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

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.

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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

10.20944/preprints201906.0090.v1 ◽

2019 ◽

Author(s):

Simon Jean-Baptiste Combes ◽

Nathalie Simonnot ◽

Fabienne Azzedine ◽

Abdessamad Aznague ◽

Pierre Chauvin

Keyword(s):

Length Of Stay ◽

Host Country ◽

Asylum Seekers ◽

Perceived Health ◽

Migrant Health ◽

Free Clinics ◽

Men And Women ◽

Positive Effect ◽

Over Time ◽

Unique Dataset

Health of migrant 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 show different results for men and women. Asylum seekers compared to other documented migrants have a worse health. Migrants with better living conditions tend to be in better health. Employment and stable accommodation has a positive effect on SPH. Women from poorer countries have a better physical SPH after 3 months of residing in the host country. This paper contributes widely to knowledge of health of migrants. Contrarily to other evidence, health of migrants tends to improve for some migrants.

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The Violent Legacy of Conflict: Evidence on Asylum Seekers, Crime, and Public Policy in Switzerland

The American Economic Review ◽

10.1257/aer.20170263 ◽

2019 ◽

Vol 109 (12) ◽

pp. 4378-4425 ◽

Cited By ~ 7

Author(s):

Mathieu Couttenier ◽

Veronica Petrencu ◽

Dominic Rohner ◽

Mathias Thoenig

Keyword(s):

Public Policy ◽

Asylum Seekers ◽

Detrimental Effect ◽

Market Access ◽

Civil Conflict ◽

Childhood Exposure ◽

Integration Policies ◽

Labor Market Access ◽

Over Time ◽

Unique Dataset

We study empirically how past exposure to conflict in origin countries makes migrants more violence-prone in their host country, focusing on asylum seekers in Switzerland. We exploit a novel and unique dataset on all crimes reported in Switzerland by the nationalities of perpetrators and of victims over 2009–2016. Our baseline result is that cohorts exposed to civil conflict/mass killing during childhood are 35 percent more prone to violent crime than the average cohort. This effect is particularly strong for early childhood exposure and is mostly confined to co-nationals, consistent with inter-group hostility persisting over time. We exploit cross-region heterogeneity in public policies within Switzerland to document which integration policies are best able to mitigate the detrimental effect of past conflict exposure on violent criminality. We find that offering labor market access to asylum seekers eliminates two-thirds of the effect. (JEL D74, F22, K42, Z18)

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Perceived Health among Adolescent and Young Adult Survivors of Childhood Cancer

Current Oncology ◽

10.3390/curroncol28010080 ◽

2021 ◽

Vol 28 (1) ◽

pp. 825-836

Author(s):

Morgan Young-Speirs ◽

Caitlin Forbes ◽

Michaela Patton ◽

K. Brooke Russell ◽

Mehak Stokoe ◽

...

Keyword(s):

Childhood Cancer ◽

Health Resources ◽

Adult Survivors ◽

Perceived Health ◽

Good Health ◽

Adolescent And Young Adult ◽

Control Group ◽

Increased Risk ◽

Patient Reported ◽

Survivors Of Childhood Cancer

Survivors of childhood cancer (SCCs) are at increased risk of late effects, which are cancer- and treatment-related side-effects that are experienced months to years post-treatment and encapsulate a range of physical, cognitive and emotional problems including secondary malignancies. Perceived health can serve as an indicator of overall health. This study aims to (1) understand how a patient reported outcome (PRO) of perceived health of SCCs compares to controls who have not had a cancer diagnosis and (2) examine the relationships between perceived health and demographic and clinical variables, and health behavior. A total of 209 SCCs (n = 113 (54.10%) males; median age at diagnosis = 6.50 years; median time off treatment = 11.10 years; mean age at study = 19.00 years) were included. SCCs completed annual assessments as part of Long-Term Survivor Clinic appointments, including a question on perceived health answered on a five-point Likert scale. Data were collected retrospectively from medical charts. Perceived health of SCCs was compared to a control group (n = 836) using data from the 2014 Canadian Community Health Survey. Most SCCs (67%) reported excellent or very good health. The mean perceived health of SCCs (2.15 ± 0.91) was not statistically different from population controls (2.10 ± 0.87). Pain (B = 0.35; p < 0.001), physical activity (B = −0.39; p = 0.013) and concerns related to health resources (B = 0.59; p = 0.002) were significant predictors of perceived health. Factors shown to influence SCCs’ perceived health may inform interventions. Exploration into how SCCs develop their conception of health may be warranted.

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Are Norwegian Municipality policies enabling intersectoral collaboration in migration health?

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.756 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

C Nordström ◽

B Kumar

Keyword(s):

Public Health ◽

Social Determinants ◽

Local Level ◽

Good Health ◽

Migrant Health ◽

Intersectoral Collaboration ◽

Health Work ◽

Integration Policy ◽

Intersectoral Action ◽

The Social

Abstract Issue Sporadic accounts of initiatives, interventions and good practices in Migrant Health at the Municipality level account for Norways' lower score on “Measures to achieve change” in the Migrant Integration Policy Index (MIPEX). While the structure and organization at the municipality level should enable intersectoral action (as all under one umbrella), the municipal counties say lack of intersectoral collaboration is one of the main barriers for long-term public health work. Description of the Problem 51 municipalities have an immigrant population larger than the national average 17,8% (2019). In a recent Country Assessment (part of Joint Action on Health Equity Europe), limited inter-sectoral action on the social determinants of health including migration was observed. Although multiple agencies are engaged in attempts to address these issues. While there is a drive to promote public health and primary health care in municipalities, these initiatives do not pay special attention to migrants. In the first stage of this project, we have reviewed municipal policy documents to map policy and measures on public health, migrant health and intersectoral collaboration. In the second stage, municipalities will be contacted to engage them in the implementation of intersectoral actions. Results The desk review and mapping show that only 8 of the “top” 32 municipalities mention “intersectoral” in the municipal master plan (5 were not available online), its mentioned in 9 action program/budgets, but not necessarily by the same municipalities. 15 of the municipalities mention migrants, but rarely in relation to health. We observe that, the size of the municipality, financial resources and support from the County are factors that may play a significant role in prioritising migrant health and intersectoral collaboration. Lessons Advocating for and supporting the local/municipal level for intersectoral action is highly relevant, timely and essential. Key messages Intersectoral action on the social determinants of migrants’ health needs to be implemented through municipal policies to reduce inequities in migrants’ health. Implementation on the local level is the main arena for good public health work and is crucial to ensure good health for migrants.

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Developing an evidence assessment framework and appraising the academic literature on migrant health in Malaysia: a scoping review

BMJ Open ◽

10.1136/bmjopen-2020-041379 ◽

2021 ◽

Vol 11 (1) ◽

pp. e041379

Author(s):

Allard Willem de Smalen ◽

Zhie X Chan ◽

Claudia Abreu Lopes ◽

Michaella Vanore ◽

Tharani Loganathan ◽

...

Keyword(s):

Scoping Review ◽

Multiple Correspondence Analysis ◽

Population Data ◽

Good Health ◽

Migrant Health ◽

High Quality ◽

Level Of Evidence ◽

Cross Sectional ◽

Academic Literature

BackgroundA large number of international migrants in Malaysia face challenges in obtaining good health, the extent of which is still relatively unknown. This study aims to map the existing academic literature on migrant health in Malaysia and to provide an overview of the topical coverage, quality and level of evidence of these scientific studies.MethodsA scoping review was conducted using six databases, including Econlit, Embase, Global Health, Medline, PsycINFO and Social Policy and Practice. Studies were eligible for inclusion if they were conducted in Malaysia, peer-reviewed, focused on a health dimension according to the Bay Area Regional Health Inequities Initiative (BARHII) framework, and targeted the vulnerable international migrant population. Data were extracted by using the BARHII framework and a newly developed decision tree to identify the type of study design and corresponding level of evidence. Modified Joanna Briggs Institute checklists were used to assess study quality, and a multiple-correspondence analysis (MCA) was conducted to identify associations between different variables.Results67 publications met the selection criteria and were included in the study. The majority (n=41) of studies included foreign workers. Over two-thirds (n=46) focused on disease and injury, and a similar number (n=46) had descriptive designs. The average quality of the papers was low, yet quality differed significantly among them. The MCA showed that high-quality studies were mostly qualitative designs that included refugees and focused on living conditions, while prevalence and analytical cross-sectional studies were mostly of low quality.ConclusionThis study provides an overview of the scientific literature on migrant health in Malaysia published between 1965 and 2019. In general, the quality of these studies is low, and various health dimensions have not been thoroughly researched. Therefore, researchers should address these issues to improve the evidence base to support policy-makers with high-quality evidence for decision-making.

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Partnership among hospitals to reduce healthcare associated infections: a quasi-experimental study in Brazilian ICUs

BMC Infectious Diseases ◽

10.1186/s12879-021-05896-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Ladjane Santos Wolmer de Melo ◽

Maria Verônica Monteiro de Abreu ◽

Bernuarda Roberta de Oliveira Santos ◽

Maria das Graças Washington Casimiro Carr ◽

Maria Fernanda Aparecida Moura de Souza ◽

...

Keyword(s):

Experimental Study ◽

Length Of Stay ◽

Public Hospitals ◽

Incidence Density ◽

Healthcare Associated Infections ◽

Collaborative Project ◽

Quasi Experimental ◽

Tract Infections ◽

Healthcare Associated ◽

Over Time

Abstract Background Healthcare-associated infections (HAIs) are relevant in developing countries where frequencies can be at least 3 times higher than in developed countries. The purpose of this research was to describe the intervention implemented in intensive care units (ICUs) to reduce HAIs through collaborative project and analyze the variation over 18 months in the incidence density (ID) of the three main HAIs: ventilator associated pneumonia (VAP), central line-associated bloodstream infections (CLABSIs) and catheter-related urinary tract infections (CAUTIs) and also the length of stay and mortality in these ICUs. Methods A quasi-experimental study in five public adult clinical-surgical ICUs, to reduce HAIs, through interventions using the BTS-IHI “Improvement Model”, during 18 months. In the project, promoted by the Ministry of Health, Brazilian philanthropic hospitals certified for excellence (HE), those mostly private, certified as excellence and exempt from security contributions, regularly trained and monitored public hospitals in diagnostics, data collection and in developing cycles to improve quality and to prevent HAIs (bundles). In the analysis regarding the length of stay, mortality, the IDs of VAP, CLABSIs and CAUTIs over time, a Generalized Estimating Equation (GEE) model was applied for continuous variables, using the constant correlation (exchangeable) between assessments over time. The model estimated the average difference (β coefficient of the model) of the measures analyzed during two periods: a period in the year 2017 (prior to implementing the project) and in the years 2018 and 2019 (during the project). Result A mean monthly reduction of 0.427 in VAP ID (p = 0.002) with 33.8% decrease at the end of the period and 0.351 in CAUTI ID (p = 0.009) with 45% final decrease. The mean monthly reduction of 0.252 for CLABSIs was not significant (p = 0.068). Length of stay and mortality rates had no significant variation. Conclusions Given the success in reducing VAP and CAUTIs in a few months of interventions, the achievement of the collaborative project is evident. This partnership among public hospitals/HE may be applied to other ICUs including countries with fewer resources.

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The Double Standard of Aging for Men and Women: Evidence From Across Europe, 2006–2018

Innovation in Aging ◽

10.1093/geroni/igaa057.1829 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 556-557

Author(s):

Richard Settersten ◽

Jack Day ◽

Gunhild Hagestad

Keyword(s):

Multilevel Modeling ◽

Old Age ◽

Double Standard ◽

European Social Survey ◽

Individual Characteristics ◽

Social Survey ◽

Men And Women ◽

Variation Explained ◽

Cultural Constructions ◽

Over Time

Abstract Is there a “double standard” (i.e., a harsher judgment) in the perceived ages at which women and men reach old age, and have these judgments changed over time? We use European Social Survey data from 23 countries in 2006 and newly released data from 16 of those countries in 2018. In both 2006 and 2018, men typically assign women substantially earlier ages than women themselves do. In some places, however, men also give themselves lower ages than women give them. With respect to when women become old, the differential views of men and women are persistent. So is the fact that women differentiate less between the sexes¬–though men differentiate less in 2018 relative to 2006. We use multilevel modeling to examine variation explained by both individual characteristics and country indicators of demographic and policy contexts. Findings underscore the significance of the double standard in cultural constructions of aging.

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

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17103530 ◽

2020 ◽

Vol 17 (10) ◽

pp. 3530 ◽

Cited By ~ 2

Author(s):

Danny Sheath ◽

Antoine Flahault ◽

Joachim Seybold ◽

Luciano Saso

Keyword(s):

Mental Health ◽

Forced Migration ◽

Disease Outbreaks ◽

Good Health ◽

Migrant Health ◽

Lessons Learned ◽

World Health ◽

Expert Group ◽

Good Mental Health ◽

University Of Rome

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.

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A retrospective cohort study of 27,049 polytraumatized patients age 60 and above: identifying changes over 16 years

European Geriatric Medicine ◽

10.1007/s41999-021-00546-9 ◽

2021 ◽

Author(s):

Y. Kalbas ◽

M. Lempert ◽

F. Ziegenhain ◽

J. Scherer ◽

V. Neuhaus ◽

...

Keyword(s):

Length Of Stay ◽

Injury Severity ◽

Descriptive Analysis ◽

Patient Characteristics ◽

Severe Trauma ◽

Diagnostic Tools ◽

Trauma Patients ◽

Treatment Algorithms ◽

Injured Patients ◽

Over Time

Abstract Purpose The number of severely injured patients exceeding the age of 60 has shown a steep increase within the last decades. These patients present with numerous co-morbidities, polypharmacy, and increased frailty requiring an adjusted treatment approach. In this study, we establish an overview of changes we observed in demographics of older severe trauma patients from 2002 to 2017. Methods A descriptive analysis of the data from the TraumaRegister DGU® (TR-DGU) was performed. Patients admitted to a level one trauma center in Germany, Austria and Switzerland between 2002 and 2017, aged 60 years or older and with an injury severity score (ISS) over 15 were included. Patients were stratified into subgroups based on the admission: 2002–2005 (1), 2006–2009 (2), 2010–2013 (3) and 2014–2017 (4). Trauma and patient characteristics, diagnostics, treatment and outcome were compared. Results In total 27,049 patients with an average age of 73.9 years met the inclusion criteria. The majority were males (64%), and the mean ISS was 27.4. The proportion of patients 60 years or older [(23% (1) to 40% (4)] rose considerably over time. Trauma mechanisms changed over time and more specifically low falls (< 3 m) rose from 17.6% (1) to 40.1% (4). Altered injury patterns were also identified. Length-of-stay decreased from 28.9 (1) to 19.5 days (4) and the length-of-stay on ICU decreased from 17.1 (1) to 12.7 days (4). Mortality decreased from 40.5% (1) to 31.8% (4). Conclusion Length of stay and mortality decreased despite an increase in patient age. We ascribe this observation mainly to increased use of diagnostic tools, improved treatment algorithms, and the implementation of specialized trauma centers for older patients allowing interdisciplinary care.

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Gender and payments for environmental services: impacts of participation, benefit-sharing and conservation activities in Viet Nam

Oryx ◽

10.1017/s0030605320000733 ◽

2021 ◽

pp. 1-9

Author(s):

Pamela McElwee ◽

Huệ Thị Văn Lê ◽

Tuyến Phương Nghiêm ◽

Hương Diệu Vũ ◽

Nghị Hữư Trần

Keyword(s):

Decision Making ◽

Rapid Expansion ◽

Benefit Sharing ◽

Environmental Services ◽

Viet Nam ◽

Payments For Environmental Services ◽

Men And Women ◽

Female Headed Households ◽

Women Participation ◽

Over Time

Abstract There has been a rapid expansion in the use of payments for environmental services (PES) as a key conservation finance policy. However, there is insufficient understanding of how gender can affect PES implementation and outcomes. We present results from a case study in Viet Nam, where a national PES programme has been in place for a decade. Through panel household survey data, focus groups and interviews, we examined how women have been involved in PES policies, what the impacts have been on decision-making by men and women, participation rates and use of PES income over time, and the potential conservation outcomes. Our research confirms that resource use varies between men and women, and changes in access rights can fall disproportionately on women. Participation in PES has been lower for female-headed households and for women within male-headed households, although gradually more equitable participation has evolved within households. Female-headed households reported expending more yearly effort on PES activities despite protecting less land, and also increased their conservation activities over time as they presumably became more familiar with PES. Use of income from PES also showed differences between male and female-led households, with men more likely to spend funds on non-essential goods. Within households, although men initially decided how to spend PES money, decision-making has become more equitable over time. We conclude with some recommendations on how to increase attention to gender in PES projects and future research to improve outcomes.

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