scholarly journals The health of asylum seekers in Finland: a total population health examination survey (TERTTU)

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
N Skogberg ◽  
P Koponen ◽  
E Lilja ◽  
K-L Mustonen ◽  
F Garoff ◽  
...  
Keyword(s):  
Asylum Seekers ◽  
National Level ◽  
Circulatory System ◽  
Participation Rate ◽  
Evidence Base ◽  
Population Based ◽  
Health Examination ◽  
Assessment Protocol ◽  
Health And Wellbeing ◽  
Health Examination Survey

Abstract Background There is scarcity of representative population-based data on the health and wellbeing of asylum seekers in Europe. The Asylum Seekers Health and Wellbeing Survey (TERTTU) was launched to provide the evidence-base for developing services for asylum seekers as well as for planning and allocation of healthcare resources at a national level. Methods A sample of all first-time asylum applicants between 19.2-30.11.2018 was drawn from the Finnish Immigration Services electronic asylum database. Altogether 784 adults aged 18 years and older took part in the standardised health examination and face-to-face interview with participation rate of 79%. Interviewed health measures included the Minimum European Health Module, conditions previously diagnosed by a physician, permanent injury due to violence or accident and somatization. Results Self-rated health was good among 66% (95% CI 62,5-69,1) and 42% (95% CI 38,5-45,4) reported having some self-reported long-term illness or health problem. The most common previously diagnosed conditions were diseases of the circulatory system (19%, 95% CI 16,5-22,0), musculoskeletal system (18%, 95% CI 15,6-21,1), mental and behavioural disorders (13%, 95% CI 10,9-15,6) and diseases of the respiratory system (10%, 95% CI 8,0-12,2 ). Nearly half (47%, 95% CI 43,7-50,8) reported having a permanent injury due to violence or accident. Somatisation was common: 23% (95% CI 20,3-26,2) reported having headache, 23% (95% CI 19,9-25,8) back ache and 13% (95% CI 10,8-15,6) other pains at least several times a week. Conclusions The overall health of newly-arrived asylum seekers was poorer compared with the general Finnish population and migrant origin populations from similar countries of origin permanently living in Finland. Significant differences in asylum seekers health were found by sex and region of origin. Survey data will be used for developing the national initial health assessment protocol for asylum seekers during 2019. Key messages The TERTTU Survey is the largest population-based health examination survey among newly-arrived asylum seekers in Europe to date. The extensive data gathered over the course of the survey will be used for developing services for asylum seekers at a national level and is of high relevance also to other European countries.

scholarly journals Health of asylum seeker children in Finland: a total population health examination survey (TERTTU)

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
N Skogberg ◽  
P Koponen ◽  
E Lilja ◽  
K-L Mustonen ◽  
F Garoff ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Asylum Seekers ◽  
Sleep Disturbances ◽  
Population Based ◽  
Service Development ◽  
Health Examination ◽  
Assessment Protocol ◽  
Health And Wellbeing ◽  
Healthcare Needs ◽  
Health Examination Survey

Abstract Background There is scarcity of representative population-based data on the health and wellbeing of asylum seekers in Europe, especially children and adolescents. The Asylum Seekers Health and Wellbeing Survey (TERTTU) was launched to inform evidence-based policy-making and development of services. Methods A sample of all first-time asylum applicants was drawn from the Finnish Immigration Services electronic asylum database. Data on 303 children aged 0-17 years was gathered with a standardised health examination (including a dental assessment for 7-17 year-olds) and face-to-face-interview including the Minimum European Health Module and somatic and behavioural symptoms over the past 30 days. Guardians of 0-12 year-olds were interviewed, 13-17 year-olds responded themselves. Participation rate was 72%. Results 62% (95% CI 49,4-73,0) of 13-17 year-olds have had their growth and development monitored compared with 91% (95% CI 83,6-95,6) of 7-12 year-old and 86% (95% CI 79,4-91,0) of 0-6 year-olds. Long-standing health problems were more common among 13-17 year-olds (28%, 95% CI 18,2-39,7) and 7-12 year-olds (25%, 95% CI 16,8-34,2) compared 0-6 year-olds (13%, 95% CI 8,2-19,5). Sleep disturbances were more common among 13-17 year-olds (35%, 95% CI 24,2-47,4) and 7-12 year-olds (28%, 95% CI 19,6-37,5) than 2-6 year-olds (18%, 95% CI 11,3-26,7). Approximately fifth of children aged 7-17 years and slightly more than tenth of younger children had fears and anxieties. Signs of dental caries were found in 46% (95% CI 35,4-55,9) of 7-12 year-olds and in 23% (95% CI 14,1-35,1) of 13-17 year-olds. Conclusions Timely and accurate assessment of healthcare needs is crucial to support and improve the health and wellbeing of children and adolescents. Survey data will be used for developing the national initial health assessment protocol for asylum seeking children and adolescents. Key messages The TERTTU Survey is the largest population-based health examination survey among newly-arrived asylum seeking adults, adolescents and children in Europe, allowing for examining family units. Health information on asylum seeking children and adolescents in Finland, is relevant for service development, also for other European countries.

scholarly journals Asylum seekers health and wellbeing (TERTTU) survey: study protocol for a prospective total population health examination survey on the health and service needs of newly arrived asylum seekers in Finland

BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e027917 ◽  
Author(s):  
Natalia Skogberg ◽  
Päivikki Koponen ◽  
Paula Tiittala ◽  
Katri-Leena Mustonen ◽  
Eero Lilja ◽  
...  
Keyword(s):  
Health Service ◽  
Asylum Seekers ◽  
Total Population ◽  
Well Being ◽  
Evidence Base ◽  
Population Based ◽  
Baseline Data ◽  
Health Examination ◽  
Service Needs ◽  
Health And Wellbeing

IntroductionHealth, well-being and health service needs of asylum seekers have emerged as urgent topics following the arrival of 2.5 million asylum seekers to the European Union (EU) between 2015 and 2016. However, representative information on the health, well-being and service needs of asylum seekers is scarce. The Asylum Seekers Health and Wellbeing (TERTTU) Survey aims to: (1) gather population-based representative information; (2) identify key indicators for systematic monitoring; (3) produce the evidence base for development of systematic screening of asylum seekers’ health, well-being and health service needs.Methods and analysisTERTTU Survey is a population-based prospective study with a total population sample of newly arrived asylum seekers to Finland, including adults and children. Baseline data collection is carried out in reception centres in 2018 and consists of a face-to-face interview, self-administered questionnaire and a health examination following a standardised protocol. Altogether 1000 asylum seekers will be included into the study. Baseline data will be followed up with national electronic health record data encompassing the entire asylum process and later with national register data among persons who receive residency permits.Ethics and disseminationEthical approval has been granted by the Coordinating Ethics Committee of the Helsinki and Uusimaa Hospital District. Participation is voluntary and based on written informed consent. Results will be widely disseminated on a national and international level to inform health and welfare policy as well as development of services for asylum seekers. Results of the study will constitute the evidence base for development and implementation of the initial health assessment for asylum seekers on a national level.

scholarly journals The first Portuguese National Health Examination Survey (2015): design, planning and implementation

2019 ◽  
Vol 41 (3) ◽  
pp. 511-517 ◽  
Author(s):  
Baltazar Nunes ◽  
Marta Barreto ◽  
Ana P Gil ◽  
Irina Kislaya ◽  
Sónia Namorado ◽  
...  
Keyword(s):  
National Health ◽  
General Health Questionnaire ◽  
National Level ◽  
Participation Rate ◽  
Epidemiological Data ◽  
Blood Collection ◽  
Health Examination ◽  
Cross Sectional ◽  
Health Examination Survey ◽  
Design Planning

Abstract Background In Health Examination Surveys interview information is complemented with objective information, providing more accurate indicators than self-reported data. We report the study design, planning and implementation of the first Portuguese Health Examination Survey (INSEF). Methods INSEF was a cross-sectional population-based study representative at regional and national level. Individuals aged between 25 and 74 years old, residing in Portugal were selected from the national health users’ registry through multi-stage stratified probabilistic sampling. Sample size was set at 4200 individuals. Data was collected in primary care units and included blood pressure, height, weight, hip and waist measurements, blood collection for lipid profile, HbA1c and blood count and a general health questionnaire. European HES procedures were followed. Results A total of 4911 individuals agreed to participate (43.9% participation rate). Participation rate varied by region, sex and age group, being lower in Lisbon and Tagus Valley (32.8%), for men (41.8%) and for those aged 25–34 years old (36%). Conclusions INSEF has set up an experienced national and regional structure for HES implementation. Nationally representative quality epidemiological data is now available for public health monitoring, planning and research.

Estimates of prediabetes and undiagnosed type 2 diabetes in Denmark: The end of an epidemic or a diagnostic artefact?

2018 ◽  
Vol 48 (1) ◽  
pp. 106-112 ◽  
Author(s):  
Marit Eika Jørgensen ◽  
Christina Ellervik ◽  
Ola Ekholm ◽  
Nanna Borup Johansen ◽  
Bendix Carstensen
Keyword(s):  
Type 2 Diabetes ◽  
Diagnostic Criteria ◽  
Population Study ◽  
Participation Rate ◽  
Population Level ◽  
Population Based ◽  
Health Examination ◽  
Health Examination Survey ◽  
Danish Health

Background: Up-to-date information on undiagnosed type 2 diabetes and prediabetes based on current diagnostic criteria is lacking. The study aimed to model the total numbers of people with undiagnosed type 2 diabetes and prediabetes in Denmark based on existing population-based surveys. Methods: Two population-based Danish studies with information on HbA1c, date of examination, gender, age and known type 2 diabetes were identified: the Danish General Suburban Population Study, n = 21,205, and the Danish Health Examination Survey, n = 18,065. The prevalence of known, undiagnosed and pre-diabetes were estimated in the Danish General Suburban Population Study, and population-level age-specific prevalence of known type 2 diabetes was estimated from national registers. The Danish Health Examination Survey was included for sensitivity analysis. Combining estimates of the survey participation rate among known type 2 diabetes patients with known overall participation rates from the studies allowed for the correction of survey prevalence to plausible population-level estimates of age- and gender-specific prevalence. Results: The prevalence of known, undiagnosed and pre-diabetes was highest among men, increasing with age with a peak at age 70. Applying the survey-based prevalence to the entire Danish population, the estimated number (May 2011) with undiagnosed type 2 diabetes was 60,681, corresponding to 24% of all type 2 diabetes cases, and 292,715 had prediabetes, about 50% more than the total type 2 diabetes population. Conclusions: Estimates of undiagnosed type 2 diabetes and prediabetes are dramatically lower than reported in previous studies (60,681 vs 200,000 and 292,715 vs 750,000); however, whether this reflects a true decrease in incidence or the change to HbA1c-based diagnostic criteria is not clear.

scholarly journals Enhancing Survey Participation among Foreign-Born Populations

2019 ◽  
Vol 53 ◽  
pp. 89-110 ◽  
Author(s):  
Anu Castaneda ◽  
Shadia Rask ◽  
Tommi Härkänen ◽  
Teppo Juntunen ◽  
Natalia Skogberg ◽  
...  
Keyword(s):  
General Population ◽  
Data Collection ◽  
Large Scale ◽  
Participation Rate ◽  
Migrant Health ◽  
Population Based ◽  
Health Examination ◽  
Foreign Born ◽  
Extra Effort ◽  
Scale Population

The Finnish Migrant Health and Wellbeing Study (Maamu) is the first large-scale population-based health examination survey among the foreign-born population in Finland, unique also at the European level. It provides information on wellbeing of three major foreign-born groups: Russian, Somali, and Kurdish. In data collection, extra effort was put into reaching the sampled persons (n=3,000), for example by recruiting bilingual personnel to carry out the data collection, reaching participation rates as high as 70%, 51%, and 63%, respectively. A comparison group of the general population was available from a general population survey. The main challenges in fieldwork included reaching sampled persons, supervision of the fieldwork personnel, and special linguistic or cultural needs. Our experiences show that participation rate can be improved by engaging the target groups in all stages of the survey process and using several recruitment strategies, ending up with succeeding in pointing out health inequalities in the population.

scholarly journals Utilisation of evidence from Thailand’s National Health Examination Survey in policy development: finding the weakest link

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Sripen Tantivess ◽  
Jomkwan Yothasamut ◽  
Wilailak Saengsri
Keyword(s):  
Data Collection ◽  
National Health ◽  
Policy Development ◽  
Health Surveys ◽  
National Level ◽  
Monitoring And Evaluation ◽  
Governance Structure ◽  
Health Surveillance ◽  
Health Examination ◽  
Health Examination Survey

Abstract Background Health surveillance and survey data are helpful in evidence-informed policy decisions. This study is part of an evaluation of the National Health Examination Survey (NHES) programme in Thailand. This paper focuses on the obstacles in the translation of survey information into policies at a national level. Methods In-depth interviews with relevant individuals and representatives of institutes were carried out for the data collection. A total of 26 focal informants included executives and staff of NHES funders, government health agencies, civil society organisations, health experts, NHES programme managers and researchers in the survey network. Results Utilisation of NHES data in policy-making is limited for many reasons. Despite the potential users’ positive views on the technical integrity of experts and practitioners involved in the NHES, the strength of employing health examinations in the data collection is not well recognised. Meanwhile, alternative health surveillance platforms that offer similar information on a shorter timescale are preferable in policy monitoring and evaluation. In sum, the lack of governance of Thailand’s health surveillance system is identified as a key element hindering the translation of health surveys, including the NHES, into policies. Conclusion Despite an adequate capacity to conduct population health surveys, the lack of governance structure and function has resulted in a fragmented health monitoring system. Large and small survey projects are conducted and funded by different institutes without common policy direction and alignment mechanisms for prioritising survey topics, collective planning and capacity-building programmes for survey practitioners and users. Lessons drawn from Thailand’s NHES can be helpful for policy-makers in other low- and middle-income countries, as effective governance for evidence generation and utilisation is necessary in all contexts, regardless of income level and available resources.

scholarly journals Mental Health and Traumatization of Newly Arrived Asylum Seeker Adults in Finland: A Population-Based Study

2021 ◽  
Vol 18 (13) ◽  
pp. 7160
Author(s):  
Ferdinand Garoff ◽  
Natalia Skogberg ◽  
Antti Klemettilä ◽  
Eero Lilja ◽  
Awa Ahmed Haji Omar ◽  
...  
Keyword(s):  
Mental Health ◽  
North Africa ◽  
Asylum Seekers ◽  
Mental Health Problems ◽  
Significant Risk ◽  
Cumulative Effect ◽  
Participation Rate ◽  
Psychological Trauma ◽  
Population Based ◽  
Screening Tools

Asylum seekers frequently experience potentially traumatic events (PTEs), but the type and frequency vary depending on the country of origin. The cumulative effect of multiple PTEs and other stressors expose asylum seekers to a significant risk of mental ill health. The aim of the study was to examine the prevalence of PTEs, depression and anxiety symptoms, risk for psychological trauma, psychotropic medication use and previous mental health diagnoses among adult asylum seekers in the Asylum Seekers Health and Wellbeing (TERTTU) Survey (n = 784 respondents, participation rate 78.6%). A substantial majority (88.7%, 95% CI 86.9–90.3) of asylum seekers reported one or more PTEs before arriving to Finland. PTEs during the asylum-seeking journey were reported at 12.0% (95% CI 10.7–13.4), however, when examined by region of origin, the proportion was 34.5% (95% CI 29.5–39.8) for asylum seekers from Africa (excluding North Africa). Significant symptoms of depression were reported by 41.7% (95% CI 39.6–43.9) of asylum seekers and symptoms of anxiety by 34.2% (95% CI 32.1–36.2). Half of the asylum seekers were assessed as having at least a medium-risk for psychological trauma. Prevalence rates were higher among females and asylum seekers from Africa. This study highlights the importance of using screening tools to identify asylum seekers with severe mental health problems that may need referral to further assessment and treatment. Asylum seekers from Africa (excluding North Africa) should be given additional attention in initial health screenings and examinations.

scholarly journals Creating a Scientific Solution: Local Problem Solving in the Portuguese Health Examination Survey: A Mixed Method Study

2022 ◽  
Author(s):  
Heidi Lyshol ◽  
Ana Paula Gil ◽  
Hanna Tolonen ◽  
Sónia Namorado ◽  
Irina Kislaya ◽  
...  
Keyword(s):  
Participation Rate ◽  
Local Context ◽  
Health Examination ◽  
Local Health ◽  
Central Research ◽  
Participation Rates ◽  
Local Staff ◽  
Staff Members ◽  
Health Examination Survey ◽  
Scientific Standards

Abstract BackgroundParticipation rates in health surveys, recognized as an important quality dimension, have been declining over the years, which may affect representativeness and confidence in results. The Portuguese national health examination survey INSEF (2015) achieved a participation rate of 43.9%, which is in line with participation rates from other similar health examination surveys. The objective of this article is to describe strategies used by the local teams to increase participation rates and to solve practical survey problems.MethodsAfter a literature search, informal interviews were conducted with 14 public health officials from local health examination teams, regional and central authorities. 41 of the local staff members also filled in a short questionnaire anonymously. The interviews and self-administered questionnaires were analysed using mixed methods, informed by thematic analysis.ResultsThe local teams believed that the detailed manual, described as a "cookbook for making a health examination survey", made it possible to maintain high scientific standards while allowing for improvising solutions to problems in the local context. The quality of the manual, supported by a series of training workshops with the central research and support team, gave the teams the confidence and knowledge to implement local solutions. Motivation and cohesion within the local teams were among the goals of the training process. Local teams felt empowered by being given large responsibilities and worked hard to incite people to attend the examination through a close and persuasive approach.Local teams praised their INSA contacts for being available for assistance throughout the survey, and said they were inspired to try harder to reach participants to please their contacts for interpersonal reasons.ConclusionsThe theory of organizational improvisation or bricolage, which means using limited resources to solve problems, was useful to discuss and understand what took place during INSEF.A detailed manual covering standard procedures, continuous monitoring of the data collection and face-to-face workshops, including role-play, were vital to assure high scientific standards and high participation rates in this health examination survey. Close contacts between the central team and local focal points in all regions and all survey sites were key to accommodating unexpected challenges and innovative solutions.

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