Res. Public Health 2020, 17(7), 2250; https://doi.org/10.3390/ijerph17072250 - 27 Mar 2020

Cited by 4 | Viewed by 2347

Abstract

By considering the prevalence of diabetes in migrants living in northern Italy, this editorial aims to highlight the need for the measurement of the economic burden of disease in migrant and refugee populations. This type of assessment is potentially useful to address the emerging challenges of the migrant health burden, by enhancing the ability of health systems and policies to respond to migrants’ health needs—in terms of health care and promotion—leading to significant better conditions for future multicultural environments. Full article

(This article belongs to the Special Issue Migrant Health Burden: Emerging Challenges and Future Solutions)

Research

Jump to: Editorial

22 pages, 376 KiB

Open AccessArticle

Health System Response during the European Refugee Crisis: Policy and Practice Analysis in Four Italian Regions

by Leonardo Mammana, Chiara Milani, Paola Bordin, Lorenzo Paglione and Chiara Salvia

Int. J. Environ. Res. Public Health 2020, 17(15), 5458; https://doi.org/10.3390/ijerph17155458 - 29 Jul 2020

Cited by 2 | Viewed by 2886

Abstract

The decentralization of the provision of health services at the subnational level produces variations in healthcare offered to asylum seekers (ASs) across the different Italian regions, even if they are entitled to healthcare through the national health service. The present study aims to map the healthcare path and regional policies for ASs upon arrival and identify challenges and best practices. This is a multicentric, qualitative study of migrant health policies and practices at the regional level within four Italian regions. For the analysis, a dedicated tool for the systematic comparison of policies and practices was developed. The collection and analysis of data demonstrated the presence of many items of international recommendations, even if many gaps exist and differences between regions remain. The analysis of practices permitted the identification of three models of care and access. Some aspects identified are as follows: fragmentation and barriers to access; a weakness in or lack of a governance system, with the presence of many actors involved; variability in the response between territories. The inclusion of ASs in healthcare services requires intersectoral actions, involving healthcare sectors and other actors within local social structures, in order to add value to local resources and practices, reinforce networks and contribute to social integration. Full article

(This article belongs to the Special Issue Migrant Health Burden: Emerging Challenges and Future Solutions)

15 pages, 364 KiB

Open AccessCommunication

Health and Healthcare Utilization among Asylum-Seekers from Berlin’s LGBTIQ Shelter: Preliminary Results of a Survey

by Nora Gottlieb, Conny Püschmann, Fabian Stenzinger, Julia Koelber, Laurette Rasch, Martha Koppelow and Razan Al Munjid

Int. J. Environ. Res. Public Health 2020, 17(12), 4514; https://doi.org/10.3390/ijerph17124514 - 23 Jun 2020

Cited by 13 | Viewed by 3548

Abstract

Background: LGBTIQ asylum-seekers face multiple health risks. Yet, little is known about their healthcare needs. In 2016, Berlin opened the only major shelter for LGBTIQ asylum-seekers in Germany. This preliminary study describes health and healthcare utilization by asylum-seekers living in Berlin’s LGBTIQ shelter. To identify particular healthcare needs, we compared our results to asylum-seekers from other shelters. Methods: We surveyed residents of the LGBTIQ shelter and 21 randomly selected shelters in Berlin, using a validated questionnaire in nine languages (n = 309 respondents, including 32 respondents from the LGBTIQ shelter). Bivariate tests and generalized linear mixed models were applied to examine differences in health and healthcare utilization between the two groups. Results: Residents of the LGBTIQ shelter show high rates of chronic and mental illness. They use ambulatory and mental health services more frequently than asylum-seekers from other shelters, including a significantly higher chance of obtaining psychotherapy/psychiatric care in case of need. Emergency room utilization is also higher in the LGBTIQ group. Conclusions: Asylum-seekers from the LGBTIQ shelter face high chronic and mental health burdens. Tailored services in the LGBTIQ shelter help obtain adequate healthcare; they should be scaled up to maximize their potential. Yet, unmet needs remain and warrant further research. Full article

(This article belongs to the Special Issue Migrant Health Burden: Emerging Challenges and Future Solutions)

10 pages, 594 KiB

Open AccessArticle

Diverse and Complex Challenges to Migrant and Refugee Mental Health: Reflections of the M8 Alliance Expert Group on Migrant Health

by Danny Sheath, Antoine Flahault, Joachim Seybold and Luciano Saso

Int. J. Environ. Res. Public Health 2020, 17(10), 3530; https://doi.org/10.3390/ijerph17103530 - 18 May 2020

Cited by 20 | Viewed by 4339

Abstract

Forced migration is likely to continue to grow in the coming years due to climate change, disease outbreaks, conflict, and other factors. There are a huge number of challenges to maintaining good health, and specifically good mental health, among migrants at all stages of migration. It is vital to fully understand these diverse challenges so that we can work towards overcoming them. In 2017, as a response to the growing health challenges faced by migrants and refugees, the M8 Alliance created an expert group focussing on migrant and refugee health. The group meets annually at the Sapienza University of Rome, Italy, and this article is based on the discussions that took place at the third annual meeting (6–7 June 2019) and a special session on “Protecting the Mental Health of Refugees and Migrants,” which took place on 27 October at the World Health Summit 2019 in Berlin. Our discussions are also supported by supplementary literature to present the diverse and complex challenges to the mental health of migrants and refugees. We conclude with some lessons learned and hope for the future. Full article

(This article belongs to the Special Issue Migrant Health Burden: Emerging Challenges and Future Solutions)

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11 pages, 1309 KiB

Open AccessArticle

Organ Trafficking and Migration: A Bibliometric Analysis of an Untold Story

by Juan Gonzalez, Ignacio Garijo and Alfonso Sanchez

Int. J. Environ. Res. Public Health 2020, 17(9), 3204; https://doi.org/10.3390/ijerph17093204 - 05 May 2020

Cited by 23 | Viewed by 12688

Abstract

The debate over trafficking of human beings for the purpose of organ removal (THBOR) remains largely absent from policy debates, as its crime is hardly detected, reported and sparsely researched. However, criminal networks continue to exploit vulnerable populations, particularly migrants. To help bridge this gap in knowledge, we employ a bibliometric analysis to examine whether the nexus between organ removal and migration is being addressed by the current academic literature. Our results indicate that (1) research exploring the link between THBOR and migrants is relatively scarce; (2) organ trafficking literature output is largely clustered in a couple of Western countries, and (3) despite the international nature of the topic, most empirical studies on organ trafficking and migration lack representation within the social sciences and humanities. Taken together, our results point to a huge gap on scientific publications between THBOR and migration. Quantitative data is required to lift the current knowledge constraints and better inform policymakers. Full article

(This article belongs to the Special Issue Migrant Health Burden: Emerging Challenges and Future Solutions)

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14 pages, 354 KiB

Open AccessArticle

Self-Perceived Health among Migrants Seen in Médecins du Monde Free Clinics in Europe: Impact of Length of Stay and Wealth of Country of Origin on Migrants’ Health

by Simon Jean-Baptiste Combes, Nathalie Simonnot, Fabienne Azzedine, Abdessamad Aznague and Pierre Chauvin

Int. J. Environ. Res. Public Health 2019, 16(24), 4878; https://doi.org/10.3390/ijerph16244878 - 04 Dec 2019

Cited by 4 | Viewed by 2774

Abstract

Health of migrants is a widely studied topic. It has been argued that migrant health may deteriorate over time. Though migrants are a “hard to reach” population in survey data, this paper builds on a unique dataset provided by Médecins du Monde from five countries. We study self-perceived health (SPH) in connection with socio-economic and demographic factors and length of stay. Results differ for men and women. Compared to other documented migrants, asylum seekers have a 50–70% greater chance of having worse health. Migrants with better living conditions have a 57–78% chance of being in better health. Male migrants with a job have between a 82–116% chance of being in good health. The probability for women from poorer countries to have a better physical SPH after three months of residing in the host country is six-fold that of women from richer countries. This paper contributes widely to the knowledge of health of migrants. Contrary to other evidence, health of women migrants from poorer countries tends to improve with length of stay. Full article

(This article belongs to the Special Issue Migrant Health Burden: Emerging Challenges and Future Solutions)

10 pages, 339 KiB

Open AccessArticle

Major Depressive Syndrome (MDS) and its Association with Time of Residence among Spanish Speaking Au-Pairs Living in Germany

by Bernarda Espinoza-Castro, Tobias Weinmann, Rossana Mendoza López and Katja Radon

Int. J. Environ. Res. Public Health 2019, 16(23), 4764; https://doi.org/10.3390/ijerph16234764 - 28 Nov 2019

Cited by 3 | Viewed by 2430

Abstract

The number of au-pairs in Germany is on the rise. In 2017, about 13,500 au-pairs were living in German families, almost half of them originating from non-European Union (EU) countries and many of them from Spanish speaking countries. Knowledge about mental health among au-pairs in Germany is limited. Therefore, the main objective of this study was to assess the prevalence of Major Depressive Syndrome (MDS) and its potential association with time of residence among Spanish speaking au-pairs living in Germany via an exploratory analysis. This study included a sample of 409 Spanish speaking au-pairs living in Germany. We classified the au-pairs into those who lived less than three weeks in Germany (newcomer au-pairs) and those who lived more than three weeks (experienced au-pairs). The participants were recruited by an online survey (Facebook and Instagram) from August 2018 to June 2019. Socio-demographic characteristics, time of residence in Germany and the level of education were assessed. MDS was assessed by the Patient Health Questionnaire depression module (PHQ-9). Poisson regression models were calculated to evaluate the association between time of residence in Germany and prevalence of MDS. Most of the participants were female (91%). Almost half of them came from Colombia (48%) and were in the age range between 22–24 years (40%). Prevalence of MDS was 8% among newcomers and 19% among experienced au-pairs (p = 0.002). Differences remained statistically significant after adjustment for potential confounders (age, level of education and time of residence in Germany) (prevalence ratio 2.25; 95% confidence interval: 1.22–4.14). In conclusion, au-pairs may develop mental symptoms during their time abroad. Future prospective studies should aim at identifying potential risk factors and preventive measures. Full article

(This article belongs to the Special Issue Migrant Health Burden: Emerging Challenges and Future Solutions)

6 pages, 280 KiB

Open AccessCommunication

Health Care Needs in School-Age Refugee Children

by Anders Hjern and Stefan Kling

Int. J. Environ. Res. Public Health 2019, 16(21), 4255; https://doi.org/10.3390/ijerph16214255 - 01 Nov 2019

Cited by 17 | Viewed by 3529

Abstract

Most European countries have systematic health assessments of refugees with a main focus on infectious diseases. The aim of this study was to describe the broader health care needs identified in newly settled refugee children in a school health setting. The study population consisted of all 609 recently settled Non-European refugee and asylum-seeking children in the age range 6–15 years who were enrolled in the schools of Malmö, Sweden during the autumn semester of 2015, of which 265 had arrived in Sweden unaccompanied. The data were collected in a structured routine intake interview by an experienced school nurse. Almost half of the children had obvious untreated caries. For the unaccompanied children, prominent mental health needs were present in almost one in three. Previously unidentified vision and/or hearing problems were identified in one in ten and around 5% had a daily medication, and 4.5% of the unaccompanied children and 1.2% of the accompanied children were judged to be in need of immediate care and were referred accordingly. Newly settled refugee children in northern Europe have considerable health care needs apart from communicable diseases. School health services have a unique platform to identify and initiate this care. Full article

(This article belongs to the Special Issue Migrant Health Burden: Emerging Challenges and Future Solutions)

11 pages, 512 KiB

Open AccessArticle

Food Security and Obesity among Mexican Agricultural Migrant Workers

by José Castañeda, Graciela Caire-Juvera, Sergio Sandoval, Pedro Alejandro Castañeda, Alma Delia Contreras, Gloria Elena Portillo and María Isabel Ortega-Vélez

Int. J. Environ. Res. Public Health 2019, 16(21), 4171; https://doi.org/10.3390/ijerph16214171 - 29 Oct 2019

Cited by 13 | Viewed by 3490

Abstract

Mexican migrant farm workers are one of the poorest and most marginalized social groups within the country. They face the double burden of malnutrition, food insecurity, as well as harsh living and labor conditions. Objective: To examine the relationship between household food insecurity (HFI) and obesity in a population of migrant farm workers in highly modernized agribusiness areas of Northwest Mexico. Methods: This was a cross-sectional study with a concentric (site) (n = 146 households) and systematic selection of participants (adult men and women). Methods included questionnaires regarding socio-demographic characteristics, food security, diet (two non-consecutive 24-h recalls), and physical activity (PA). Anthropometric data included height, weight, and waist circumference. Data analysis covered descriptive statistics, multivariate linear and logistic regression. Results: Sample showed 75% prevalence of overweight and obesity, while 87% of households reported some level of HFI. Mild HFI resulted in five times more probability of farm workers’ obesity (OR = 5.18, 95% CI: 1.37–19.58). However, there was a protective effect of HFI for obesity among men (OR 0.089, 95% CI: 0.01–0.58) in a context of intense labor-related PA. Conclusion: There is a difference by gender in the relationship of HFI with obesity prevalence related perhaps to the energy expenditure of male agricultural migrant workers. Full article

(This article belongs to the Special Issue Migrant Health Burden: Emerging Challenges and Future Solutions)

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7 pages, 307 KiB

Open AccessArticle

Suicidal Ideation and Severity of Distress among Refugees Residing in Asylum Accommodations in Sweden

by Anna Leiler, Michael Hollifield, Elisabet Wasteson and Anna Bjärtå

Int. J. Environ. Res. Public Health 2019, 16(15), 2751; https://doi.org/10.3390/ijerph16152751 - 01 Aug 2019

Cited by 16 | Viewed by 4612

Abstract

Refugees worldwide suffer high levels of distress and are at increased risk for death by suicide. The Refugee Health Screener (RHS) was developed to screen for emotional distress among refugees and can be used to assess distress severity. This paper examines the association between distress severity and suicidal ideation in a sample of refugees residing in asylum accommodations. Data from the RHS and item 9 on the Patient Health Questionnaire-9 (PHQ-9) was analyzed. Results showed that individuals at moderate and severe levels of distress were much more likely to exhibit suicidal ideation than individuals with low levels of distress. Even though we cannot conclude that individuals with low levels of distress do not have thoughts of ending their lives, further suicide assessment is warranted in asylum seekers with moderate to severe distress on the RHS. Full article

(This article belongs to the Special Issue Migrant Health Burden: Emerging Challenges and Future Solutions)

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