International Journal of Migration, Health and Social Care

Publisher:: Emerald Group Publishing Limited
Publication date:: 2021-02-01

ISBN:: 1747-9894

Issue Number

Latest documents

Cultural participation and extra disability and health costs of Syrian migrants in Turkey
Purpose: The effects of disability are well recognised by the social security systems worldwide. This study aims to examine the disability and health-related costs of Syrian migrants in Turkey using the standard of living (SoL) approach. Design/methodology/approach: The empirical analysis relies on primary data collected from 1,067 Syrian migrants in Turkey, and the author applies the ordered Probit model. The SoL is operationalized by frequency of attendance to a Turkish theatrical play or movie, inviting Turkish friends for food and attending a theatrical play or movie with Turkish friends. Findings: The findings show that health problems and disability are negatively related to the frequency of participation in socio-cultural activities. Moreover, employed, wealthier and educated Syrian migrants participate more frequently in the social and cultural activities explored. Practical implications: The results show that the costs range between 9% and 38%, which translates in monetary values between 3,700 and 10,700 Turkish Liras (TL) per annum or between US$530 and US$1,530 expressed in 2020 values. These findings highlight the significant cost and burden that disability and health problems may put in migrant households. Social implications: Policies encouraging immigrants to participate in socio-cultural events, particularly those with disabilities and health issues, may promote their integration into the host society’s social and cultural values. Furthermore, policies improving employment opportunities, income and educational attainment of Syrian migrants may enhance their participation in socio-cultural activities. Originality/value: To the best of the author’s knowledge, this is the first study exploring the disability and health costs of migrants related to integration and participation in cultural activities.
Concerns about COVID-19 among undocumented women in justice-involved families
Purpose: The COVID-19 pandemic has exacerbated chronic disparities in income, employment and health-care access. Yet, little is known about how various sources of economic and emotional strain (i.e. caregiving, justice system involvement and documentation status) intersect during the pandemic. The purpose of this study is to understand how undocumented women in justice-involved families experienced the pandemic. Design/methodology/approach: Surveys of 221 mothers of justice-involved youth examined differences between documented and undocumented parents in COVID-19 testing, health and economic concerns related to the pandemic and generalized anxiety. Findings: The results revealed undocumented women were less likely to receive COVID-19 testing than documented women, despite no difference between the two groups in suspicion that they may have contracted the virus. Also, undocumented women were more concerned than documented women about losing a job, not having enough food, not having enough non-food supplies, not having access to basic utilities or internet, losing their usual childcare services and losing a loved one to COVID-19. Originality/value: The findings highlight the vulnerability of justice-involved families who have an undocumented member and implications for long-term solutions to address these disparities are discussed.
Language mediation in psychotherapeutic healthcare for refugees in Germany – shunting responsibility between levels and actors
Purpose: Refugees’ access to psychotherapeutic care is insufficient in Germany. One factor particularly contributing to hindering their access to adequate therapeutic care is a lack of provision of language mediation. This paper aims to explore the institutional system in which the financing of language mediation in the context of the medical treatment of asylum seekers in Germany is located. It examines why the language barrier problem resulting from a lack of financing is not being solved, even though it has been well known for years as a structural problem of day-patient health care to refugees and migrants in Germany. Design/methodology/approach: The financing of language mediation is analysed against the background of theories of the so-called “shunting yard”, in which public responsibilities for the assumption of costs are shifted from one level and actor to the other, thus preventing sustainable solutions being achieved. A mix of qualitative methods including the evaluation of official documents, reports and secondary literature, and of 23 expert interviews was used. Findings: The financing of language mediation is a perfect example of the “shunting yard” phenomenon, with responsibilities being shifted between federal government, health insurance bodies and the municipalities in Germany. This paper argues that the specific financing structure in the German federal system can be viewed as a reason for the non-solution of the language barrier that hinders refugees’ access to health care. Originality/value: The problem of the financing of language mediation in the context of health care has been rarely treated from a social sciences perspective. This paper contributes to addressing this gap.
Measuring physicians’ religious competence in clinical health communication context: female Muslim immigrant patients’ expectations
Purpose: This exploratory study aims to examine female Muslim immigrant patients’ expectations of physicians’ religious competence during clinical interactions. Design/methodology/approach: In total, 101 female Muslim immigrants in Ottawa, Canada, completed an eight-item survey measuring patients’ expectations of physicians’ religious competence during clinical communication. Findings: Results from the independent samples t-tests and one-way ANOVA suggested that female Muslim immigrant patients in this study expected their doctors to be aware of Islam as a religion and be sensitive to their religious needs, especially food/dietary practices during clinical communication. Although the participants did not differ in their expectations of physicians’ religious competence based on age, educational level, employment status and income level, they differed based on their frequencies of visiting doctors and their ethnic/cultural origin. Originality/value: This study fills a gap in the literature by advancing understanding of religious competence during clinical interactions from female Muslim immigrant patients’ perspective. The findings can contribute to developing religiously competent and accessible health-care services for religiously diverse populations.
Challenges of undocumented immigrants in Canada and the USA during the COVID-19 pandemic: a review
Purpose: Pandemics pose challenges to all groups of people and all aspects of human lives. Undocumented migrants are likely to face more challenges during global pandemics. The purpose of this paper is to explore the possible challenges of undocumented immigrants in Canada and the USA in the ongoing COVID-19 pandemic. Design/methodology/approach: From existing literature, the authors examined the challenges of undocumented migrants in Canada and the USA and suggested recommendations to address those challenges at both policy and national levels. Findings: The undocumented status of some international immigrants makes them vulnerable in their host nations. They face myriad challenges in their host countries, spanning from economic, health, social isolation and employment challenges, and these are further exacerbated during pandemics such as the ongoing COVID-19. The provision of culturally sensitive and safe policies may support this particular population, especially in times of crisis like the COVID-19 pandemic. Originality/value: This paper provides critical insights into the possible intersections that worsen the vulnerability of undocumented migrants in pandemic crises like COVID-19. Further, this review serves to initiate the discourse on policy and interventions for undocumented immigrants during pandemics or disease outbreaks.
Patient-reported experiences in primary health care access of Nepalese immigrant women in Canada
Purpose: Canada has a globally recognized universal health-care system. However, immigrants experience a number of obstacles in obtaining primary health care (PHC) that may differ within various communities due to the intersection of culture, gender and other identities. To date, no research has been done on the difficulties Nepalese immigrant women in Canada may face accessing PHC. The purpose of this study was to learn about their perceptions of barriers to PHC access and to share the findings with a wide range of stakeholders, including health-care providers and policymakers. Design/methodology/approach: The authors conducted a community-engaged qualitative study in Calgary, Alberta, Canada. A total of six focus group discussions (FGD) among 34 participants (each FGD consisted of 5–7 participants) were conducted. The authors collected demographic information before each focus group. The FGDs were audio recorded and transcribed verbatim. The transcriptions were coded and analysed thematically. Findings: The focus groups identified long wait times as a major barrier to receiving PHC services. Long wait times in emergency rooms, unable to see family doctors when they were sick, tedious referral procedures, long waits at the clinic even after scheduling an appointment, family responsibilities and work all impacted their access to PHC. Further, a lack of proficiency in English was another significant barrier that impeded effective communication between physicians and immigrant women patients, thus compromising the quality of care. Other barriers mentioned included lack of access to medical records for walk-in doctors, insufficient lab/diagnostic services, a lack of urgent care services and unfamiliarity with the Canadian health-care system. Originality/value: Accessible PHC is essential for the health of immigrant populations in Canada. This study recognizes the extent of the barriers among a relatively less studied immigrant population group, Nepalese immigrant women, which will help effectively shape public policy and improve access to PHC for the versatile immigrant population fabric in Canada.
Determinants of mental disorders of Afghan migrants during the COVID-19 pandemic
Purpose: Afghan migrants are at an increased risk of mental disorders due to various political, economic and security-associated stressors. COVID-19 has brought extra concerns for this group of migrants around the world. Few studies have examined how the perception of the host society and perceived stress are associated with the mental health of migrants during the COVD-19 pandemic. This study aims to examine the role of perceived justice, freedom and the burden of COVID-19 on experienced stress and depression among Afghan migrants in Iran. Design/methodology/approach: N = 497 participants representing the Afghan migrant community between 15 and 80 years old participated in the study. The target population was recruited from Afghan migrants residing in Kerman city in Iran, the capital of one of the provinces with the highest number of Afghan migrants in Iran. The participants answered questions on depression, positive mental health and a series of stressors such as perceived justice, freedom and the burden of COVID-19. Data was collected in November and December 2021 during the third wave of the COVID-19 pandemic in Iran. Findings: The authors found a significant effect of the burden of the COVID-19 pandemic on migrants’ perceived stress and depression. On the other hand, perceptions of justice and freedom in the host country can significantly reduce stress and depression. The results show that stress mediates the effect of justice, freedom and the burden of COVID-19 on depression. In addition, positive mental health moderates the impact of stress on depression. Originality/value: The current study is one of the pioneering studies that examines the determinants of Afghan migrants’ mental disorders during the COVID-19 pandemic in Iran.
Provision of health-related information for immigrant patrons in public libraries in a large US city
Purpose: Public libraries can help immigrants adjust to life in the USA, including maintaining health and well-being. The purpose of this study was to understand how immigrants use public libraries and how library staff provide health-related information and services for immigrant audiences. Design/methodology/approach: This study used semistructured interviews with library staff (n = 9) and immigrant library patrons (n = 10), representing multiple first languages and countries of origin from two different library locations within a large public library system in a US mid-Atlantic city. Findings: Staff reported offering many health-related programs and services, but only one of the 10 patron respondents had used them. Patrons more commonly used the library in ways indirectly related to health (e.g. learning English) than direct health-related services. Staff reported comfort interacting with immigrant patrons, but lacked consensus on navigating language barriers and determining community needs. Research limitations/implications: This qualitative study provides insights from a specific geographic and cultural setting. It focused on immigrants using the library and may have excluded vulnerable populations of immigrants who encounter barriers to using the library. Future research and practice should focus on how public libraries can better meet the health information needs of immigrant populations, including navigating controversial social and political topics, as well as emerging health-related information during a pandemic. Originality/value: Public health practitioners often overlook public libraries as community collaborators. This research identifies that while there is important and essential work happening in public libraries to improve immigrant health, more can be done, especially in collaboration with public health professionals.
“Basically, everything needs to be adapted”: provider perceptions of challenges and recommendations for effective health care with Karen people
Purpose: Karen people from Burma are a new population in resettlement countries. While research increasingly documents their health needs, few studies describe how health-care providers adapt their practices to serve this group. The purpose of this study was to explore the experiences of providers who work with Karen patients/clients in health settings, documenting the challenges they face, how they adapt their practice and recommendations. Design/methodology/approach: This study used a qualitative survey and one phone interview with a total of 20 providers who had first-hand experience caring for Karen people in health settings. Data were analyzed using qualitative content analysis. Findings: Two main categories described challenges providers faced in working with Karen people in health settings: system-level challenges and interpersonal communication challenges. Five main categories described specific strategies and support needed to adapt practice for Karen patients in health settings: strategies for improving communication and mutual understanding; partnering with Karen staff, interpreters and cultural brokers; strategies for building trust and rapport; addressing needs related to case management, care coordination and social determinants of health; recommendations for provider training. Originality/value: This paper contributes suggestions for adapting practice to meet the health needs of Karen people from the perspective of health-care providers in a location that is nationally recognized for its excellence in refugee health.
“Let’s manage the stressor today” exploring the mental health response to forced migrants in Johannesburg, South Africa
Purpose: In South Africa, the majority of the population struggles to access care and support for mental health challenges. Drawing on challenges faced by asylum seekers and refugees in the urban margins of Johannesburg, this paper aims to explore the relationship between migration and mental health through a lens of heightened vulnerability, precarious urban spaces and unmet basic needs. Design/methodology/approach: Remote interviews were conducted with respondents working in the mental health-care sector (public and private) and with migrant communities in Johannesburg. Respondents were identified via purposive sampling and interviews were conducted in English. Key findings were identified using thematic analysis. Findings: Effective responses to asylum seekers and refugees facing mental health challenges are based on an understanding of context, of crisis and of the need to meet basic needs such as paying rent, finding employment and providing for families. These “daily stressors” not only compound “extreme traumatisation” but are a form of trauma in and of itself. Originality/value: This paper shows how alternative responses determined by an understanding of context, of crisis and of the need to meet basic needs provide critical and potentially far-reaching interventions. Locating trauma in the unmet needs, precarious urban spaces and marginalisation opens up space to further question the ways that migration and mental health shape and reshape one another.