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While the health of and healthcare use by migrants has received significant scholarly and policy attention in Australia, current debates highlight that a critical examination of the theoretical underpinnings of these inquiries and responses is needed. We conducted a systematic review and critical interpretive synthesis (CIS) to critically examine how the policy and scholarly literature conceptualises migrants' interactions with and experiences of the Australian health system. Guided by PRISMA, we searched for literature without imposing any limits. We also searched key State and Federal Government websites for relevant policy documents. Our initially broad inclusion criteria became refined as the CIS progressed. We prioritised the likely relevance and theoretical contribution of the papers to our inquiry over methodological quality. The CIS of 104 papers revealed that the Australian scholarly literature and policy documents consistently homogenise and reduce migrants according to an assumed, (1) cultural identity, (2) linguistic affiliation, and/or (3) broad geographic origin. Based on these three critiques and drawing on the theoretical literature, we propose a synthesising argument on how the Australian literature could better conceptualise migrants' experiences of the Australian health system. We contend that both research and policy should explicitly recognise and engage with the multifaceted and shifting ways that migrants define themselves, generally, and during their encounters with destination country health systems. Engagement with this notion is necessary for also understanding how aspects of migrants' identities are dynamically co-constructed during their interactions with the health system. These understandings have implications for improving the design and implementation of policies and programs directed at improving the responsiveness of Australia's health system to the needs and expectations of migrant communities specifically, and destination countries broadly. [ABSTRACT FROM AUTHOR]

Purpose: Current and predicted continued dramatic increases in international migration and ethnocultural diversity of older adult cohorts pose challenges for health care services. Review studies on ethnoculturally diverse older adults and health care show a lack of focus on their service use experiences. This study aims to report a meta-ethnography that addresses this knowledge gap through answering the review question: How do ethnoculturally diverse older adults who are immigrants experience health careservices? Design/methodology/approach: The authors applied a seven-phase method of meta-ethnography to guide the review. The authors conducted two literature searches (April 2018 and June 2020) in MEDLINE, CINAHL, Embase, Sociological Abstracts and Abstracts in Social Gerontology that yielded 17 papers eligible for review. Findings: "There's always something positive and something negative" is the overarching metaphor for answering the review question. Findings highlight positive and negative tensions within ethnoculturally diverse older adults' health care use experiences of understanding and being understood, having trust in providers and the health care system, having needs, preferences and resources met and desire for self-care over dependency. The majority of experiences were negative. Tipping points towards negative experiences included language, fear, provider attitudes and behaviours, service flexibility, attitudes towards Western and traditional health care and having knowledge and resources. Originality/value: The authors propose concrete actions to mitigate the tipping points. The authors discuss policy recommendations for health care system changes at the micro, meso and macro service levels to promote positive experiences and address mainstream service policy inequities. [ABSTRACT FROM AUTHOR]

Eldercare is often regarded as "dirty work" due to its association with dysfunctional, decaying, and diseased bodies. This paper focuses on eldercare work, and studies how current practices and organization of eldercare have been justified and legitimized in different and sometimes conflicting ways. Drawing on ethnographic fieldwork with workers in nursing homes for the elderly and homecare service, this paper examines eldercare work through the theoretical lens of "orders of worth." The concept of orders of worth affords a moral political analysis of eldercare work that helps to explain those dilemmas and situations which eldercare workers encounter and negotiate. Through the analysis, the moral entanglements between individual practices, institutional logics, and the political economy of care labor are systematically revealed. [ABSTRACT FROM AUTHOR]

Objectives Aging populations and an increasing number of immigrants in recent years have led to numerous changes in intergenerational relationships. Although many studies have investigated the impact of providing care to a parent with dementia, little is known about the impact of caregiving activities provided from a distance, such as in the case of immigration, and over a long period of time to a person with dementia. Our understanding of how transnational caregiving for a person with dementia affects relationships is also limited. Using the Intergenerational Solidarity Theory as a theoretical framework, this paper examines the experiences of adult children and immigrant caregivers of a parent with dementia living in Poland. Methods A qualitative, semistructured interview was conducted with 37 caregivers living in the United States while providing transnational care to a parent with Alzheimer's disease or other forms of dementia. The data analysis was based on the thematic analysis strategy. Results Four themes were identified: (1) filial obligations and solidarity, (2) caregivers' contradictory emotions regarding transnational care, (3) financial and emotional exhaustion, and (4) challenges of nursing home dilemmas. Discussion Transnational caregivers represent a unique group who face distinctive challenges related to competing demands and limited resources. This study contributes to a better understanding of their experiences whereas the findings highlight the importance of addressing the mental and physical well-being of immigrant caregivers of individuals with dementia and have important implications for health care professionals and immigration policies. Implications for future research were also identified. [ABSTRACT FROM AUTHOR]

Climate change is an important driver of migration, but little research exists on whether migrant communities in the U.S. identify climate change-related factors as reasons for migrating. In 2021, we conducted a multidisciplinary, collaborative project to better understand the nexus of climate change and immigrant health in the Atlanta area. This paper presents one arm of this collaboration that explored both the role of climate change in decisions to immigrate to Georgia and the ways that climate change intersects with other possible drivers of migration. First generation migrants from Latin America were recruited primarily through CPACS Cosmo Health Center and were invited to participate in an intake survey and an in-depth interview. Results were analyzed using descriptive statistics and thematic analysis. Findings suggest that while participants may not have explicitly identified climate change as a primary reason for migration, in both surveys and in-depth interviews, participants reported multiple and intersecting social, economic, political, and environmental factors that are directly or indirectly influenced by climate change and that are involved in their decisions to migrate. The narratives that emerged from in-depth interviews further contextualised survey data and elucidated the complex nexus of climate change, migration, and health. [ABSTRACT FROM AUTHOR]

Mental health is impacted by social, economic, and environmental factors, the Social Determinants of Health (SDH). Migrants experiencing precarious living and working conditions may be more at risk of poor mental health than the majority population. This paper aims to evaluate the relationship of educational attainment and other SDH with depressive symptoms among the resident population, including Italians and migrants. This study examined the respondents to the Italian "Progressi delle Aziende Sanitarie per la Salute in Italia" (PASSI) surveillance system, 2014–18. The sample of 144.055 respondents is composed of the resident working adults aged 25–69 with Italian citizenship (n = 136.514) and foreign citizenship (n = 7.491). Findings show that among Italians high level of education appears to be a protective factor for mental health, in accordance with the international evidence (adjPR: tertiary education 0,74 p-value = 0.000). However, among immigrants high level of education is associated with the presence of depressive symptoms (adjPR: tertiary education: 1.61 p-value = 0.006), particularly for men (adjPR: tertiary education: 2.40 p-value = 0.006). The longer the length of stay in Italy for immigrants the higher the risk of depressive symptoms: adjPR for 10+ years: 2.23 p-value = 0.005. The data show that high education could represent a risk factor for mental health of immigrants. Moreover, among migrants there are some significant mental health inequities between male and female related to the duration of stay in Italy, economic activity and educational level. Considering that health is related to the nature of society as well as to access to technical solutions, multicultural societies require culturally oriented interventions for tackling health inequities. This means developing evidence-based policies in order to tackle health inequalities in the population as a whole, including culturally oriented measures in the larger framework of developing diversity sensitive services. [ABSTRACT FROM AUTHOR]

Migrant access to sexual and reproductive health (SRH) services has been highlighted as an urgent priority for the 800,000+ Venezuelans who have arrived in Peru in recent years due to political and economic crisis. Venezuelan migrants in Peru, however, negotiate their access to SRH services in what anthropologists term a 'geography of blame', and are accused and stigmatised for having imported sexually transmitted infections to the local population. Alongside this blame, female migrants are highly sexualised and face stigma, resulting in real and perceived threats to their safety, wellbeing, and integration. By juxtaposing ethnographic research and 50 interviews conducted with female migrants living in Lima, their Limeño neighbours, and with local NGOs, the paper argues how stigma is itself a neglected public health issue. Addressing SRH needs for Venezuelan migrants is not only a question of rolling out health campaigns or providing pills, but that underlying social issues such as sexualisation and stigma need to also be recognised and incorporated into policy. [ABSTRACT FROM AUTHOR]

States vary in their participation in federal immigration enforcement, leading to differing state-level policy contexts that profoundly shape the lives of immigrants. This paper examines the effects of sanctuary policies and driver's licenses for undocumented immigrants on immigrants' children's access to preventative healthcare. The 2008–2016 Medical Panel Expenditure Survey merged with state-level policy data were analyzed using a difference-in-difference OLS regression. Outcome variables included whether the child had a usual source of care, any unmet medical needs, or a well child check-up. State driver's license and sanctuary policies were associated with having a usual source of care and fewer unmet medical needs among children of immigrants. The recent pandemic highlights the importance of access to preventative health care. State policies that limit federal immigration enforcement involvement are associated with improved access to preventative health services among immigrants' children, most of whom are U.S. citizens. [ABSTRACT FROM AUTHOR]

Background: Migrant populations from countries with generalised HIV epidemics make up a significant proportion of all HIV/AIDS cases in many European Union and European Economic Area (EU/EEA) countries, with heterosexual transmission the predominant mode of HIV acquisition. While most of these infections are diagnosed for the first time in Europe, acquisition is believed to have predominantly occurred in the home country. A proportion of HIV transmission is believed to be occurring post-migration, and many countries may underestimate the degree to which this is occurring. Our objectives were to review the literature estimating the proportion of migrants believed to have acquired their HIV post-migration and examine which EU member states are able to provide estimates of probable country of HIV acquisition through current surveillance systems. Methods: A systematic review was undertaken to gather evidence of sexual transmission of HIV within Europe among populations from countries with a generalised epidemic. In addition, national surveillance focal points from 30 EU/EEA Member States were asked to complete a questionnaire about surveillance methods and monitoring of the likely place of HIV acquisition among migrants. Results & discussion: Twenty-seven papers from seven countries were included in the review and 24 countries responded to the survey. Estimates of HIV acquisition post-migration ranged from as low as 2 % among sub Saharan Africans in Switzerland, to 62 % among black Caribbean men who have sex with men (MSM) in the UK. Surveillance methods for monitoring post-migration acquisition varied across the region; a range of methods are used to estimate country or region of HIV acquisition, including behavioural and clinical markers. There is little published evidence addressing this issue, although Member States highlight the importance of migrant populations in their epidemics. Conclusions: There is post-migration HIV acquisition among migrants in European countries but this is difficult to quantify accurately with current data. Migrant MSM appear at particular risk of HIV acquisition post-migration. Countries that identify migrants as an important part of their HIV epidemic should focus on using an objective method for assigning probable country of HIV acquisition. Robust methods to measure HIV incidence should be considered in order to inform national prevention programming and resource allocation. [ABSTRACT FROM AUTHOR]

This study investigates whether there is a gender gap in health among migrants. Focusing on migrants from Uzbekistan and Tajikistan in Russia, where there are high levels of both immigration and gender inequality, this paper exploits unique data collected by the authors recording detailed information on health and migration trajectories. We find that migrant women are on average in poorer health than migrant men. This gender gap is only partly explained by gender differences in observed socioeconomic, demographic, living and working characteristics and differences in pre-migration health. We show that migrant women's health is more likely than men's to deteriorate during migration. This women's health disadvantage is sensitive to the migration profile, as it only appears after a certain time spent migrating and for migrants with a vulnerable legal status. These results call for targeted public health policies to address this gender health gap. [ABSTRACT FROM AUTHOR]

Objectives: Differences in health among migrant groups are related to the length of stay in host countries. We examined the health of people reporting Caribbean ethnic origins within and outside of Canada; and the possible associations between length of stay and poorer physical and mental health outcomes. Method: Analyses were conducted on population data collected in Canada (2000/2001, 2003, 2005), Jamaica (2005) and Guyana (2005). Physician-diagnosed and self-rated health measures were used to assess physical and mental health statuses. Results: Rates of chronic conditions were generally higher among people reporting Caribbean ethnic origins in Canada compared to those living in the Caribbean region. Self-rated fair or poor general health rates, however, were higher among participants in the Caribbean region. Higher rates of any mood disorders were also found among Caribbean region participants in comparison to those in Canada. Logistic regression analyses revealed that new Caribbean immigrants (less than 10 years since immigration) in Canada had better physical health than those who were more established. Those who immigrated more than 20 years ago showed consistently better health conditions than those who had immigrated between 11 and 20 years ago. This healthy immigration effect, however, was not present for all chronic conditions among all Caribbean origin migrant groups. Moreover, mood disorders were highest among new immigrants compared to older immigrants. Conclusions: When and where ethnic Caribbeans migrate to and emigrate from matters in health statuses. These results have implications for policies related to health and well-being in support of ethnic Caribbean origin individuals who relocate to Canada. The paper concludes with suggestions for future studies regarding the health of ethnic origin Caribbeans living within and outside their regions of birth. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to outlines the findings of the first qualitative evidence synthesis of empirical research on the impact of the No Recourse to Public Funds (NRPF) rule which prevents most temporary migrants from accessing social security benefits in the UK. Design/methodology/approach: The review used the 2020 Preferred Reporting Items for Systematic reviews and Meta-Analyses protocol guidelines. Data were analysed by using Thomas and Harden's (2008) thematic synthesis methodology. An initial 321 articles were identified from 13 databases, of which 38 studies met the inclusion criteria. Findings: The key insights were that NRPF causes destitution and extreme poverty and has a disproportionate impact on racialised women. Studies found that support services were underdeveloped, underfunded, inconsistent and had a culture of mistrust and racism towards migrants. Migrants were often fearful of services due to concerns around deportation, destitution and state intervention around children. Research limitations/implications: The review focussed on qualitative research. Future empirical and theoretical research is needed in the following areas: NRPF as a practice of everyday bordering, the role of the Home Office in creating and sustaining the policy; differing gendered experiences of NRPF; and a broader geographical scope which includes all four UK nations and takes an international comparative approach. Originality/value: Despite an estimated 1.4 million people in the UK with NRPF (Citizens Advice, 2020), there is little policy or theoretical discussion of the experience of having NRPF or the implications of the rule. This lack of analysis is a significant gap in both our understanding of the landscape of poverty in the UK, and the ways in which immigration policies create extreme poverty. To the best of the authors' knowledge, this paper is the first systematic qualitative review on NRPF, bringing together the research evidence on how NRPF negatively affects outcomes for migrants, local authority and voluntary sector responses to NRPF and theoretical perspectives on NRPF. [ABSTRACT FROM AUTHOR]

OBJECTIVES: The involvement of individuals and communities in health decision‐making is enshrined in WHO policies. However, migrant groups are under‐represented in health decision‐making processes. Our aim was to explore migrants' involvement in health policy, service development and research in the WHO European Region to identify levers for inclusive and meaningful practice. METHODS: We conducted a narrative review of grey literature and peer‐reviewed research on migrants' involvement in health decision‐making across the 53 countries in WHO Europe. We searched for articles published in English between 2010 and the present in two electronic databases (PubMed, Scopus), IOM MIPEX Health Strand country reports, the EU SOPHIE project and using a Google advanced search. Findings were analysed descriptively and using Normalisation Process Theory to investigate levers and barriers to implementation of policy into practice. RESULTS: Of 1,444 articles retrieved, 79 met the inclusion criteria. We identified 20 policies promoting migrants' involvement, but national‐level policies were present in only two countries. We identified 59 examples of migrants' involvement in practice from half of the WHO Europe countries (n = 27). Our Normalisation Process Theory (NPT) analysis of 14 peer‐reviewed empirical papers found that participatory research approaches are a lever to putting policy into practice in a meaningful way. CONCLUSIONS: Migrants' involvement in health decision‐making requires explicit national policies that are implemented evenly across policymaking, service provider and research activities in all countries in the WHO European Region. Participatory approaches to involvement activities are encouraged because they are a lever to perceived barriers to migrants' involvement. [ABSTRACT FROM AUTHOR]

The growth of migrant communities continues to rise globally, creating unique and complex health challenges. Literature on immigrant health in New Zealand (NZ) remains scant. This integrative literature review was conducted drawing on peerreviewed research articles on immigrant health in NZ published between 2012 and 2018. The objectives were to: (i) provide a critical overview of immigrant health in NZ; (ii) identify general trends in health research conducted in NZ on immigrants; (iii) compare, contrast, and evaluate the quality of the information; (iv) develop a summary of research results and; (v) identify priorities and recommendations for future research. A search yielded more than 130 articles with 28 articles constituting the foundation of the review. This review is timely following the rapid increase in the scale, speed, and spread of immigration and its potential for changing NZ's national health patterns and priorities. This integrative review led to the four primary conclusions. Firstly, migration in NZ is a gendered phenomenon, as there has been more women and girls arriving as migrants in NZ and being at risk of poor health in comparison with their male counterparts. Secondly, studies on infectious diseases take precedence over other health problems. Thirdly, research methodologies used to collect data may not be relevant to the cultural and traditional customs of the migrant populations. Furthermore, a number of research findings implemented have failed to meet the needs of NZ migrants. Lastly, policy initiatives are inclined more towards supporting health practitioners and lack a migrant centred approach. What is already known about this topic? Despite NZ becoming more ethnically and linguistically diverse, there is limited literature on the health of migrants living in NZ. What this paper adds? This integrative literature review provides a critical overview of refugee and migrant health in NZ through reviewing and critiquing the current literature available. This paper identifies research trends, the general health of migrants in NZ, recommendations that could inform future migrant and refugee health research and health policies and initiatives to ensure effective and relevant health service provision to migrants. [ABSTRACT FROM AUTHOR]

Ageing well has been associated with the responsibility to age actively, successfully, or healthily in public and research discourses. This connection of individual responsibility with ageing has been criticised in Social Gerontology for neglecting the access to social, economic, and health resources. This paper investigates (individual) responsibility, informal support, and public initiatives in discourses on older immigrants in Germany. The research framework employs a sociology of knowledge approach to discourse, which guided the discourse analysis of German policy reports, guidelines and handbooks on ageing and migration from 2000 to 2019 (43 documents in total). The results reveal that besides public initiatives concerning long-term care, health promotion, and social services, informal solutions through social networks are frequently emphasised in the data. The focus, thereby, is on long-term care, which is presented as a responsibility of the extended family. Thus, resources are situated in the family, social networks, and ethnic group, which should be opened and connected with public services; however, the focus is shifting from older immigrants towards local municipalities. This study provides a discourse perspective on the construction of resources and challenges for older immigrants concerning health, care, and social services and offers an assessment of the cultural and integrating/excluding qualities in active ageing discourses. [ABSTRACT FROM AUTHOR]

Background: There is a growing concern that the quality of health systems in humanitarian crises and the care they provide has received little attention. To help better understand current practice and research on health system quality, this paper aimed to examine the evidence on the quality of health systems in humanitarian settings. Methods: This systematic review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. The context of interest was populations affected by humanitarian crisis in low- and middle- income countries (LMICs). We included studies where the intervention of interest, health services for populations affected by crisis, was provided by the formal health system. Our outcome of interest was the quality of the health system. We included primary research studies, from a combination of information sources, published in English between January 2000 and January 2019 using quantitative and qualitative methods. We used the High Quality Health Systems Framework to analyze the included studies by quality domain and sub-domain. Results: We identified 2285 articles through our search, of which 163 were eligible for full-text review, and 55 articles were eligible for inclusion in our systematic review. Poor diagnosis, inadequate patient referrals, and inappropriate treatment of illness were commonly cited barriers to quality care. There was a strong focus placed on the foundations of a health system with emphasis on the workforce and tools, but a limited focus on the health impacts of health systems. The review also suggests some barriers to high quality health systems that are specific to humanitarian settings such as language barriers for refugees in their host country, discontinued care for migrant populations with chronic conditions, and fears around provider safety. Conclusion: The review highlights a large gap in the measurement of quality both at the point of care and at the health system level. There is a need for further work particularly on health system measurement strategies, accountability mechanisms, and patient-centered approaches in humanitarian settings. [ABSTRACT FROM AUTHOR]

Background: Patient‐reported Experience (PRE) is an emerging concept integrating patient perspectives and amplifying voices often marginalized in discussions surrounding health systems. However, it remains a challenge to use and integrate PREs when studying patient agency and access to quality services, particularly with data from multiple sources. In this article, using study materials from the Swiss MIWOCA project, we present and reflect upon a multistage PRE approach to study healthcare access. Methods: The MIWOCA project, a study on healthcare access and quality among immigrant women with chronic illnesses living in Switzerland, provided data from multiple sources for the integration of PRE data. These sources included interviews with women (n = 48), two focus group discussions with women (n = 15), interviews with service providers (n = 12) and observations from stakeholder dialogues (n = 3). In addition, we utilized field notes, focus group illustration maps, patient vignettes and policy briefs to develop a multistage data linking model. PRE data served as starting themes and reference topics in each of the interlinked stages of knowledge production. Results: Deploying PREs, we coherently linked the data from preceding stages and used them to inform subsequent stages. This, in turn, enabled us to identify, reflect and rectify factors limiting immigrant women's agency and access to quality services. Ultimately, the approach engaged patients as knowledge co‐producers for system‐level changes. This knowledge was transformed into a set of practice recommendations and a policy brief addressing ways to improve health systems to better serve immigrant women in Switzerland. Conclusions: Building on PREs to systematically combine multiple data sources and engage patients continuously can improve our understanding of barriers in health systems. Beyond individual patient‐doctor encounters, a multistage PRE approach can identify structural problems and provide clues for resolving them at the systems level. The PREs approach presented may serve as an example and encourage more public health experts to consider PREs in future research and practice. Patient and Public Contribution: Women with chronic illness and immigration experience contributed to interview‐guideline development, provided PREs in interviews, identified priority areas for health‐service change and actively participated in the development of practice recommendations. [ABSTRACT FROM AUTHOR]

This paper considers the role of culture in rural health, suggesting that the concept and its impacts are insufficiently understood and studied. It reviews some of the ways that culture has been considered in (rural) health, and states that culture is either used ambiguously and broadly - for example, suggesting that there is a rural culture, or narrowly - indeed perhaps interchangeably with ethnicity, for example Aboriginal culture as a unity. The paper notes that, although culture is a dynamic social concept, it has been adopted into a biomedical research paradigm as though it is fixed. Culture is often treated as though it is something that can be addressed simplistically, for example, through cultural sensitivity education. Authors suggest that culture is an unaddressed 'elephant in the room' in rural health, and that exploring cultural differences and beliefs and facing up to cultural differences are vital in understanding and addressing rural health and health system challenges. [ABSTRACT FROM AUTHOR]

The annual number of opioid prescriptions for pain relief has been increasing in the United States. This increase has raised concerns about prescription opioid abuse and overdose. The purpose of this study was to examine opioid risks (risk factors that increase the chance of opioid abuse) among uninsured primary care patients utilizing a free clinic. Data were collected using a self-administered paper survey in the waiting room of the free clinic from May to July 2017 (N = 506). Higher levels of somatic symptoms were associated with higher levels of opioid risks. U.S.-born English speakers had higher levels of opioid risk than non–U.S.-born English speakers and Spanish speakers. Being employed was associated with higher levels of opioid risk while attending college or being postcollegiate was related to lower levels of opioid risk. Research surrounding best practices, prescription trends, and population risk is vital in driving health and social policy. Further research would benefit from examining where people are obtaining opioids. In addition, further research on opioid abuse among Hispanic populations would be beneficial. Finally, future studies should examine how prescribing practices are different among free clinic health professionals in comparison to health care professionals working in-patient or at for-profit clinics. [ABSTRACT FROM AUTHOR]

Renal replacement therapy is guaranteed for all US citizens with end-stage renal disease (ESRD). Undocumented immigrants with ESRD are a particularly vulnerable subset of renal failure patients. There is no federal legislation for these patients except for the requirement to treat them during "emergency medical conditions" and federal legislation excluding them from the guarantee of renal replacement therapy described above. Different states have developed different methods for dealing with this problem, with variation in management even addressed on a center by center basis. This review of the original studies published in the literature reveals the medical, ethical, and financial problems with this situation. These patients frequently have delayed presentation to care, poor access to routine care, increased complications, increased utilization of services, and increased morbidity and mortality in an emergent dialysis model compared to chronic outpatient care. They present an ethical dilemma for practitioners who know they are providing substandard care and occasionally making decisions on how to allocate resources. Emergent dialysis is associated with inadequate reimbursement, increased threat to sustained unemployment, and an overburdening of our healthcare infrastructure. This practice puts patients at risk, places an unfair ethical burden on providers and is financially unsustainable. Special considerations described for kidney transplant and peritoneal dialysis are considered and considerations for a new model are reviewed in the paper. Ultimately accommodations must be made with the input of government, healthcare practitioners, and facilities needs to be reached to protect these vulnerable patients. [ABSTRACT FROM AUTHOR]

The US South Asian population has grown tremendously, and is now over 2.5 million. South Asians often face tremendous cultural, socioeconomic, linguistic and structural obstacles to good health, and face staggering cardiovascular disease (CVD) and cancer risk. Coupled with this is a paucity of detailed data on the population's unique CVD and cancer risk profiles, etiologic mechanisms, and effective interventions to address South Asian health disparities. This data gap compelled an initiative to develop more targeted research and evidence-based practice and policy approaches. The South Asian Health Initiative (SAHI), a community based participatory research partnership between the Immigrant Health and Cancer Disparities Center at Memorial Sloan Kettering Cancer and the South Asian Council for Social Services (SACSS), and the Palo Alto Medical Foundation Research Institute thus partnered to effect the first national South Asian translational research endeavor, South Asian Health: From Research to Practice and Policy, summarized in this paper. [ABSTRACT FROM AUTHOR]

Introduction: As the burden of migration to Europe increases, Greece is in a critical geographical crossroad and despite its longstanding financial troubles, is now mapping new paths for coping with modern immigration influx via adhering to improved social status of refugees and migrants. In terms of access to health services by refugees and immigrants in Greece, it should be noted that the institutional framework concerning access has been relatively restricted until recently. Aim: The main objective of this paper is to explore factors associated with nursing and contemporary migration and also to present an overview of the European and Greek policies and initiatives to protect migrants' health. Method: A critical literature search was performed, seeking key material and benchmark policy statements exploring and explaining the complexities and the challenges associated with migration per se and the impact on people's health. Findings-Discussion: Findings are grouped and discussed further under five pillars, i.e.: Immigration in Europe in Recent Years, Configuring Europe's migration policy to address first migration rates, How is Europe securing migrant's health, Health care provision and utilization for migrants in Europe and Health care provision and utilization for migrants in Greece. Overall, it can be argued that the refugee crisis had a major impact on the Greek NHS and that the influx of forcibly displaced people raised critical issues concerned health care provision including services for mental comorbidities and psychosocial support. Yet, efforts are made to adjust policy and practice in the light of meeting health needs for migrants despite economic limitations, which are affecting both locals and refugees alike. Conclusions: Nursing, in this turbulent health provision environment is expected to provide health interventions addressed to migrants. As the spectrum of migration into Europe continues due to various political, social and financial complexities, the need for societal responses including appropriate policy implementation and relevant nursing education is essential. Thus, migration will continue to pose challenges to society and to health in Greece and beyond. Only through continuous attentiveness will it be possible to identify, and then avoid or reduce health disadvantages faced by persons with a migration background. [ABSTRACT FROM AUTHOR]

Purpose Between 2012 and 2016, the Government of Canada modified health insurance for refugees and asylum seekers. In Quebec, this resulted in refusals of care and uncertainties about publicly reimbursed services, despite guaranteed coverage for people with this status under the provincial plan. The Chronic Viral Illness Service (CVIS) at the McGill University Health Centre in Montreal continued to provide care to refugees and asylum seekers living with HIV. The purpose of this paper is to explain how and why challenges brought by this policy change could be overcome.Design/methodology/approach A qualitative case study was conducted using interviews with patients and staff members, observation sessions and a review of media, documents and articles. A discussion group validated the interpretation of preliminary results.Findings The CVIS provides patient-centered care through a multidisciplinary team. It collectively responds to medical, social and legal issues specific to refugees. Its organizational culture and expertise explain the sustained provision of care. The team's empathetic view of patients, anchored in the service's history, care for men who have sex with men and commitment to human rights, is key. A culture of care developed over time thanks to the commitment of exemplary figures. Because they countered the team's values, changes in refugee healthcare coverage strengthened the service's culture of care. However, the healthcare system reform launched in 2014 in Quebec is perceived as jeopardizing the culture of care, as it makes, refugee and asylum-seeker patients a non-lucrative venture for providers.Originality/value This research analyzes the origin of sustained provision of care to refugees and asylum seekers living with HIV through the lens of culture of care. It considers the historical and political contexts in which this culture developed. [ABSTRACT FROM AUTHOR]

Background: The relationship between gender, migration status and non-communicable diseases (NCDs) is rarely examined. In this study, we rely on data from the MIGHEAL Survey on health inequalities in Greece collected in 2016 comprising 1332 respondents of which 59.98% identified themselves as Greek-born, 24.02% as immigrants from Albania and 15.99% as immigrants from another country than Albania, to analyse this often neglected relationship. With the help of average risk ratios, this paper explores and explains gender inequalities in heart or circulation problems, high blood pressure, breathing problems, allergies, back or neck pain, muscular pain, stomach or digestion-related problems, skin conditions, severe headaches, and diabetes in Greece among Greek-born individuals, Albanian immigrants and among immigrants of 'other origin'. We found that both among Greek-born and among immigrant groups women report substantially higher rates of NCDs although gender inequalities are more pronounced among 'other-origin' immigrants. Further, our findings show that the observed gender inequalities are fostered by occupational factors both among Greek-born and migrants. Policies targeted at reducing the risk of NCDs need to consider not only gender and migration status but also how their intersection renders certain social groups more vulnerable than others. Moreover, specific attention should be paid to the underlying structural factors associated with NCD reporting, such as working conditions, labour market regulations and employment initiatives that have a differential health influence across diverse population groups. [ABSTRACT FROM AUTHOR]

Background: While the incidence of active tuberculosis (TB) in Canada is among the lowest in the world, the rates of TB among immigrants and Indigenous people remain high. In fact, the majority of new active TB cases are disproportionately found among immigrants. This study profiles TB-related acute care hospitalizations among new immigrants to Canada by selected characteristics. Data and methods: This study is based on the 2000-to-2013 Longitudinal Immigration Database (IMDB) linked to the Canadian Institute for Health Information's Discharge Abstract Database (DAD) from 2001/2002 to 2013/2014. It examines the timing of first TB-related acute care hospitalization occurring from the fiscal year 2001/2002 to the fiscal year 2013/2014 among immigrants who landed in Canada from 2000 to 2013 outside of Quebec and the territories. Mean and median hospital days and the percentage of total TB hospitalizations incurred by these new immigrants are calculated to measure the burden of hospital care among recent immigrants. Results: From 2001/2002 to 2013/2014, 1,120 out of 2.7 million immigrants arriving between 2000 and 2013 were found to have, in total, 1,340 TB-related hospital discharges. The majority of cases (97%) were among immigrants from the Immigration, Refugees and Citizenship Canada (IRCC) designated country list for TB, in which about three quarters of the cases were from the World Health Organization (WHO) list of high TB-burden countries. Approximately half (45%) of immigrants hospitalized for TB were aged 18 to 34 at the time of hospitalization. Around 10% of all TB patients had been hospitalized before formally landing as immigrants. Mean and median length of hospital stay were 17 days and 11 days, respectively (22 days and 14 days, respectively, for the overall population in Canada). While new immigrants who landed between 2000 and 2013 represent 7% of the overall population of Canada, they incurred 17% of all TB-related hospital discharges occurring during this period. Interpretation: This paper demonstrates the value of linked administrative data to understanding immigrant health and is important for future work in this area. Current immigration protocols surrounding TB involve screening for active pulmonary TB and identifying some migrants with latent TB. Results of this study, linking TB-related hospitalizations to immigrant landing files, provide unique information that can inform public health action, as well as migration policy and program development to contribute to the efforts to eliminate TB. [ABSTRACT FROM AUTHOR]

The objective of this paper was to systematically review the literature on the prevalence of selected infectious diseases among migrants/refugees of African origin and to provide policy makers and health care professionals with evidence-based information. We pursued a systematic review and meta-analysis to determine the prevalence of six selected infectious diseases (i.e., syphilis, helminthiasis, schistosomiasis, intestinal protozoa infections, hepatitis B, and hepatitis C) among migrants/refugees of African origin. Three electronic databases (i.e., PubMed, EMBASE, and ISI Web of Science) were searched without language restrictions. Relevant data were extracted and random-effects meta-analyses conducted. Only adjusted estimates were analyzed to help account for heterogeneity and potential confounding. We assessed the quality of evidence using the GRADE approach. The results were stratified by geographical region. Ninety-six studies were included. The evidence was of low quality due to the small numbers of countries, infectious diseases, and participants included. African migrants/refugees had median (with 95% confidence interval [95% CI]) prevalence for syphilis, helminthiasis, schistosomiasis, intestinal protozoa infection, hepatitis B, and hepatitis C of 6.0% [95% CI: 2.0-7.0%], 13.0% [95% CI: 9.5-14.5%], 14.0% [95% CI: 13.0-17.0%], 15.0% [95% CI: 10.5-21.0%], 10.0% [95% CI: 6.0-14.0%], and 3.0% [95% CI: 1.0-4.0%], respectively. We found high heterogeneity regardless of the disease (I²; minimum 97.5%, maximum 99.7%). The relatively high prevalence of some infectious diseases among African migrants/refugees warrants for systematic screening. The large heterogeneity of the available published data does not allow for stratifying such screening programs according to the geographical origin of African migrants/refugees. [ABSTRACT FROM AUTHOR]

Background During the Coronavirus Disease 2019 (COVID-19) pandemic, immunization programmes struggled to reach all population groups equally. While migrant groups face multiple barriers to health systems, including vaccination, little is known about their vaccine uptake. Methods We conducted a cross-sectional telephone survey on adults with and without migration history in Germany to investigate barriers and drivers to COVID-19 vaccination (11 April 2021 to 18 December 2021). Interviews were conducted in six languages. We used logistic regression models and a mediation model to analyze the association between migration history and vaccine uptake. Furthermore, we determined the effect of psychological determinants (5C model) on vaccine uptake. Results The survey comprised 2039 individuals, including 1015 with migration history. Of these, 448 were interviews conducted in languages other than German. Individuals with migration history had a significantly lower vaccine uptake but, while still unvaccinated, had a higher intention to get vaccinated (P  = 0.015) compared with those without migration history. The association between migration history and vaccine uptake was no longer significant when other factors were included in the regression model (odds ratio = 0.9; 95% confidence interval: 0.57–1.47). Socio-economic index, language skills and discrimination experience fully mediated this association. Among the psychological determinants, 'higher confidence' and 'higher collective responsibility' increased the chance of individuals with migration history to be vaccinated. Conclusion Migration history alone cannot explain vaccine uptake; socio-economic index, language skills and discrimination experiences need to be considered. To achieve vaccine equity, future public health policy should aim to reduce relevant barriers through tailored interventions. [ABSTRACT FROM AUTHOR]

Purpose – In this paper, the aim is to present an historical analysis to account for the association between prostitution, disease, and victimization. It also seeks to examine how stigmatization and rejection are currently focused on the immigrant sex worker. Design/methodology/approach – The analysis is based on historical data about regulations in Portugal, in a recent ethnography carried out with street prostitutes and in a current study on immigrant sex workers and health care. Findings – Sex workers have been recognized as a group "at risk" both because they are associated with sexually transmitted diseases and because they are acknowledged as victims of traffic and sexual exploitation. This label "group at risk" justifies some state policies often expressed in sanitary and social control measures, as regulations. Because migrant sex workers are simultaneously immigrants and sex workers they are perceived as a threat to social order and a sign of moral disorder and, so, they experience processes of rejection and stigmatization more significantly than local sex workers. Originality/value – The knowledge of the negative consequences experienced by migrant sex workers implies an effort to produce changes in the policies and practices towards them. All those involved in research or intervention with migrant sex workers have the responsibility to be aware of the discrimination, violence, and control they are subjected to and must be committed enough to challenge them. This paper can be a contribution to that. [ABSTRACT FROM AUTHOR]

This paper compares the health of Australian immigrants with that of the Australian-born population and examines the extent to which differences vary with time since migration. Health is measured using self-reports of chronic diseases from three national health surveys. Probit models are used to estimate the health effects of immigrant arrival cohorts, years since migration and country of birth. We find that the health of Australian immigrants is better than the Australian-born population, but the longer immigrants spend in Australia, the closer their health approximates that of the Australian-born population. There are variations for different immigrant groups and for particular chronic diseases. [ABSTRACT FROM AUTHOR]

With the passing of Royal Decree-Law 16/2012, Spain's national health system switched from a model defined by universal and free health care principles, to a private insurance system that excluded large population groups. Based on a qualitative research design, this paper examines the media treatment of undocumented immigrants' prerogatives to public health care in Spain (2012–2018). The analysis of 234 articles, drawn from three major Spanish newspapers, reveals three frames that underscore the media's "rhetorics of inclusion," which argue for the extension of free medical services to irregular immigrantsa topic traditionally underestimated by the literature. The moralist frame, supported by social justice arguments, is found in tandem with the cost-benefit frame that advocates for immigrants' health care access as a means for containing medical expenses. The overall predominance of the legalist frame largely relies on arguments that reflect a Spanish political culture rooted in the universality of health rights. [ABSTRACT FROM AUTHOR]

Introduction In Hong Kong, migrants arriving from Mainland China often have multiple roles and responsibilities while adapting to new lives in their host destination. This paper explored the factors that contribute to the inequity in health services utilisation experienced by these migrants; and, identified the elements that could constitute an effective health delivery model to address the service gap. Methods Site visits and a focus group discussion (n = 13) were held with both public and private health providers before a number of innovative health delivery models were formulated. They were then circulated among the panel in two further rounds of Delphi survey (n = 11) from March- April 2012 to systematically collect opinions and select the most endorsed health service models to serve this target population. Results Focus group members perceived that most migrants were unaware of, or even ignored, their own physical and mental health needs, and had low utilisation of healthcare services, because of their pre-occupation with daily chores and hardship as well as differing health values, practices and expectations. They further identified that the structural issues such as the healthcare setting or the operation of current service provisions had failed to meet migrants' health needs. Consequently, four new service models that incorporated professional advice and empowerment, which were identified as the two most important elements, were put forward. Thus, the model of having a nurse with social work training, supported by volunteer groups, was selected as the best option to familiarise and empower patients within the labyrinth of local healthcare services. Conclusion Implementation of a social empowerment model by way of targeted support and specific health information is recommended. Further evaluation of this model is needed to understand its effectiveness for improving health literacy and health status in this disadvantaged group in the long term. [ABSTRACT FROM AUTHOR]

In many parts of the world access to adequate water, sanitation and hygiene (WASH) is entwined with gender relations. While there is emerging research on how gender relations intersect with socio-cultural practices and norms to produce gender-based violence in WASH, little is known about how these gender relations are intimately produced, reproduced and embodied in place. Drawing insights from feminist political ecology and gendered geographies of power, this paper uses retrospective narratives of Ghanaian migrants in Canada to advance this scholarship in three significant ways. First, the findings demonstrate how gender relations in WASH produce everyday vulnerabilities differently among women and men. Second, they highlight the complex ways women bargain with patriarchal structures to ensure their safety in WASH spaces. Finally, the findings show how gender relations and roles in WASH transform in transnational spaces in which gendered WASH roles and responsibilities are blurred. The findings draw policy attention to the interconnectedness of WASH and gender equality and the need for policy and practice change to advance gender equity in WASH. • Water, sanitation and hygiene (WASH) security is entwined with gender relations. • Gender relations intersect with socio-cultural practices and norms to (re)produce gender-based violence in WASH. • Women bargain with patriarchal structures to ensure their safety in WASH spaces. • Gender relations and roles in WASH are reconstituted across space and time. [ABSTRACT FROM AUTHOR]

Background: Migration and urbanization are central to sustainable development and health, but data on temporal trends in defined populations are scarce. Healthy men and women migrate because opportunities for employment and betterment are not equally distributed geographically. The disruption can result in unhealthy exposures and environments and income returns for the origin household. Objectives: The objectives of the paper are to describe the patterns, levels, and trends of temporary migration in rural northeast South Africa; the mortality trends by cause category over the period 2000-2011; and the associations between temporary migration and mortality by broad cause of death categories. Method: Longitudinal, Agincourt Health and Demographic Surveillance System data are used in a continuous, survival time, competing-risk model. Findings: In rural, northeast South Africa, temporary migration, which involves migrants relocating mainly for work purposes and remaining linked to the rural household, is more important than age and sex in explaining variations in mortality, whatever the cause. In this setting, the changing relationship between temporary migration and communicable disease mortality is primarily affected by reduced exposure of the migrant to unhealthy conditions. The study suggests that the changing relationship between temporary migration and non-communicable disease mortality is mainly affected by increased livelihood benefits of longer duration migration. Conclusion: Since temporary migration is not associated with communicable diseases only, public health policies should account for population mobility whatever the targeted health risk. There is a need to strengthen the rural health care system, because migrants tend to return to the rural households when they need health care. [ABSTRACT FROM AUTHOR]

Research on sexuality among older immigrants is extremely inadequate. This paper presents the results and analysis based on a national survey using a random sample of 2,272 Chinese-Canadian seniors. Self-reported health is examined in relation to a range of demographic as well as sexuality variables. Logistic regression analysis shows that language (English) ability and income play an important role in the health of Chinese-Canadian seniors, along with the sexuality variables. Among men, both the frequency of sexual activity and satisfaction with sex life have a positive effect on health. Among women, only sexual satisfaction is found to be significant. Results from this study can inform future research, service delivery, and policymaking in health care and social service for seniors. [ABSTRACT FROM AUTHOR]

This article discusses the development of the home care sector in Austria. It analyses what impacts the interplay of the traditional family orientation to care, a universal cash-for-care scheme (reaching about 5% of the population) and a growing migrant care sector have on formal home care in Austria. The article is based on an analysis of research papers, policy documents and statistical data covering the period from the introduction of the cash-for-care scheme in 1993 up to 2011. Some authors have argued that generous cash benefits with no direct link to service use - as in the case of Austria - limit the development of home care, particularly in countries with a traditionally strong family orientation towards long-term care. Additionally, a tradition of family care and an emphasis on cash benefits may be conducive to the employment of migrant carers in private households, as a potential substitute for both family care and formal care. Despite this context, Austria has seen a substantial increase in formal home care over the past two decades. This has been driven by clients using their increased purchasing power and by policy priorities emphasising the extension of home care. Migrant care work was regularised in 2007, and the analysis suggests that while migrant care has usually worked as a substitute for other care arrangements, migrant care can also become a more integral element of care schemes. The article concludes that family orientation, unconditional cash benefits and the use of migrant carers do not necessarily preclude the development of a strong social service sector. However, there is a risk that budgetary limitations will primarily affect social service development. [ABSTRACT FROM AUTHOR]

Current tuberculosis control strategies in Canada rely exclusively on screening and surveillance of immigrants. This is consistent with current public health discourse that attributes the high burden of immigrant tuberculosis to the exposure of immigrants to infection in their country of origin. The effectiveness of control strategies is questionable given the evidence that many immigrants are at higher risk of tuberculosis reactivation because of risk factors such as poverty, malnutrition and overcrowded housing. This paper argues that the absence of policies that address poverty-related disadvantages among immigrants makes these populations more vulnerable to the reactivation of their tuberculosis long after they have been exposed in their countries of birth. Policies for tuberculosis prevention in the Aboriginal population attend to their poverty and other social determinants of health. Effective health prevention policy for tuberculosis within the immigrant population must take similar direction. [ABSTRACT FROM AUTHOR]

Background: In Europe, progress in the development of health policies that address the needs of migrants and ethnic minorities has been slow. This is partly due to the absence of a strategic commitment by the health authorities. The Ministry of Public Health commissioned the ETHEALTH (EThnicity & HEALTH) group to formulate relevant recommendations to the public authorities with a view to reducing health inequalities among ethnic minorities. This paper describes the political process and the outcomes of the ETHEALTH expert group. Results: After ten meetings, the ETHEALTH group came up with 46 recommendations, which were presented at a national press conference in December 2011. Target groups concerned by these recommendations covered both irregular migrants and migrants entitled to the national insurance coverage. Recommendations were supported by the need of combining universal approaches to health care with more specific approaches. The scope of the recommendations concerned health care as well as prevention, health promotion and access to health care. When analysing the content of the recommendations, some ETHEALTH recommendations were not fully measurable, and time-related; they were, however, quite specific and realistic within the Belgian context. The weak political commitment of an executive agency was identified as a major obstacle to the implementation of the recommendations. Conclusions: The ETHEALTH group was an example of scientific advice on a global health issue. It also demonstrated the feasibility of coming up with a comprehensive strategy to decrease ethnic health inequalities, even in a political context where migration issues are sensitive. Two final lessons may be highlighted at the end of the first phase of the ETHEALTH project: firstly, the combination of scientific knowledge and practical expertise makes recommendations SMART; and, secondly, the low level of commitment on the part of policymakers might jeopardise the effective implementation of the recommendations. [ABSTRACT FROM AUTHOR]

In this article, I discuss compulsory genital examinations in Swedish African, mainly Somali, girls. The discussion is based on data from 122 police files, including criminal investigations regarding suspected "female genital mutilation" (FGM). A growing body of research in European countries indicates that processes of cultural change are occurring among immigrant communities from areas where traditionally girls are subjected to what is construed as "circumcision". Many studies show growing opposition to these practices among people who have migrated to Europe, and there is little evidence to support the assertion that large-scale illegal activities are prevalent. Yet there is a dominant discourse stating that FGM is secretively practised on a large scale among some immigrant groups in Europe, and policies encourage the detection of cases to charge in criminal court. I describe the current situation in Sweden and highlight some of the drawbacks of a very harsh, although well-intended, policy to check for FGM in Europe. While the ultimate aim is to protect girls at risk for FGM, current policies have ramifications that are invasive and sometimes even traumatising for the girls involved. This paper offers an empirical example of how politics in western multicultural societies may negatively influence the sexual health and rights of a target group, in this case, girls and young women whose families originate from countries where circumcision of girls is practiced. [ABSTRACT FROM AUTHOR]

While numerous factors contributing to racial/ethnic health disparities have been identified, the clustering and interaction of these factors as a syndemic or trajectory has not been well-studied (Starfield in Soc Sci Med 64:1355-1362, 2007; Singer in Soc Sci Med 39(7):931-948, 1994). More importantly, for immigrant/refugee populations, the interaction of contributing factors is not documented adequately enough to provide a solid framework for planning, implementation and evaluation of interventions aimed at reducing disparities. In this paper, the authors draw from the literatures on health disparities and immigrant/refugee health, as well as direct program and research experience, to propose an approach for assessment of the diachronic interaction of ecological factors (a trajectory, or 'diachronic ecology') contributing to health disparities among immigrant/refugee populations. It is our hope that this approach will contribute to the important effort to collect data supporting the development of interventions and policies that effectively address the dynamic processes through which health disparities are created, maintained, and changed. [ABSTRACT FROM AUTHOR]

International population mobility is an underlying factor in the emergence of public health threats and risks that must be managed globally. These risks are often related but not limited to transmissible pathogens. Mobile populations can link zones of disease emergence to low-prevalence or non-endemic areas through rapid or high-volume international movements, or both. Against this background of human movement, other global processes such as economics, trade, transportation, environment and climate change, and civil security influence the health impacts of disease emergence. Concurrently, global information systems, together with regulatory frameworks for disease surveillance and reporting, affect organizational and public awareness of events of potential public health significance. International regulations directed at disease mitigation and control have not kept pace with the growing challenges associated with the volume, speed, diversity, and disparity of modern patterns of human movement. The thesis that human population mobility is itself a major determinant of global public health is supported in this article by review of the published literature from the perspective of determinants of health (genetics/biology, behaviour, environment, and socio-economics); population-based disease prevalence differences, existing national and international health policies and regulations, and inter-regional shifts in population demographics and health outcomes. The paper highlights some of the emerging threats and risks to public health, identifies gaps in existing frameworks to manage health issues associated with migration and suggests changes in approach to population mobility, globalization, and public health. The proposed integrated approach includes a broad spectrum of stakeholders from individual health care providers to policy makers and international organizations that are primarily involved in global health management, or are influenced by global health events. [ABSTRACT FROM AUTHOR]

When exercising their public health powers, states claim various rights against their subjects and aliens. The paper considers whether public health considerations can help justify some of these rights, and explores some constraints on the justificatory force of public health considerations. I outline two arguments about the moral grounds for states’ rights with regard to public health. The principle of fairness emphasizes that those who benefit from public health measures ought to contribute their fair share in upholding them. Alternatively, states’ rights might be justified by a natural duty of justice to uphold and not to obstruct institutions implementing public health policies. I indicate some reasons for preferring the latter justification. I further argue that the assignment of some rights to states via public health-based justification is undermined on several counts. Domestic political institutions cannot effectively perform some of their functions in protecting public health. Furthermore, transborder public health threats pose collective action problems at the global level. Finally, concerns about human rights work against the assignment of some rights to states. I conclude by arguing that these concerns call for global coordination, and that some rights claimed by states ought instead to be assigned to global institutions. [ABSTRACT FROM PUBLISHER]

The rapid economic growth after economic reform, known in Viet Nam as “ Doi Moi”, and the growing scope of urban migration raise specific questions for social policy, including migration and health policies. This paper compares issues of health status and its determinants as they affect temporary urban migrants versus permanent urban migrants and non-migrants. The analyses utilize multivariate logistic regression and data from the 1997 Vietnam Migration and Health Survey. The results show that temporary migrants staying in guest houses are most vulnerable to health problems. Though most of them are initially healthier, their reported health deteriorates faster than other groups of urban residents. The findings also present important implications for the current migration and health policies in Vietnam: 1) A special attention should be given to temporary migrants in guest houses; 2) Different priorities in health policy should be applied to different groups of migrants and non-migrants; 3) The current population management policy by registration system needs to be reviewed; 4) Providing clean water is one of the most important ways to improve health of temporary migrants; 5) Targeting educational investments and reducing unemployment would likely to improve overall health; 6) A higher priority on health policies targeting women would likely pay dividends, and; 7) Improving management and collaboration between government offices and interested partners is important to improving health status and reducing inequity. [ABSTRACT FROM AUTHOR]

Currently, migrants and other mobile individuals, such as migrant workers and asylum seekers, are an expanding global population of growing social, demographic and political importance. Disparities often exist between a migrant population's place of origin and its destination, particularly with relation to health determinants. The effects of those disparities can be observed at both individual and population levels. Migration across health and disease disparities influences the epidemiology of certain diseases globally and in nations receiving migrants. While specific disease-based outcomes may vary between migrant group and location, general epidemiological principles may be applied to any situation where numbers of individuals move between differences in disease prevalence. Traditionally, migration health activities have been designed for national application and lack an integrated international perspective. Present and future health challenges related to migration may be more effectively addressed through collaborative global undertakings. This paper reviews the epidemiological relationships resulting from health disparities bridged by migration and describes the growing role of migration and population mobility in global disease epidemiology. The implications for national and international health policy and program planning are presented. [ABSTRACT FROM AUTHOR]

Purpose: An identification card facilitates access to municipal services for migrants with precarious status (MPS) in Montreal. The purpose of this study was to explore from MPS' perspective the utility of the identity (ID) card and its influence on social inclusion for MPS. Design/methodology/approach: A sequential explanatory mixed methods design was used. First, a descriptive phone survey was administered (n = 119). Associations between ID card use and levels of social inclusion were assessed using ordinal logistic regression. Second, semi-structured interviews (n = 12) were done with purposely selected participants. Results were mixed using a statistics-by-theme approach. Findings: Results showed that ID card users compared to nonusers reported higher levels of participation in society and more control/independence in daily life. No statistical associations were found between card use and sense of belonging nor sense of safety. Interviews highlighted that the ID card enabled participation in socio-recreational activities and perceived empowerment. A heightened sense of belonging was also found. Interview participants expressed fear of police despite owning the ID card. Practical implications: Overall, although the municipal ID card promoted social inclusion for MPS, there is a need to render the ID card official to fully achieve this goal. Findings can inform the creation of public policies that foster inclusion and health of MPS in cities around the world. Originality/value: Evaluation from MPS' perspectives of the first ID card program of its kind in Canada. [ABSTRACT FROM AUTHOR]

The article focuses on the importance of including undocumented immigrants in research while ensuring their protection and confidentiality. Topics covered include the vulnerability of undocumented immigrants; the role of Institutional Review Boards (IRBs) in providing guidelines and support; and the responsibilities of researchers in conducting ethical and inclusive studies with this population.

For over a decade, the global health community has advanced policy engagement with migration and health, as reflected in multiple global-led initiatives. These initiatives have called on governments to provide universal health coverage to all people, regardless of their migratory and/or legal status. South Africa is a middle-income country that experiences high levels of cross-border and internal migration, with the right to health enshrined in its Constitution. A National Health Insurance Bill also commits the South African public health system to universal health coverage, including for migrant and mobile groups. We conducted a study of government policy documents (from the health sector and other sectors) that in our view should be relevant to issues of migration and health, at national and subnational levels in South Africa. We did so to explore how migration is framed by key government decision makers, and to understand whether positions present in the documents support a migrant-aware and migrant-inclusive approach, in line with South Africa's policy commitments. This study was conducted between 2019 and 2021, and included analysis of 227 documents, from 2002–2019. Fewer than half the documents identified (101) engaged directly with migration as an issue, indicating a lack of prioritisation in the policy discourse. Across these documents, we found that the language or discourse across government levels and sectors focused mainly on the potential negative aspects of migration, including in policies that explicitly refer to health. The discourse often emphasised the prevalence of cross-border migration and diseases, the relationship between immigration and security risks, and the burden of migration on health systems and other government resources. These positions attribute blame to migrant groups, potentially fuelling nationalist and anti-migrant sentiment and largely obscuring the issue of internal mobility, all of which could also undermine the constructive engagement necessary to support effective responses to migration and health. We provide suggestions on how to advance engagement with issues of migration and health in order for South Africa and countries of a similar context in regard to migration to meet the goal of inclusion and equity for migrant and mobile groups. [ABSTRACT FROM AUTHOR]

Although the Chinese government has established a public health insurance system covering both rural and urban areas, the rural--urban migrants seem to have been neglected. To have a clear sense of the current status of migrants in the public health insurance system and to find ways to increase their enrollment to medical insurance, this paper attempts to construct a conceptual classification framework of China's health insurance system. This was done by reviewing the development of China's health insurance system and identifying barriers to entry for migrants. The finding suggests that migrants' limited access to health insurance owes more to their reluctance than to system exclusions. The job and residential stability of migrants are critical factors to building the classification framework to account for supply and demand factors in the formulation of China's health insurance policy. [ABSTRACT FROM AUTHOR]