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Van Hout MC, Madroumi R, Andrews MD, Arnold R, Hope VD, Taegtmeyer M. The nexus of immigration regulation and health governance: a scoping review of the extent to which right to access healthcare by migrants, refugees and asylum seekers was upheld in the United Kingdom during COVID-19. Public Health 2024; 232:21-29. [PMID: 38728905 DOI: 10.1016/j.puhe.2024.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 03/08/2024] [Accepted: 04/05/2024] [Indexed: 05/12/2024]
Abstract
OBJECTIVES Complementing the well-established evidence base on health inequalities experienced by migrants, refugees and asylum seekers in the UK; we examined the extent to which their right to equal non-discriminatory access to health services (promotive, preventive, curative) was upheld during the COVID-19 pandemic. STUDY DESIGN Arksey and O'Malley's scoping review framework. METHODS A comprehensive search was conducted on Medline, PubMed, and CINAHL using detailed MESH terms, for literature published between 01 January 2020 and 01 January 2024. The process was supported by a ten-page Google search and hand searching of reference lists. 42 records meeting the inclusion criteria were charted, coded inductively and analysed thematically in an integrated team-based approach. RESULTS Dissonance between immigration regulation and health governance is illustrated in four themes: Health systems leveraged to (re)enforce the hostile environment; Dissonance between health rights on paper and in practice; Structural failures to overcome communication and digital exclusion; and COVID-19 vaccine (in)equity exacerbated fear, mistrust and exclusion. Migrants, refugees and asylum seekers encountered substantial individual, structural and policy-level barriers to accessing healthcare in the UK during COVID-19. Insecure immigration status, institutional mistrust, data-sharing and charging fears, communication challenges and digital exclusion impacted heavily on their ability to access healthcare in an equitable non-discriminatory manner. CONCLUSIONS An inclusive and innovative health equity and rights-based responses reaching all migrants, refugees and asylum seekers are warranted if the National Health Service is to live up to its promise of 'leaving no one behind' in post-pandemic and future responses.
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Affiliation(s)
- M C Van Hout
- School of Public and Allied Health, Faculty of Health, Liverpool John Moores University, UK.
| | - R Madroumi
- School of Psychology, Faculty of Health, Liverpool John Moores University, UK.
| | - M D Andrews
- Department of Clinical Sciences, Faculty of Clinical Sciences and International Public Health, Liverpool School of Tropical Medicine, UK.
| | - R Arnold
- Department of Public Health, Policy and Systems, Institute of Population Health, University of Liverpool, UK.
| | - V D Hope
- School of Public and Allied Health, Faculty of Health, Liverpool John Moores University, UK.
| | - M Taegtmeyer
- Department of Clinical Sciences, Faculty of Clinical Sciences and International Public Health, Liverpool School of Tropical Medicine, UK.
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2
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Miles S, Renedo A, Kühlbrandt C, McGowan C, Stuart R, Grenfell P, Marston C. Health risks at work mean risks at home: Spatial aspects of COVID-19 among migrant workers in precarious jobs in England. SOCIOLOGY OF HEALTH & ILLNESS 2024; 46:381-398. [PMID: 37728181 DOI: 10.1111/1467-9566.13711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 08/11/2023] [Indexed: 09/21/2023]
Abstract
During COVID-19 lockdowns in England, 'key workers' including factory workers, carers and cleaners had to continue to travel to workplaces. Those in key worker jobs were often from more marginalised communities, including migrant workers in precarious employment. Recognising space as materially and socially produced, this qualitative study explores migrant workers' experiences of navigating COVID-19 risks at work and its impacts on their home spaces. Migrant workers in precarious employment often described workplace COVID-19 protection measures as inadequate. They experienced work space COVID-19 risks as extending far beyond physical work boundaries. They developed their own protection measures to try to avoid infection and to keep the virus away from family members. Their protection measures included disinfecting uniforms, restricting leisure activities and physically separating themselves from their families. Inadequate workplace COVID-19 protection measures limited workers' ability to reduce risks. In future outbreaks, support for workers in precarious jobs should include free testing, paid sick leave and accommodation to allow for self-isolation to help reduce risks to workers' families. Work environments should not be viewed as discrete risk spaces when planning response measures; responses and risk reduction approaches must also take into account impacts on workers' lives beyond the workplace.
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Affiliation(s)
- Sam Miles
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
- Barts & The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Alicia Renedo
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Charlotte Kühlbrandt
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Catherine McGowan
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Rachel Stuart
- College of Business, Arts and Social Sciences, Brunel University London, London, UK
| | - Pippa Grenfell
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Cicely Marston
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
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3
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Sevik I, Ciceklioglu M. Healthcare Access Worsened for Women in Precarious Housing During the COVID-19 Pandemic: A Qualitative Study. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2024; 61:469580241246478. [PMID: 38602064 PMCID: PMC11008088 DOI: 10.1177/00469580241246478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 03/21/2024] [Accepted: 03/22/2024] [Indexed: 04/12/2024]
Abstract
This research aims to gain an in-depth understanding of precariously housed women's experiences related to health and access to health care during the COVID-19 pandemic using a grounded theory approach. Qualitative data were obtained through interviews with 17 precariously housed women from Izmir, Turkey. Poor health among most participants was primarily attributed to unfavorable living conditions and weakened community networks. The COVID-19 pandemic exacerbated existing health issues due to barriers in accessing basic needs. Food insecurity was widespread during the pandemic and the critical role of aid and the inadequacy of social assistance in securing food were emphasized. Women's health perceptions were significantly shaped by gender, and gendered caregiving duties have restricted women's healthcare access. Access to healthcare was also limited by financial challenges, with health insurance being a crucial determinant. Longer waiting times, often exacerbated by the appointment system, and language were significant barriers to healthcare access. The findings propose that the participants were precarized by the blindness of COVID-19 measures to vulnerabilities, which resulted in deeper inequalities in housing, food, employment, and healthcare access. This research addresses the political, commercial, and social determinants of precariously housed women's health. Improving precariously housed women's health and wellbeing requires implementation of public policies targeting to improve housing quality, provide targeted assistance to food insecurity, promote gender inclusiveness, and foster gender empowerment.
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Affiliation(s)
- Irem Sevik
- Department of Public Health, Ege University Medical Faculty, Izmir, Turkey
| | - Meltem Ciceklioglu
- Department of Public Health, Ege University Medical Faculty, Izmir, Turkey
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4
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Bozorgmehr K, McKee M, Azzopardi-Muscat N, Bartovic J, Campos-Matos I, Gerganova TI, Hannigan A, Janković J, Kállayová D, Kaplan J, Kayi I, Kondilis E, Lundberg L, Mata IDL, Medarević A, Suvada J, Wickramage K, Puthoopparambil SJ. Integration of migrant and refugee data in health information systems in Europe: advancing evidence, policy and practice. THE LANCET REGIONAL HEALTH. EUROPE 2023; 34:100744. [PMID: 37927430 PMCID: PMC10625017 DOI: 10.1016/j.lanepe.2023.100744] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 08/29/2023] [Accepted: 09/19/2023] [Indexed: 11/07/2023]
Abstract
Coverage of migrant and refugee data is incomplete and of insufficient quality in European health information systems. This is not because we lack the knowledge or technology. Rather, it is due to various political factors at local, national and European levels, which hinder the implementation of existing knowledge and guidelines. This reflects the low political priority given to the topic, and also complex governance challenges associated with migration and displacement. We review recent evidence, guidelines, and policies to propose four approaches that will advance science, policy, and practice. First, we call for strategies that ensure that data is collected, analyzed and disseminated systematically. Second, we propose methods to safeguard privacy while combining data from multiple sources. Third, we set out how to enable survey methods that take account of the groups' diversity. Fourth, we emphasize the need to engage migrants and refugees in decisions about their own health data. Based on these approaches, we propose a change management approach that narrows the gap between knowledge and action to create healthcare policies and practices that are truly inclusive of migrants and refugees. We thereby offer an agenda that will better serve public health needs, including those of migrants and refugees and advance equity in European health systems. Funding No specific funding received.
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Affiliation(s)
- Kayvan Bozorgmehr
- Department of Population Medicine & Health Services Research, School of Public Health, Bielefeld University, Bielefeld, Germany
- Section Health Equity Studies & Migration, University Hospital Heidelberg, Heidelberg, Germany
- Lancet Migration European Hub
| | - Martin McKee
- European Observatory on Health Systems and Policies, London, UK
- London School of Medicine & Tropical Hygiene, London, UK
| | | | | | - Ines Campos-Matos
- Office for Health Improvement and Disparities, Department of Health and Social Care, London, UK
| | | | - Ailish Hannigan
- WHO Collaborating Centre for Migrant’s Involvement in Health Research, School of Medicine, University of Limerick, Limerick, Ireland
| | | | - Daniela Kállayová
- Lancet Migration European Hub
- Department of Public Health, Screening and Prevention, Ministry of Health, Slovak Republic
- Trnava University, Trnava, Slovak Republic
| | - Josiah Kaplan
- UNICEF Global Office of Research and Foresight, Florence, Italy
| | - Ilker Kayi
- Department of Public Health, School of Medicine, Koç University, Istanbul, Türkiye
| | - Elias Kondilis
- Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Lene Lundberg
- Lancet Migration European Hub
- Norwegian Centre for E-health Research, Tromsø, Norway
| | | | - Aleksandar Medarević
- Institute of Public Health of Serbia 'Dr Milan Jovanovic Batut', Belgrade, Serbia
| | - Jozef Suvada
- St. Elizabeth University of Public Health and Social Work, Slovak Republic
- WHO Collaborating Centre for Infectious Diseases, Research Methods and Recommendations, and McMaster GRADE Centre, Department of Health Research Methods, Evidence and Impact, McMaster University, Canada
| | - Kolitha Wickramage
- UN Migration Agency Global Data Institute, Migration Health Division, International Organization for Migration, Berlin, Germany
| | - Soorej Jose Puthoopparambil
- WHO Collaborating Centre on Migration and Health Data and Evidence, Global Health and Migration Unit, Department of Women’s and Children’s Health, Uppsala University, Sweden
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Li L, Taeihagh A, Tan SY. A scoping review of the impacts of COVID-19 physical distancing measures on vulnerable population groups. Nat Commun 2023; 14:599. [PMID: 36737447 PMCID: PMC9897623 DOI: 10.1038/s41467-023-36267-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 01/23/2023] [Indexed: 02/05/2023] Open
Abstract
Most governments have enacted physical or social distancing measures to control COVID-19 transmission. Yet little is known about the socio-economic trade-offs of these measures, especially for vulnerable populations, who are exposed to increased risks and are susceptible to adverse health outcomes. To examine the impacts of physical distancing measures on the most vulnerable in society, this scoping review screened 39,816 records and synthesised results from 265 studies worldwide documenting the negative impacts of physical distancing on older people, children/students, low-income populations, migrant workers, people in prison, people with disabilities, sex workers, victims of domestic violence, refugees, ethnic minorities, and people from sexual and gender minorities. We show that prolonged loneliness, mental distress, unemployment, income loss, food insecurity, widened inequality and disruption of access to social support and health services were unintended consequences of physical distancing that impacted these vulnerable groups and highlight that physical distancing measures exacerbated the vulnerabilities of different vulnerable populations.
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Affiliation(s)
- Lili Li
- Policy Systems Group, Lee Kuan Yew School of Public Policy, National University of Singapore, Singapore, Singapore
| | - Araz Taeihagh
- Policy Systems Group, Lee Kuan Yew School of Public Policy, National University of Singapore, Singapore, Singapore.
| | - Si Ying Tan
- Alexandra Research Centre for Healthcare in The Virtual Environment (ARCHIVE), Department of Healthcare Redesign, Alexandra Hospital, National University Health System, Singapore, Singapore
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Moffat M, Nicholson S, Darke J, Brown M, Minto S, Sowden S, Rankin J. A Qualitative Evaluation of a Health Access Card for Refugees and Asylum Seekers in a City in Northern England. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1429. [PMID: 36674184 PMCID: PMC9859311 DOI: 10.3390/ijerph20021429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 01/03/2023] [Accepted: 01/10/2023] [Indexed: 06/17/2023]
Abstract
Refugees and asylum seekers residing in the UK face multiple barriers to accessing healthcare. A Health Access Card information resource was launched in Newcastle upon Tyne in 2019 by Newcastle City Council, intended to guide refugees and asylum seekers living in the city, and the professional organisations that support them, to appropriate healthcare services provided locally. The aim of this qualitative evaluation was to explore service user and professional experiences of healthcare access and utilisation in Newcastle and perspectives on the Health Access Card. Eleven semi-structured interviews took place between February 2020 and March 2021. Participants provided diverse and compelling accounts of healthcare experiences and described cultural, financial and institutional barriers to care. Opportunities to improve healthcare access for these population groups included offering more bespoke support, additional language support, delivering training and education to healthcare professionals and reviewing the local support landscape to maximise the impact of collaboration and cross-sector working. Opportunities to improve the Health Access Card were also described, and these included providing translated versions and exploring the possibility of developing an accompanying digital resource.
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Affiliation(s)
- Malcolm Moffat
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4AX, UK
| | - Suzanne Nicholson
- Newcastle City Council, Public Health Team, Civic Centre, Newcastle upon Tyne NE1 8QH, UK
| | - Joanne Darke
- UK Health Security Agency North East, Health Protection Team, Civic Centre, Newcastle upon Tyne NE1 8QH, UK
| | - Melissa Brown
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4AX, UK
| | - Stephen Minto
- Northumbria Healthcare NHS Foundation Trust, One-to-One Centre Shiremoor, Brenkley Avenue, Shiremoor, Newcastle upon Tyne NE27 0PR, UK
| | - Sarah Sowden
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4AX, UK
| | - Judith Rankin
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4AX, UK
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Leung T, Greenhalgh T, Hughes G, Finlay T, Wherton J. Desperately Seeking Intersectionality in Digital Health Disparity Research: Narrative Review to Inform a Richer Theorization of Multiple Disadvantage. J Med Internet Res 2022; 24:e42358. [PMID: 36383632 PMCID: PMC9773024 DOI: 10.2196/42358] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 10/20/2022] [Accepted: 11/16/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Digital consultations between patients and clinicians increased markedly during the COVID-19 pandemic, raising questions about equity. OBJECTIVE This study aimed to review the literature on how multiple disadvantage-specifically, older age, lower socioeconomic status, and limited English proficiency-has been conceptualized, theorized, and studied empirically in relation to digital consultations. We focused mainly on video consultations as they have wider disparities than telephone consultations and relevant data on e-consultations are sparse. METHODS Using keyword and snowball searching, we identified relevant papers published between 2012 and 2022 using Ovid MEDLINE, Web of Science, Google Scholar, and PubMed. The first search was completed in July 2022. Papers meeting the inclusion criteria were analyzed thematically and summarized, and their key findings were tabulated using the Grading of Recommendations Assessment, Development, and Evaluation Confidence in the Evidence from Reviews of Qualitative Research criteria. Explanations for digital disparities were critically examined, and a search was undertaken in October 2022 to identify theoretical lenses on multiple disadvantage. RESULTS Of 663 articles from the initial search, 27 (4.1%) met our inclusion criteria. In total, 37% (10/27) were commentaries, and 63% (17/27) were peer-reviewed empirical studies (11/27, 41% quantitative; 5/27, 19% qualitative; 1/27, 4% mixed methods; 1/27, 4% systematic reviews; and 1/27, 4% narrative reviews). Empirical studies were mostly small, rapidly conducted, and briefly reported. Most studies (25/27, 93%) identified marked digital disparities but lacked a strong theoretical lens. Proposed solutions focused on identifying and removing barriers, but the authors generally overlooked the pervasive impact of multiple layers of disadvantage. The data set included no theoretically informed studies that examined how different dimensions of disadvantage combined to affect digital health disparities. In our subsequent search, we identified 3 theoretical approaches that might help account for these digital disparities. Fundamental cause theory by Link and Phelan addresses why the association between socioeconomic status and health is pervasive and persists over time. Digital capital theory by Ragnedda and Ruiu explains how people mobilize resources to participate in digitally mediated activities and services. Intersectionality theory by Crenshaw states that systems of oppression are inherently bound together, creating singular social experiences for people who bear the force of multiple adverse social structures. CONCLUSIONS A limitation of our initial sample was the sparse and undertheorized nature of the primary literature. The lack of attention to how digital health disparities emerge and play out both within and across categories of disadvantage means that solutions proposed to date may be oversimplistic and insufficient. Theories of multiple disadvantage have bearing on digital health, and there may be others of relevance besides those discussed in this paper. We call for greater interdisciplinary dialogue between theoretical research on multiple disadvantage and empirical studies on digital health disparities.
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Affiliation(s)
| | - Trisha Greenhalgh
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Gemma Hughes
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Teresa Finlay
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Joseph Wherton
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
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8
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Khai TS, Asaduzzaman M. 'I Doubt Myself and Am Losing Everything I Have since COVID Came'-A Case Study of Mental Health and Coping Strategies among Undocumented Myanmar Migrant Workers in Thailand. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15022. [PMID: 36429741 PMCID: PMC9690308 DOI: 10.3390/ijerph192215022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 11/07/2022] [Accepted: 11/11/2022] [Indexed: 06/16/2023]
Abstract
Migrant populations have always been vulnerable to a high burden of social exclusion, mental disorders, physical illnesses, and economic crises. The current COVID-19 pandemic has further created a frantic plight among them, particularly for undocumented migrant workers in the global south. We have conducted a mixed method study among the undocumented Myanmar migrant workers (UMMWs) in Thailand to explore how the COVID-19 disruption has impacted their mental health and what coping strategies they have adopted. Following the onset of COVID-19 and the recent coup d'état in Myanmar, our current study is the first attempt to understand the mental health status and predicament of this neglected migrant group. A total of 398 UMMWs were included in the online survey, of which 23 participated in qualitative interviews. The major mental health issues reported by the study participants were depression, generalized anxiety disorder, frustration, stress, and panic disorders, while loss of employment, worries about the pandemic, social stigma, lack of access to healthcare, lockdown, and fear of detention were the predominant contributing factors. In response, we identified two key coping mechanisms: coping at a personal level (listening to music, playing online game, praying, and self-motivation) and coping at a social level (chatting with family and friends and visiting religious institutions). These findings point to the importance of policy and intervention programs aimed at upholding mental health at such humanitarian conditions. Sustainable institutional mental health care support and social integration for the migrant workers, irrespective of their legal status, should be ensured.
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Affiliation(s)
- Tual Sawn Khai
- Sociology and Social Policy, School of Graduate Studies, Lingnan University, Hong Kong, China
| | - Muhammad Asaduzzaman
- Department of Community Medicine and Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, 450 Oslo, Norway
- Planetary Health Working Group, Be-Cause Health, Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerp, Belgium
- Planetary Health Alliance, Boston, MA 02115, USA
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9
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Gama A, Marques MJ, Rocha JV, Azeredo-Lopes S, Kinaan W, Machado AS, Dias S. 'I Didn't Know Where to Go': A Mixed-Methods Approach to Explore Migrants' Perspectives of Access and Use of Health Services during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13201. [PMID: 36293781 PMCID: PMC9603706 DOI: 10.3390/ijerph192013201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 10/04/2022] [Accepted: 10/11/2022] [Indexed: 06/16/2023]
Abstract
The COVID-19 pandemic put pressure on health systems, affecting populations' use of health services, especially those experiencing increased difficulties in healthcare access, as some migrant groups. This study aimed to investigate access and use of health services during the COVID-19 pandemic among migrants in Portugal. A mixed-methods approach was used. A community-based cross-sectional survey was conducted involving migrant communities residing in the Lisbon Metropolitan Area. Analyses of a subsample of participants (n = 929) examined factors associated with perceived worsening of access to health services during the pandemic. Semi-structured interviews with 14 migrants were conducted and thematically analyzed to further understand experiences and difficulties in health services' use. Around 44% of surveyed participants reported worsening of access to health services since the pandemic, more frequently women, those with lower income, and those who perceived being at moderate or high risk for COVID-19 infection. Digital change in services and lack of formal and informal support during lockdowns were highlighted by interviewers as main barriers in access to healthcare for migrants. The pandemic renewed concerns about inequalities in healthcare access among migrants. It is key that in following years health systems are able to address the potential accumulated burden of disease.
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Affiliation(s)
- Ana Gama
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, 1600-560 Lisboa, Portugal
- Comprehensive Health Research Centre (CHRC), Universidade NOVA de Lisboa, 1169-056 Lisboa, Portugal
| | - Maria J. Marques
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, 1600-560 Lisboa, Portugal
- Comprehensive Health Research Centre (CHRC), Universidade NOVA de Lisboa, 1169-056 Lisboa, Portugal
| | - João Victor Rocha
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, 1600-560 Lisboa, Portugal
- Comprehensive Health Research Centre (CHRC), Universidade NOVA de Lisboa, 1169-056 Lisboa, Portugal
| | - Sofia Azeredo-Lopes
- Comprehensive Health Research Centre (CHRC), Universidade NOVA de Lisboa, 1169-056 Lisboa, Portugal
- Statistics and Operational Research Department, Sciences Faculty, University of Lisbon, 1749-016 Lisboa, Portugal
| | - Walaa Kinaan
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, 1600-560 Lisboa, Portugal
| | - Ana Sá Machado
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, 1600-560 Lisboa, Portugal
- Comprehensive Health Research Centre (CHRC), Universidade NOVA de Lisboa, 1169-056 Lisboa, Portugal
| | - Sónia Dias
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, 1600-560 Lisboa, Portugal
- Comprehensive Health Research Centre (CHRC), Universidade NOVA de Lisboa, 1169-056 Lisboa, Portugal
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10
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Burns R, Stevenson K, Miller A, Hargreaves S. Migrant-inclusive healthcare delivery in the UK: Lessons learned from the COVID-19 Pandemic. Lancet Reg Health Eur 2022; 21:100505. [PMID: 36091080 PMCID: PMC9450880 DOI: 10.1016/j.lanepe.2022.100505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Rachel Burns
- Research Fellow, Institute of Health Informatics, University College London, 222 Euston Road, London NW1 2DA, United Kingdom
- Corresponding author at: Institute of Health Informatics, University College London, 222 Euston Road, London NW1 2DA, United Kingdom.
| | - Kerrie Stevenson
- Migrant Health Lead, UK Faculty of Public Health
- NIHR Academic Public Health Doctor, Faculty of Public Health and Policy, LSHTM, 15-17 Tavistock Place, London WC1H 9SH, United Kingdom
| | - Anna Miller
- Head of Policy & Advocacy, Doctors of the World UK, 29, One Canada Square, London E14 5AA, United Kingdom
| | - Sally Hargreaves
- Associate Professor, Migrant Health Research Group, Institute for Infection and Immunity, St George's University of London, London SW17 0QT, United Kingdom
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11
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Scarlett H, Melchior M, Davisse-Paturet C, Aarbaoui TE, Longchamps C, Figueiredo N, Ducarroz S. Substance Use Among Residents of Homeless Shelters During the COVID-19 Pandemic: Findings From France. Int J Public Health 2022; 67:1604684. [PMID: 36090832 PMCID: PMC9452639 DOI: 10.3389/ijph.2022.1604684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 07/26/2022] [Indexed: 12/01/2022] Open
Abstract
Objectives: To record the prevalence and risk factors of substance use amongst homeless persons during the COVID-19 pandemic. Methods: The ECHO study consisted in two independent cross-sectional waves of data collection in the regions of Paris, Lyon, and Strasbourg during the Spring of 2020 (n = 530) and 2021 (n = 319). Factors associated with substance use were explored using generalised logistic regression models. Results: The most prevalent substance used was tobacco (38%–43%), followed by alcohol (26%–34%). The use of both substances positively associated with each other, although risk factors varied depending on the substance. The only factors consistently associated with alcohol and tobacco use were being male, exposure to theft/assault and participants’ region of origin. Whilst the rate of tobacco use was relatively stable between Spring 2020 and 2021, alcohol use was more common in 2021. Conclusion: These findings highlight a high prevalence of substance use amongst homeless persons. People experiencing homelessness face specific challenges in the context of the pandemic, alongside greater vulnerability to illness and low healthcare access, therefore the need to improve prevention and support services for substance abuse within this population is vital.
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Affiliation(s)
- Honor Scarlett
- Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Paris, France
- *Correspondence: Honor Scarlett, ; Simon Ducarroz,
| | - Maria Melchior
- Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Paris, France
- CNRS, Institut Convergences Migration, Aubervilliers, France
| | - Camille Davisse-Paturet
- Research on Healthcare Performance RESHAPE, INSERM U1290, Université Claude Bernard Lyon 1, Lyon, France
| | - Tarik El. Aarbaoui
- Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Paris, France
| | - Cécile Longchamps
- Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Paris, France
| | - Natasha Figueiredo
- Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Paris, France
| | - Simon Ducarroz
- Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Paris, France
- CNRS, Institut Convergences Migration, Aubervilliers, France
- *Correspondence: Honor Scarlett, ; Simon Ducarroz,
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