Search Results (986)

This paper discusses emerging findings from a large-scale, ongoing UKRI-funded study (2024–2027) undertaken in twelve diverse areas of England. While the main project focuses on reducing health inequalities for refugees, asylum seekers and migrant populations, this interim paper focuses on emerging evidence related to the question of how perceptions of deservingness and route of entry link to access to housing and support services available to the four main refugee and asylum seeker groups who are the predominant focus within the wider research study. We argue that the level and type of support received and access to housing have a direct impact on the wellbeing of the populations. Housing is one of the key social determinants of health, with impacts on both mental health and broader wellbeing. Our findings show that nationality, together with route of entry, legal status and eligibility for statutory support (or lack thereof), clearly affects housing pathways. This, in turn, impacts on the likelihood of being housed in temporary/dispersal accommodation, as well as experiencing homelessness and longer-term housing precarity. These are factors which are widely recognised as affecting mental health and wellbeing as well as the ability to receive uninterrupted health care for other conditions. This study explores how vulnerability, desirability, and deservingness shape different trajectories of refugee housing and resettlement and the resultant impacts on different migrant populations. Full article

This concept paper advances stigma power as a central analytical mechanism for understanding how patriarchy, capitalism, white supremacy, and cis-heteronormativity operate with particular intensity against sex workers. Integrating Link and Phelan’s stigma power with Bourdieu’s symbolic violence and Foucauldian productive power, the framework theorises stigma as a mechanism institutionalised through law and enforced by institutions, which produces measurable consequences that include violence, exclusion, and health harms. Analysing the intersecting axes of gender, sexuality, race, migration, and class across three qualitative studies (SWMH, SEXHUM, VICSW), the article demonstrates why labour-rights reforms, including decriminalisation, are necessary but insufficient. Dismantling stigma requires not only removing sanctions but actively contesting the actors exercising stigma power and interrupting the stabilising mechanisms that reproduce it. This requires policy that acknowledges stigma’s existence whilst working to dismantle it, rather than eliding its reality through liberal mainstreaming or strengthening it through criminalisation or rescue frameworks. The framework explains why decriminalisation is associated with better access to rights and health; why all criminalisation including the so-called Swedish model correlates with increased violence; why stigma persists under optimal legal conditions; and how intersecting marginalisations produce differential vulnerability. Policy implications emphasise pairing decriminalisation with peer-led anti-stigma work, institutional reform, migrant rights, and funded support for sex worker self-organisation. Full article

Background/Aim: Routine ultrasonography now detects gallbladder polyps (GBPs) more often, but reported prevalence varies across populations. Jeju Island has South Korea’s highest obesity prevalence and red meat consumption, suggesting a rapid nutritional transition similar to that reported in Native Hawaiians. This study aimed to first analyze risk factors influencing GBP prevalence, including birthplace, and second compare clinical variables between JNs and JMs. Methods: Between May 2018 and October 2023, 28,751 individuals underwent medical checkups at Jeju National University Hospital. GBPs were diagnosed via ultrasonography, and risk factors including age, sex, birthplace, metabolic syndrome, hepatitis B virus antigen (HBsAg) positivity, lipid profiles, and alcohol consumption were assessed using univariate and multivariate logistic regression. Results: After exclusions, 15,219 participants were analyzed. The overall prevalence of GBPs was 10.3%. Male participants had a higher prevalence than females (11.4% vs. 9.1%, p < 0.001). The younger age group (20–49 years) showed the highest prevalence, while those aged ≥70 years had the lowest (11.6% vs. 8.6%, p = 0.001). Jeju Natives (JNs) exhibited a significantly higher prevalence than Jeju migrants (JMs) (10.6% vs. 9.0%, p = 0.004). Multivariate analysis identified female sex [odds ratio (OR) = 0.644, p < 0.001], age ≥ 70 years (OR = 0.601, p < 0.001), JN birthplace (OR = 1.260, p = 0.015), HBsAg positivity (OR = 1.347, p = 0.040), and high-risk alcohol drinking (OR = 0.758, p = 0.001) as independent predictors. Notably, the 60–69 age group did not reach statistical significance in the optimized model (p = 0.158). Compared to JMs, JNs were older and had a higher prevalence of fatty liver disease, a higher BMI, and higher levels of AST and GGT, but lower levels of HDL-cholesterol and triglycerides. Conclusions: GBPs are more prevalent among JNs compared to JMs, with birthplace emerging as a novel independent risk factor. Fatty liver disease, BMI, and reduced HDL-cholesterol were associated with GBP risk. These findings hypothesize that dietary and metabolic health factors may be potential pathways for the higher GBP prevalence among JNs, though direct dietary assessment is required for confirmation. Full article

Hepatitis C virus (HCV) infection is still a major worldwide health concern. It is distinguished by a high degree of genetic variation that affects the course of the illness and the effectiveness of treatment. The epidemiological profile of HCV is prone to rapid change in areas where there is significant human migration, like Turkey. The purpose of this study was to evaluate the impact of long-term migration on local viral diversity by analyzing the distribution and temporal trends of HCV genotypes among Turkish citizens and asylum seekers in Kayseri, Turkey, over an eight-year period. From January 2014 to December 2021. 1173 HCV RNA-positive patients at Kayseri City Training and Research Hospital were the subject of a retrospective analysis. Genotypes were determined using the Abbott RealTime HCV Genotype II assay and Montania 4896 assay (Anatolia Geneworks, Türkiye). The most prevalent genotypes were Genotype 1b (48.3%, 95% CI: 45.5–51.2%), Genotype 4 (25.0%, 95% CI: 22.5–27.5%), and Genotype 1a (10.3%, 95% CI: 8.6–12.1%). Turkish patients exhibited the highest prevalence of Genotype 1b (98.2%), while asylum seekers demonstrated greater relative burdens of Genotype 4 (8.5% of total GT4) and Genotype 5 (83.3% of total GT5). Genotype 3a emerged in 2018, with a predominance in males (73.9%). The Cochran–Armitage trend test revealed statistically significant increasing trends for Genotype 3 (Z = 3.572, p = 0.0004) and Genotype 3a (Z = 2.600, p = 0.009). This eight-year retrospective study demonstrates that the HCV genotype distribution in Kayseri has undergone significant changes in the context of migration and demographic shifts. The statistically significant increasing trends of Genotypes 3 and 3a, particularly among younger male populations, suggest evolving transmission dynamics. These findings underscore the necessity of demographically targeted and culturally appropriate screening and treatment strategies for both resident and migrant populations to achieve HCV elimination goals. Full article

Alcohol use has been linked to sexual risk-taking behaviour, particularly among young people in Australia, who are also substantially represented in sexually transmissible infection (STI). While research on alcohol use and sexual risk-taking among university students in Australia exists, no studies outside recent Tertiary Students Sexual and Reproductive Health Survey (TSSHS) publications have distinguished between Australian-born and overseas-born domestic students, despite evidence that migrant populations may show different alcohol use and sexual behaviour patterns. Using data from the TSSHS and a cross-sectional anonymous online survey of university-enrolled students, this study is the first to compare sexually active Australian-born domestic, overseas-born domestic, and international students on alcohol use and sexual risk-taking. Findings align with past research, with Australian-born domestic students being more likely to consume alcohol at high-risk levels than international and overseas-born domestic students. Differences in sexual risk-taking behaviours between the three enrolment groups were fully mediated by harmful alcohol use, indicating an indirect effect between group membership and sexual risk-taking. Age moderated this mediation, with the association between harmful drinking and sexual risk-taking strongest among students aged 20–24, compared with younger and older groups. Full article

Background: The COVID-19 pandemic triggered unprecedented mobility disruptions worldwide as governments imposed strict lockdowns to contain the spread of the virus. In India, prolonged restrictions severely affected economic activity, particularly for migrant workers, leading to a large-scale and unplanned exodus from urban employment centres to native places. This sudden population movement undermined containment efforts and contributed to the spatial diffusion of infections. Understanding evacuees’ behavioural responses during such crises is therefore critical for effective emergency logistics and evacuation planning. Methods: This study examines the determinants of transport mode and shelter choice decisions made by migrants during the COVID-19-induced evacuation in India. Using primary survey data, a multinomial logistic regression model is developed to analyze how socio-economic characteristics influence evacuees’ choices of travel mode and shelter type. Results: The results reveal significant heterogeneity in decision-making, highlighting the role of economic vulnerability and accessibility constraints in shaping evacuation behaviour. Conclusions: The findings offer actionable insights for policymakers and emergency planners to design inclusive evacuation strategies, improve crisis-responsive transportation planning, and enhance shelter provisioning in future pandemics or large-scale disruptions. The study contributes to the logistics and humanitarian operations literature by providing empirical evidence on evacuation behaviour under public health emergencies. Full article

Background: Sexual health research with migrant and refugee communities presents unique challenges, shaped by cultural sensitivities, stigma, and the under-representation of these populations in health research. However, lived experiences insights are essential for the development of appropriate and useful research and health initiatives. It is important to learn from researchers’ experiences to expand the representation of migrant and refugee community voices. Method: This paper draws on two qualitative studies conducted in South Australia: one exploring the sexual and reproductive health perspectives of refugee and migrant women, and the other of men. We reflect upon the methodological and ethical considerations in conducting research in this sensitive field and provide recommendations for future researchers and healthcare providers when working with migrant and refugee communities. Results: Both studies encountered difficulties in relation to participant recruitment, cross-cultural communication, and addressing taboos surrounding sexual health. At the same time, they highlighted opportunities for generating meaningful insights through culturally safe, gender-sensitive approaches and collaboration with community stakeholders. Conclusions: By synthesising experiences from both projects, we identify practical strategies for building trust, overcoming linguistic and cultural barriers, and creating supportive environments for discussing sensitive topics. These reflections offer guidance for researchers and clinicians aiming to advance culturally responsive sexual health research and strengthen healthcare provision for migrant and refugee populations. Full article

Background: Health and social outcomes of previous opiate users (POUs) are not well-documented. We characterize the life situation, health status, and health-related quality of life (HRQoL) of POUs entering antiviral hepatitis C (HCV) treatment, compared with HCV patients without past illicit opiate use (NOU), and with HCV patients currently in opiate agonist treatment (OAT). Methods: Data are taken from the German Hepatitis C-Registry (“Deutsches Hepatitis C-Register”, DHCR), a multi-centre registry study focussing on the course and outcome of HCV treatment with directly acting antivirals. At treatment entry, patients underwent a standardized clinical assessment, including the Short Form 36 (SF-36) for self-reported HRQoL. Results: POUs (n = 734) and OAT patients (n = 554) were similar with regard to age, sex, migrant background, and psychiatric comorbidity. Employment rate and cannabis, alcohol, and smoking abstinence rates were higher for POUs than for OAT patients, but still lower than for NOU (n = 4147) patients. Mental and physical HRQoL was better for POUs than for OAT patients, but worse than for NOU patients. Compared with SF-36 normative data, POUs showed decreased HRQoL, especially regarding mental health. Conclusions: Compared with opiate-dependent patients in OAT, POUs showed less psychotropic substance use and better HRQoL. Compared with NOU patients and the general population, mental health problems were especially increased. Challenges persist for POUs even during abstinence from opiates, highlighting the need for targeted interventions tailored to the specific needs of this population. Full article

Mental health inequities affecting migrant populations stem from structural determinants that hierarchize access to resources, recognition, and social protection. Among these determinants, structural racism plays a central role in the experiences of racialised Brazilian immigrant women in Portugal, producing vulnerabilities at the intersection of race, gender, nationality, and migration status. Grounded in intersectional feminist and decolonial epistemology, this study analyses how structural racism operates as a health determinant through specific mechanisms traversing material conditions of life, distress trajectories, and experiences of psychological care, and it examines how these women navigate the limitations of mental health services, identifying conditions for a practice committed to racial equity. Fifteen semi-structured interviews were conducted with racialised Brazilian immigrant women and analyzed through Reflexive Thematic Analysis. The findings indicate that racism is manifested through professional devaluation, labour precarity, documentation instability, and linguistic racialisation, impacting access to rights and the production of psychological distress. Mental health inequities are not limited to barriers to access, as institutional and clinical dynamics tend to individualize distress and disregard its historical and social bases, operating as epistemic violence. The community-based strategies mobilized by participants challenge models centred on individual intervention. This study underscores the need for structurally competent approaches and for institutional reforms oriented toward equity and racial justice within mental health systems. Full article

African migrants living in High-Income Countries are more vulnerable to socio-economic insecurity, as well as higher morbidity and mortality. In their cultural background, these populations, especially the Bamiléké ethnic group from Cameroon, tend to socially value stoutness as a symbol of health and prosperity, potentially obesogenic in urban areas. However, recent studies showed that urbanisation has led to an acculturation process toward the promotion of thinness in young African adults, exposing them to emerging eating disorders. From this perspective, we conducted an original mixed-methods anthropological study, through a repeated qualitative cross-sectional study (two time points in 2011 and 2021) and a quantitative survey (in 2012), in young Cameroonian Bamiléké [18–39 y] migrating to urban Cameroon and France to innovatively explore obesity- and eating disorder-related body weight perceptions. We observed that the qualitative rural–urban tendencies were similar between 2011 and 2021. While rural people tended to value stoutness as a symbol of prosperity, wellbeing and peacefulness, urban people, especially in Paris, tended to value thinness, even extreme thinness, as a symbol of beauty and health and reported a pronounced weight stigma. Quantitatively, we found that Parisian Bamiléké had a desired and ideal body size (DBS and IBS) in the normal-weight category with standard deviations reaching or close to the underweight category, whereas the rural and urban ones had DBS and IBS means between normal-weight and overweight categories. Moreover, we observed a high prevalence of overweight and obesity in both urban groups while the Parisian one tended to underestimate one’s weight and expected to lose it. Public health policies should consider body image as a persisting risk factor for obesity and also a risk factor for emerging eating disorders in young Cameroonian migrants experiencing this dual burden within the urban transition. Full article

(1) Background: Colombia hosts one of the world’s largest mixed-displacement crises, combining longstanding internal displacement with the influx of Venezuelan migrants. This case study examines how the Emergency Medical Team (EMT) Hospital Barco San Raffaele (HBSR) adapted its service-delivery model to respond simultaneously to internal displacement in the Colombian Pacific region and the Venezuelan refugee influx. Using the WHO EMT Surge Capacity Framework, the study analyses how health services were adapted across two concurrent displacement contexts. (2) Methods: A mixed-methods comparative case study was conducted using mission reports, epidemiological surveillance data, policy reports and institutional documents collected between November 2020 and May 2021. Data were analyzed through a thematic analysis structured around the four domains of the WHO EMT Surge Capacity Framework (Staff, Structure, Supplies and Systems), to examine how service adaptation was operationalized across different geographic, sociocultural and legal environments; (3) Results: EMT HBSR adapted staffing composition, supply chains, infrastructure, and operational systems across both settings. Its hybrid model, combining a hospital boat platform with mobile outreach teams, enabled continuity of primary care, mental, maternal and child health, and community-based services in geographically isolated and culturally diverse communities; (4) Conclusions: The findings illustrate how flexible EMT operational models can support the adaptation of health services, and reduce health access inequalities in displacement contexts characterized by high mobility, confinement and limited health system capacity. Mobile platforms, such as hospital boats, appear to be a viable strategy for ensuring continuity of care along migratory routes and in geographically isolated areas affected by protracted instability. Full article

Background/Objectives: In recent years, the migrant population has been increasing. Migrants are at risk for malnutrition, mental disorders and related health problems. In this study, we aimed to examine the relationships among diet quality, eating behavior, posttraumatic stress disorders and sleep quality in Syrian migrants. Methods: This study included 78 female and 72 male Syrian adult migrants. The participants completed a questionnaire including demographic information, the Pittsburgh Sleep Quality Index, the Posttraumatic Stress Disorder Short Scale, and a three-factor eating questionnaire. For the diet quality calculation, a 24 h retrospective food consumption record was taken. Results: A total of 94.0% of the participants had mild to moderate risk of posttraumatic stress disorder. It was determined that 90.7% of Syrian migrants had low or moderate diet quality. There was a positive correlation between the PTSD score and age (r = 0.244) and the Pittsburgh sleep quality index score (r = 0.244) and between the Pittsburgh sleep quality index score and uncontrolled eating (r = 0.171) (p < 0.05). The probability of impaired sleep quality increased in individuals with PTSD scores in the T2 (11–19 points) (OR: 1.342; 95% CI: 1.073–1.678) and T3 (20–31 points) (OR: 1.485; 95% CI:1.157–1.905) groups, whereas the probability of improved diet quality increased in individuals in the T2 (11–19 points) (OR: 1.042; 95% CI: 1.000–1.086) group. Conclusions: Poor diet quality, risk of posttraumatic stress disorder and poor sleep quality are very common among Syrian migrants. In this respect, evaluating Syrian migrants and taking necessary precautions may help reduce the risk of chronic diseases related to nutrient deficiencies and mental problems. There is a need for policies and programs to manage PTSD among Syrian refugees. Full article

Background: This study aims to examine the level of awareness, attitudes (including stigma and discrimination), and behaviors related to tuberculosis among the population of the Republic of Kazakhstan to identify priorities for raising awareness and reducing stigma. Methods: The study interviewed 2400 people from six regions of Kazakhstan using stratified random sampling based on gender and age. Respondents were chosen from cities and villages, including RK citizens over 18 who could answer questions. Additionally, 400 people with HIV, 200 drug users, 200 internal migrants, and 500 health workers were interviewed. Recruitment was done through profile organizations and the snowball method, with all participants giving informed consent. Results: The study showed different levels of knowledge about tuberculosis (TB) in Kazakhstan. Radiography was the most commonly known detection method (71–91%). Awareness of sputum testing was highest among drug users (84%) and HIV patients (77%), but lower among internal migrants (39%). Internal migrants had the most uncertainty about TB tests (17%). Stigmatizing views of TB patients existed, with 28–38% believing most people reject them. Among healthcare workers, only 38. 8% correctly identified the G-Xpert test for TB and rifampicin resistance, and over one-third misunderstood the Mantoux test’s purpose. Conclusions: The findings show a need for focused educational efforts to boost TB awareness and lessen stigma, especially among internal migrants and the general public. Vulnerable groups, like PLHIV and PWUD, have higher awareness but still encounter major barriers. Improving healthcare workers’ knowledge about TB diagnostics is also crucial. Specific communication strategies and policies are needed to improve TB detection, reduce social stigma, and improve healthcare access for at-risk groups in Kazakhstan. Full article

Objective: This study evaluates the pre–post changes in dental knowledge, attitudes, skills, and behaviors following a community health worker (CHW)-led intervention. Methods: Adult caregivers from migrant worker families living near the United States–Mexico border participated in the five-week, in-person, CHW-led intervention program. The two-hour once/week interactive sessions were held in Spanish and included oral health education, skill-building, and goal-setting. Participants completed pre- and post-surveys about dental knowledge, attitudes, skills, and oral hygiene behaviors (N = 117). Participants self-reported frequency of brushing and flossing in the prior week, which was dichotomized to reflect meeting the American Dental Association (ADA) guidelines of brushing twice/day and flossing once/day. Mean group comparisons and paired t-tests were conducted to assess pre- and post-intervention differences. Intervention feedback was also evaluated. Results: Pre-intervention, most adults met hygiene guidelines, and in the overall sample, there were no significant differences post-intervention. However, there were meaningful behavior change differences observed among subgroups not meeting ADA guidelines at baseline. Among the 32% of adults who did not meet ADA brushing guidelines and the 61% that did not meet ADA flossing guidelines at baseline, there were significant improvements post-intervention and increased weekly frequency for brushing (p < 0.001) and flossing (p < 0.001). Pre-intervention, 30% reported not being taught to properly brush or floss; post-intervention, only 3% reported not being taught this skill (p < 0.001). Knowledge (p < 0.001) and some attitudes, including self-efficacy (p < 0.001), significantly increased post-intervention. Program feedback from participants and CHWs was positive, and 81% of participants shared materials. Conclusions: After the CHW-led intervention, there were increases in the adults’ self-reported dental knowledge, some attitudes, and hygiene skills. Toothbrushing and flossing frequency increased post-intervention among the subgroups of adults that were not already meeting ADA guidelines at baseline. Full article

The convergence of climate change, migration, and health represents a critical global challenge, with the Middle East and North Africa (MENA) region illustrating acute vulnerabilities while offering insight relevant beyond the region. Increasing exposure to extreme heat, droughts, and floods drives displacement, constrained mobility, and adaptive migration, placing additional pressure on already stretched health systems. This paper proposes an integrated Nexus Action Framework for Climate Change, Migration, and Health (NAF-CMH) to address these interlinked dynamics and move beyond fragmented, sector-specific responses. The framework conceptualizes human mobility both as a potential resilience strategy and as a determinant of health, encompassing climate-affected migrants, displaced populations, and those experiencing involuntary immobility across diverse pathways and settings. It promotes systematic integration of health considerations into climate adaptation and migration governance and situates these interventions within the broader agenda of climate-resilient health systems. Drawing on a non-systematic narrative review of peer-reviewed and grey literature, complemented by the authors’ expertise, the paper identifies seven interrelated pillars for coordinated policy and operational action. While grounded in MENA-specific vulnerabilities, the framework is flexible and adaptable to other regions facing climate-driven mobility challenges. By providing an operational architecture for multisector collaboration, the NAF-CMH supports policymakers, public health authorities, and migration actors in strengthening resilience, reducing vulnerability and safeguarding health amid accelerating climate impacts and evolving mobility patterns. Full article