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Holm ME, Skogberg N, Kiviruusu O, Sainio P. Immigrant Origin and Disability Increase Risk for Anxiety Among Youth During COVID-19: The Role of Unmet Needs for Support in Distance Learning and Family Conflicts. J Adolesc Health 2024; 74:916-924. [PMID: 38323965 DOI: 10.1016/j.jadohealth.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 11/09/2023] [Accepted: 12/01/2023] [Indexed: 02/08/2024]
Abstract
PURPOSE Shifting to distance learning due to COVID-19 may decrease teacher support and increase family conflicts, potentially increasing anxiety. Nevertheless, there is scarce information on this topic among disability and/or immigrant-origin groups. Thus, we investigated whether these minority groups reported more anxiety than the reference group-Finnish-origin youth without disabilities-and whether unmet needs for support in distance learning and family conflicts mediated differences in anxiety during the pandemic. Differences in these mediators were also investigated. METHODS Population-based data of 165,033 youth aged 12 to 29 from the cross-sectional Finnish School Health Promotion study were obtained in 2021 using total population sampling. Logistic regressions with Stata were used to investigate the differences between the target (youth with disabilities, immigrant backgrounds, or both of these characteristics) and reference groups. The Karlson-Holm-Breen method was used to test for mediation. RESULTS The groups with disabilities (odds ratio [OR] = 4.14 [95% confidence interval (CI): 4.02-4.27]), immigrant backgrounds (OR = 1.15 [95% CI: 1.06-1.25]), or both of these characteristics (OR = 5.03 [95% CI: 4.59-5.52]) reported anxiety more often than the reference group. The difference between the minority and reference groups in unmet needs in distance learning and family conflicts were significant. Immigrant-origin youth with disabilities were most vulnerable to family conflicts, and the groups with disabilities were more prone to unmet needs. Unmet needs and family conflicts accounted for 28% of the association between immigrant-origin youth without disabilities and anxiety, whereas the mediating percentage was smaller for immigrant-origin youth with disabilities (13%) and Finnish-origin youth with disabilities (11%). DISCUSSION Immigrant-origin youth with disabilities need targeted support to prevent anxiety. Alleviating family conflicts and unmet needs in distance learning during crises could help decrease anxiety. Support for distance learning should be provided to youth with disabilities, regardless of their immigrant backgrounds.
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Affiliation(s)
- Marja Eliisa Holm
- Department of Public Health and Welfare, The Finnish Institute for Health and Welfare, Helsinki, Finland.
| | - Natalia Skogberg
- Department of Public Health and Welfare, The Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Olli Kiviruusu
- Department of Public Health and Welfare, The Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Päivi Sainio
- Department of Public Health and Welfare, The Finnish Institute for Health and Welfare, Helsinki, Finland
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Parviainen H, Kiviruusu O, Lämsä R, Skogberg N, Castaneda AE, Santalahti P. Psychiatric symptoms and the association with parents' psychiatric symptoms among recently arrived asylum-seeking children in Finland. Child Psychiatry Hum Dev 2023; 54:1699-1709. [PMID: 35587841 PMCID: PMC10582122 DOI: 10.1007/s10578-022-01371-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 03/11/2022] [Accepted: 04/19/2022] [Indexed: 11/29/2022]
Abstract
This study examined psychiatric symptoms and the association with parents' psychiatric symptoms among recently arrived accompanied asylum-seeking children in the age groups of 2-6 years (n = 93) and 7-12 years (n = 91). Children and parents were assessed using mental health and trauma measures (SDQ, HSCL-25 and PROTECT). The prevalence of total difficulties was 34.9% among 2-6-year-olds and 29.6% among 7-12-year-olds. The most common symptoms in both age groups were peer problems, followed by conduct problems among 2-6-year-olds and emotional symptoms among 7-12-year-olds. In both age groups, the children's emotional symptoms were associated with the parents' anxiety and depression as well as the trauma symptoms, while the conduct problems were only associated with the parents' trauma symptoms. In conclusion, peer problems as well as conduct problems and emotional symptoms are common among recently arrived asylum-seeking children. To support the mental health of these children, both children and parents need adequate support.
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Affiliation(s)
- Heidi Parviainen
- Department of Public Health, University of Turku, FI-20014, Turku, Finland.
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL), Helsinki, Finland.
| | - Olli Kiviruusu
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Riikka Lämsä
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Natalia Skogberg
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Anu E Castaneda
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Päivi Santalahti
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
- Department of Child Psychiatry, University of Turku, Turku, Finland
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Ruokolainen O, Lilja E, Ollila H, Castaneda AE, Koponen P, Skogberg N. Changes in smoking due to COVID-19 pandemic among persons of migrant origin compared with the general population: a population-based study. Scand J Public Health 2023:14034948231199792. [PMID: 37726894 DOI: 10.1177/14034948231199792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
AIMS Prior studies have implied that smokers may have changed their smoking behaviour during the COVID-19 pandemic. However, little is known about changes in smoking behaviour and correlates of change due to the pandemic among persons of migrant origin compared with the general population. METHODS Population-based cross-sectional studies with comparable study protocols and measures, one focusing on persons of migrant origin living in Finland (n = 3587, response rate 60%) and the other on the general Finnish population (n = 3444, response rate 56%), were utilised. The outcome measure was self-reported change in smoking behaviour due to COVID-19 among current smokers. Explanatory factors included sociodemographic-, health-, and COVID-19-related factors. Multinomial logistic regression was used in the analyses. RESULTS Most of the current smokers reported no change in their smoking behaviour. In the adjusted model, younger age was positively associated with increased smoking, while region of origin (Russia, Africa, Asia, and Latin America) and worrying about getting infected with COVID-19 were associated with decreased smoking among persons of migrant origin. In the general population, younger age, female sex, being other than employed/student, increased loneliness, and decreased contact with close ones were associated with increased smoking, while reduced working capacity and worries that someone close to the respondent will be infected with COVID-19 were associated with decreased smoking. CONCLUSIONS The findings of this study contribute to better identification of at-risk populations in future crises situations. This will allow for more efficient targeting and tailoring of health promotion services, including smoking cessation.
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Affiliation(s)
- Otto Ruokolainen
- Finnish Institute for Health and Welfare, Department of Public Health and Welfare, Helsinki, Finland
| | - Eero Lilja
- Finnish Institute for Health and Welfare, Department of Public Health and Welfare, Helsinki, Finland
| | - Hanna Ollila
- Finnish Institute for Health and Welfare, Department of Public Health and Welfare, Helsinki, Finland
| | - Anu E Castaneda
- Finnish Institute for Health and Welfare, Department of Public Health and Welfare, Helsinki, Finland
| | - Päivikki Koponen
- Finnish Institute for Health and Welfare, Department of Public Health and Welfare, Helsinki, Finland
| | - Natalia Skogberg
- Finnish Institute for Health and Welfare, Department of Public Health and Welfare, Helsinki, Finland
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Skogberg N, Prinkey T, Lilja E, Koponen P, Castaneda AE. Association of sociodemographic characteristics with self-perceived access to COVID-19 information and adherence to preventive measures among migrant origin and general populations in Finland: a cross-sectional study. BMJ Open 2023; 13:e069192. [PMID: 36914190 PMCID: PMC10015668 DOI: 10.1136/bmjopen-2022-069192] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/14/2023] Open
Abstract
OBJECTIVES This study examines how access to COVID-19 information and adherence to preventive measures varies by sociodemographic characteristics, and whether the associations differ among the migrant origin and the general Finnish population. Additionally, the association of perceived access to information with adherence to preventive measures is examined. DESIGN Cross-sectional, population-based random sample. BACKGROUND Equity in access to information is crucial for securing individual well-being and successful management of a crisis at population level. SETTING Persons who have a residence permit in Finland. PARTICIPANTS Migrant origin population constituted of persons aged 21-66 years born abroad, who took part in the Impact of the Coronavirus on the Wellbeing of the Foreign Born Population (MigCOVID) Survey conducted from October 2020 to February 2021 (n=3611). Participants in the FinHealth 2017 Follow-up Survey conducted within the same time frame, representing the general Finnish population, constituted the reference group (n=3490). OUTCOME MEASURES Self-perceived access to COVID-19 information, adherence to preventive measures. RESULTS Self-perceived access to information and adherence to preventive measures was overall high both among the migrant origin and the general population. Perceived adequate access to information was associated with living in Finland for 12 years or longer (OR 1.94, 95% CI 1.05-3.57) and excellent Finnish/Swedish language skills (OR 2.71, 95% CI 1.62-4.53) among the migrant origin population and with higher education (OR 3.56, 95% CI 1.49-8.55 for tertiary and OR 2.87, 95% CI 1.25-6.59 for secondary) among the general population. The association between examined sociodemographic characteristics with adherence to preventive measures varied by study group. CONCLUSIONS Findings on the association of perceived access to information with language proficiency in official languages highlight the need for rapid multilingual and simple language crisis communications. Findings also suggest that crisis communications and measures designed to influence health behaviours at population level may not be directly transferable if the aim is to influence health behaviours also among ethnically and culturally diverse populations.
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Affiliation(s)
- Natalia Skogberg
- Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Tyler Prinkey
- Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Eero Lilja
- Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Päivikki Koponen
- Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Anu E Castaneda
- Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
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Bastola K, Nohynek H, Lilja E, Castaneda AE, Austero S, Kuusio H, Skogberg N. Incidence of SARS-CoV-2 Infection and Factors Associated With Complete COVID-19 Vaccine Uptake Among Migrant Origin Persons in Finland. Int J Public Health 2023; 68:1605547. [PMID: 37206095 PMCID: PMC10189547 DOI: 10.3389/ijph.2023.1605547] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 04/20/2023] [Indexed: 05/21/2023] Open
Abstract
Objective: We examined incidence of SARS-CoV-2 infection, COVID-19 vaccine uptake and factors associated with complete COVID-19 vaccine uptake among persons of migrant origin in Finland. Methods: Data on laboratory-confirmed SARS-CoV-2 infection and COVID-19 vaccine doses between March 2020 and November 2021 were linked to FinMonik register sample (n = 13,223) and MigCOVID (n = 3,668) survey data using unique personal identifier. Logistic regression was the main method of analyses. Results: Among FinMonik sample, complete COVID-19 vaccine uptake was lower among persons of Russia/former Soviet Union, Estonia, and rest of Africa and higher among persons of Southeast Asia, rest of Asia, and the Middle East/North Africa than among persons originating from Europe/North America/Oceania. Male sex, younger age, migration age (<18 years) and shorter length of residence were associated with lower vaccine uptake among FinMonik sample, whereas younger age, being economically inactive, poorer language skills, experiences of discrimination and psychological distress were associated with lower vaccine uptake among MigCOVID sub-sample. Conclusion: Our Findings point to a further need of tailored and targeted communication and community outreach strategies to increase vaccine uptake among persons of migrant origin.
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García-Velázquez R, Kieseppä V, Lilja E, Koponen P, Skogberg N, Kuusio H. A multisource approach to health care use: concordance between register and self-reported physician visits in the foreign-born population in Finland. BMC Med Res Methodol 2022; 22:309. [PMID: 36460964 PMCID: PMC9717412 DOI: 10.1186/s12874-022-01780-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 10/31/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Reliable information on the use of health services is important for health care planning, monitoring and policy. It is critical to assess the validity of the sources used for this purpose, including register and survey-based data. Studies on foreign-born populations' health care use have usually implemented either survey or register data. The concordance of such data among groups of different cultural background remains largely unknown. In this study, we presented an approach to examine routinely how survey and register-related characteristics may explain disagreement found between the two information sources. METHODS We linked register- and survey-based data pertaining to the Finnish Register of Primary Health Care general physician visits and the Survey on Well-Being among Foreign Born Population (FinMonik, 2018-2019), a nationally representative survey. The sample comprised n = 5,800 informants for whom registered general physician visits were tracked in the 12-month period preceding their participation in the survey. Cohen's kappa was used as measure of multisource concordance, hierarchical loglinear models for the association between single predictors and multisource discrepancy, and a logistic regression model for examining source-related predictors of source discrepancy. Survey weights were used in all sample analyses. RESULTS Source concordance was poor. When dichotomizing general physician visits (zero vs one or more), 35% of informants had reported one or more visits while none were found from register. Both register- and informant-related predictors were associated to this discrepancy (i.e. catchment area, private health care use, inability to work, region of origin and reason for migration). CONCLUSIONS We found high discrepancy between the reported and the registered physician visits among the foreign-born population in Finland, with a particularly high number of reported physician visits when none were found in the register. There was a strong association between the specific catchment area and mismatch, indicating that both register under-coverage and survey over-report are plausible and may coexist behind the discrepancy. However, associations of informant's characteristics and mismatch were less pronounced. Implications on the validity of medical information sources are discussed.
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Affiliation(s)
- Regina García-Velázquez
- grid.14758.3f0000 0001 1013 0499Finnish Institute for Health and Welfare, Mannerheimintie 166, PL/PB/P.O. Box 30, FI-00271 Helsinki, Finland
| | - Valentina Kieseppä
- grid.14758.3f0000 0001 1013 0499Finnish Institute for Health and Welfare, Mannerheimintie 166, PL/PB/P.O. Box 30, FI-00271 Helsinki, Finland
| | - Eero Lilja
- grid.14758.3f0000 0001 1013 0499Finnish Institute for Health and Welfare, Mannerheimintie 166, PL/PB/P.O. Box 30, FI-00271 Helsinki, Finland
| | - Päivikki Koponen
- grid.14758.3f0000 0001 1013 0499Finnish Institute for Health and Welfare, Mannerheimintie 166, PL/PB/P.O. Box 30, FI-00271 Helsinki, Finland
| | - Natalia Skogberg
- grid.14758.3f0000 0001 1013 0499Finnish Institute for Health and Welfare, Mannerheimintie 166, PL/PB/P.O. Box 30, FI-00271 Helsinki, Finland
| | - Hannamaria Kuusio
- grid.14758.3f0000 0001 1013 0499Finnish Institute for Health and Welfare, Mannerheimintie 166, PL/PB/P.O. Box 30, FI-00271 Helsinki, Finland
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Skogberg N, Castaneda AE, Agyemang C, Koponen P, Lilja E, Laatikainen T. The association of depressive and anxiety symptoms with the metabolic syndrome and its components among Russian, Somali, and Kurdish origin adults in Finland: A population-based study. J Psychosom Res 2022; 159:110944. [PMID: 35605441 DOI: 10.1016/j.jpsychores.2022.110944] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 03/30/2022] [Accepted: 05/10/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Positive association of depressive and anxiety symptoms with the metabolic syndrome (MetS) have been reported, however there is little information on these among migrant origin populations. The aim of this study was to examine these associations among diverse migrant origin populations in Finland. METHODS Data of 318 Russian, 212 Somali, and 321 Kurdish origin participants in the cross-sectional Finnish Migrant Health and Wellbeing Study (Maamu) aged 30-64 years was used. The general population reference group constituted of 786 Health 2011 Survey participants. Depressive and anxiety symptoms were measured with HSCL-25 subscales. Harmonized definition of MetS was used. RESULTS Depressive symptoms were associated with elevated blood pressure in Kurdish origin (30.1%, 95% CI 22.7-38.8 vs. 19.9%, 95%CI 15.4-25.4 for those with and without symptoms respectively); and elevated waist circumference (72.1%, 95%CI 56.9-83.5 vs. 55.0%, 95%CI 50.6-59.4) and triglycerides (30.8%, 95%CI 16.0-51.0 vs. 11.9%, 95%CI 9.3-15.0) in general population. Anxiety symptoms were associated with MetS (47.0%, 95%CI 37.6-56.7 vs. 31.9%, 95%CI 26.7-37.6) and elevated blood pressure (37.2%, 95%CI 28.3-46.9 vs. 18.8%, 95%CI 14.7-23.6), and with elevated triglycerides in Somali origin (33.0%, 95%CI 14.5-59.0 vs. 5.7%, 95%CI 3.3-9.6) and general population (30.2%, 95%CI 16.4-48.8, 12.8%, 95%CI 9.9-16.2). No associations between low HDL-cholesterol and depressive or anxiety symptoms were observed. CONCLUSION Cardiometabolic health should be taken into account in mental health services. Future studies should explore the underlying pathways to the observed differences in strengths of associations of depressive and anxiety symptoms with MetS and its components across diverse migrant origin populations.
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Affiliation(s)
- Natalia Skogberg
- Department of Public Health and Welfare, Finnish institute for Health and Welfare, Helsinki, Finland.
| | - Anu E Castaneda
- Department of Public Health and Welfare, Finnish institute for Health and Welfare, Helsinki, Finland
| | - Charles Agyemang
- Department of Public and Occupational Health, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Päivikki Koponen
- Department of Public Health and Welfare, Finnish institute for Health and Welfare, Helsinki, Finland
| | - Eero Lilja
- Department of Public Health and Welfare, Finnish institute for Health and Welfare, Helsinki, Finland
| | - Tiina Laatikainen
- Department of Public Health and Welfare, Finnish institute for Health and Welfare, Helsinki, Finland; Institute of Public Health and Clinical Nutrition, Kuopio, Finland; Joint municipal authority for social and health services (Siun sote), Joensuu, Finland
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Lohiniva AL, Sibenberg K, Austero S, Skogberg N. Social Listening to Enhance Access to Appropriate Pandemic Information Among Culturally Diverse Populations: Case Study From Finland. JMIR Infodemiology 2022; 2:e38343. [PMID: 37113448 PMCID: PMC10014086 DOI: 10.2196/38343] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 05/27/2022] [Accepted: 06/24/2022] [Indexed: 04/29/2023]
Abstract
Background Social listening, the process of monitoring and analyzing conversations to inform communication activities, is an essential component of infodemic management. It helps inform context-specific communication strategies that are culturally acceptable and appropriate for various subpopulations. Social listening is based on the notion that target audiences themselves can best define their own information needs and messages. Objective This study aimed to describe the development of systematic social listening training for crisis communication and community outreach during the COVID-19 pandemic through a series of web-based workshops and to report the experiences of the workshop participants implementing the projects. Methods A multidisciplinary team of experts developed a series of web-based training sessions for individuals responsible for community outreach or communication among linguistically diverse populations. The participants had no previous training in systematic data collection or monitoring. This training aimed to provide participants with sufficient knowledge and skills to develop a social listening system based on their specific needs and available resources. The workshop design took into consideration the pandemic context and focused on qualitative data collection. Information on the experiences of the participants in the training was gathered based on participant feedback and their assignments and through in-depth interviews with each team. Results A series of 6 web-based workshops was conducted between May and September 2021. The workshops followed a systematic approach to social listening and included listening to web-based and offline sources; rapid qualitative analysis and synthesis; and developing communication recommendations, messages, and products. Follow-up meetings were organized between the workshops during which participants could share their achievements and challenges. Approximately 67% (4/6) of the participating teams established social listening systems by the end of the training. The teams tailored the knowledge provided during the training to their specific needs. As a result, the social systems developed by the teams had slightly different structures, target audiences, and aims. All resulting social listening systems followed the taught key principles of systematic social listening to collect and analyze data and used these new insights for further development of communication strategies. Conclusions This paper describes an infodemic management system and workflow based on qualitative inquiry and adapted to local priorities and resources. The implementation of these projects resulted in content development for targeted risk communication, addressing linguistically diverse populations. These systems can be adapted for future epidemics and pandemics.
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Affiliation(s)
| | | | - Sara Austero
- Finnish Institute for Health and Welfare Helsinki Finland
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Bastola K, Koponen P, Skogberg N, Gissler M, Kinnunen TI. Hypertensive disorders of pregnancy among women of migrant origin in Finland: A population-based study. Acta Obstet Gynecol Scand 2021; 101:127-134. [PMID: 34761373 DOI: 10.1111/aogs.14291] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 10/24/2021] [Accepted: 10/27/2021] [Indexed: 01/18/2023]
Abstract
INTRODUCTION Hypertensive disorders of pregnancy are a leading cause of maternal and perinatal mortality and morbidity worldwide. We studied the prevalence of hypertensive disorders of pregnancy among women of migrant origin in Finland. MATERIAL AND METHODS This study used data from the nationwide Medical Birth Register. Information on the most recent singleton birth of women who delivered between 2004 and 2014 (n = 382 233) was included. Women were classified into nine regional categories based on the country of origin. Women of Finnish origin were the reference group. Generalized linear models adjusted for maternal age, socioeconomic position, smoking in pregnancy, parity, pre-pregnancy body mass index, preexisting diabetes and delivery year were used to study the association between region/country of origin and hypertensive disorders of pregnancy. RESULTS Among the study population, almost 8% were of migrant origin. The prevalence of hypertensive disorders of pregnancy varied from 1.3% (women of East Asian origin) to 4.2% (women of Sub-Saharan African origin), compared with 4.6% in the Finnish origin reference group. Compared with women of Finnish origin, the risk for any hypertensive disorders of pregnancy after adjustment for confounders was lower for women of migrant origin, with an exception for women of Sub-Saharan African origin. When analyzing gestational hypertension and preeclampsia outcomes separately, Sub-Saharan African origin women had a lower risk for gestational hypertension (risk ratio [RR] 0.41, 95% confidence interval [CI] 0.30-0.56) but a higher risk for preeclampsia (RR 1.77, 95% CI 1.44-2.17) than women of Finnish origin. CONCLUSIONS In general, women of migrant origin in Finland had a lower risk for any hypertensive disorders of pregnancy and gestational hypertension. The risk for preeclampsia was higher among women of Sub-Saharan African origin and may warrant special attention.
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Affiliation(s)
- Kalpana Bastola
- Unit of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Päivikki Koponen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Natalia Skogberg
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Mika Gissler
- Department of Information Services, Finnish Institute for Health and Welfare, Helsinki, Finland.,Region Stockholm, Academic Primary Health Care Centre, Stockholm, Sweden.,Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
| | - Tarja I Kinnunen
- Unit of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland
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Skogberg N, Kuusio H, Lilja E, Austero S, Castaneda AE. Access to services among migrant origin persons during COVID-19 pandemic: Finnish MigCOVID Survey. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Compared with the general population, migrant origin persons had more difficulties in access to services already prior to the COVID-19 pandemic. This study examines the impact of the pandemic on the need and access to healthcare and social services among persons of migrant origin.
Methods
Data from the population-based Impact of the Coronavirus on the Wellbeing of the Foreign Born Population (MigCOVID) Survey was used. The survey was conducted in Finland among persons aged 20 to 66 years (n = 3 668 participated in the survey, participation rate 60%) between October 2020 and February 2021 with electronic and postal questionnaires and telephone interviews. Logistic regression was applied to examine age and sex-adjusted prevalence and 95 % confidence intervals (CI) for self-reported need and sufficiency of services (physician, nurse, dentist, mental health services and family services).
Results
Healthcare and family services were needed by 69.2% (95% CI 66.3-72.0). Services provided by the physician, dentist and nurse were needed most frequently. Women (74.5%, 95% CI 70.6-78.1) were more likely to report the need for health and family services than men (64.4%, 95% CI 60.0-68.5). Out of those who needed services, 34.9% (95% CI 36.1-38.3) reported that the received services were insufficient. Highest barriers were observed for mental health (45.5%, 95% CI 36.4-55.0) and dentist (33.9, 95% CI 29.6-38.6) services. Although difficulties were highly prevalent in a number of regional groups, persons originating from East, South and Central Asia had persistently high barriers in access to services.
Conclusions
Findings suggest that barriers in access to services have at least somewhat increased among persons of migrant origin during the COVID-19 pandemic. This may have both short and long-term consequences on the health and wellbeing of the migrant origin population. Of particular concern were high perceived barriers in access to mental health services.
Key messages
Barriers in access were reported by a third of persons of migrant origin who needed services. Particular difficulties were experienced in access to mental health services. The gap in access to needs to be acutely addressed to reduce both the short and long-term consequences of COVID-19 on the health and wellbeing of the population.
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Affiliation(s)
- N Skogberg
- Equality Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - H Kuusio
- Equality Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - E Lilja
- Equality Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - S Austero
- Equality Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - AE Castaneda
- Equality Unit, National Institute for Health and Welfare, Helsinki, Finland
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Skogberg N, Koponen P, Lilja E, Austero S, Castaneda AE. Information access and preventive measures during COVID-19 among migrants and general population. Eur J Public Health 2021. [PMCID: PMC8574749 DOI: 10.1093/eurpub/ckab164.245] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background Access to information and adherence to preventive measures are crucial for containing the COVID-19 outbreak. This study examines access to information and adherence to preventive measures during the COVID-19 pandemic among migrant origin persons and the general population. Methods Data from the Finnish MigCOVID Survey conducted 10/2020 to 2/2021 among persons aged 20 to 66 years was used (n = 3 668). Participants in Health 2017 follow-up survey were the reference group (n = 3 490). We examined age and sex-adjusted access to information by language skills and adherence to preventive measures (staying home if fluish; keeping a safety distance; wearing a face mask; good hand and coughing hygiene; avoiding traveling abroad; avoiding shaking hands with others; downloading the Koronavilkku contact tracing app). Results Persons with excellent Finnish/Swedish language skills (96.8%; 95% CI 95.0-97.9) reported receiving sufficient information more often those with intermediate (92.3; 95% CI 88.8-94.8) or basic (91.0%; 95% CI 88.0-93.3) language skills. Overall high adherence to preventive measures was observed both among the migrant origin and the general population. However, significant differences in the migrant origin population by region of origin were observed. More pronounced differences between migrant origin persons and general population persons were observed for avoiding traveling abroad (83.7%; 95% CI 81.1-86.0 vs. 96.6%; 95% CI 95.6-97.3) and downloading the Koronavilkku app (42.8%; 95% CI 39.8-45.9 vs. 64.3%; 95% CI 61.7-66.8). Conclusions Poorer perceived access to information by language skills points to the continuous need for use of simple language and multilingual communication materials. Self-reported adherence to key preventive measures campaigned by health authorities was generally high both among persons of migrant origin and the general population, although concerns were noted in adherence to these recommendation in some regional groups. Key messages Multilingual and multichannel communication is central in crisis situations to ensure adequate access to information among different population groups. Higher incidence of COVID-19 among migrant origin persons is likely related not only to information access and adherence to preventive measures, but also to various social and structural factors.
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Affiliation(s)
- N Skogberg
- Equality Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - P Koponen
- Department of Health and Welfare, National Institute for Health and Welfare, Helsinki, Finland
| | - E Lilja
- Equality Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - S Austero
- Equality Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - AE Castaneda
- Equality Unit, National Institute for Health and Welfare, Helsinki, Finland
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12
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Skogberg N, Laajasalo T. Being a parent in Finland: a culturally-tailored psychoeducative parental support programme. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Problem
Migrant origin children are overrepresented in child protective services and among cases of suspected maltreatment against children. Language barriers, poor understanding of the child welfare system and differences in perceptions of child rearing and disciplinary practices create additional burden during the assessment process. Authorities struggle to meet the needs of migrant origin families.
Description of the problem
A variety of universal, selective and indicative parenting support programmes are available. While these have been shown to be effective also among persons of migrant origin, cultural adaptation has also been suggested to increase the benefits. Any adaptation to a trial-tested programme may, however, impact its integrity. To avoid this, a separate culturally sensitive Being a Parent in Finland programme was developed to complement other parenting interventions and supporting services offered by the health and social welfare authorities. Intervention was developed as part of the Barnahus project coordinated by the Finnish Institute for Health and Welfare.
Results
The aim of the Being a Parent in Finland psychoeducational group programme is to increase the wellbeing and safety of children through group-based parental support. The programme consists of three two-hour meetings offered to parents of children aged 3 to 12 years. The main themes include the Finnish service system, parenting practices that support the child's development and wellbeing and wellbeing of the family as well as children's rights. Psychoeducational videos were produced as supportive material. Groups of maximum 8-10 participants are led by trained instructors, assisted by professional interpreters.
Lessons
The programme will be piloted by the city of Helsinki, with the first two groups starting in May 2021. Experiences and lessons learned from these groups will be presented. Impact assessment of the programme and will be launched in autumn 2021.
Key messages
While culturally sensitive adaptations may increase positive outcomes of parental programmes, there is a risk for compromising programme integrity, leading to minimized or even adverse consequences. Being a parent in Finland aims at supporting the wellbeing and safety of families through culturally sensitive psychoeducative groups administered as complementary support measure to other services.
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Affiliation(s)
- N Skogberg
- Eqiality Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - T Laajasalo
- Specialised Services Unit, National Institute for Health and Welfare, Helsinki, Finland
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Abstract
BACKGROUND Migrant women may have a higher risk for gestational diabetes mellitus (GDM) and the related adverse outcomes. We studied the prevalence of GDM among migrant-origin women in Finland. METHODS This study used data from the nationwide Medical Birth Register. Information on the most recent singleton births of women delivering between 2004 and 2014 (N = 379 634) was included. Women were classified into nine regional categories based on the country of origin. Finnish origin women were the reference group. Generalized linear models adjusted for maternal age, parity, socioeconomic position, pre-pregnancy body mass index and year of delivery were used to study the association between region/country of origin and GDM. RESULTS Among the study population, almost 8% were of migrant origin. The prevalence of GDM varied from 6.1% (women of Latin American/Caribbean origin) to 18.4% (South Asian origin), compared to 8.7% in the Finnish reference group. When adjusted for confounders, women of South Asian, East Asian, Middle Eastern/North African and Russian/former USSR origin had a higher risk for GDM than Finnish origin women. By country of origin, women originating from Pakistan, Bangladesh, Sri Lanka, India, Afghanistan, Nepal, China, Philippines, Vietnam, Thailand, Morocco, Turkey, Iran, Iraq and former USSR had a higher risk for GDM than Finnish origin women. CONCLUSIONS There is substantial variation in the prevalence of GDM by country of origin. Women of South Asian, East Asian and Middle Eastern/North African origin had the highest risk for GDM and may warrant special attention.
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Affiliation(s)
- Kalpana Bastola
- Unit of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland
- Correspondence: Kalpana Bastola, Faculty of Social Sciences, Tampere University, Tampere 33014, Finland, Tel: +358 44 972 7708, e-mail:
| | - Päivikki Koponen
- Department of Health, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Natalia Skogberg
- Department of Health, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Mika Gissler
- Department of Information Services, Finnish Institute for Health and Welfare, Helsinki, Finland
- Division of Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
| | - Tarja I Kinnunen
- Unit of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland
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14
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Ahmed A, Omar HAJI, Castaneda AE, Klemettilä KL, Garoff F, Skogberg N. Barriers and facilitators to surveying asylum seekers: reflections of the fieldwork personnel. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
There is scarcity of representative data on the health and service needs of asylum seekers in Europe due to numerous practical and methodological challenges in planning and implementation of studies among this population group. Yet such data is acutely needed for development of health system response to meet the needs of asylum seekers. The aim of this study was to examine barriers and facilitators for conducting a population-based study among asylum seekers in Finland.
Methods
Semi-structured face-to-face individual interviews (n = 7) were carried out with the fieldwork personnel of the Asylum Seekers Health and Well-being Survey (TERTTU). Interviews contained four themes of which two will be presented in this abstract: the recruitment of the survey participants and carrying out the interviews and health examinations of the survey. Interviews of the fieldwork personnel were recorded and transcribed in verbatim. Data were analysed qualitatively using thematic analysis.
Results
Recruitment was substantially easier in reception centers than in private accommodations. Face-to-face and written information in participant's own language reduced misunderstandings and confidentiality concerns. Certain characteristics of the fieldwork personnel (mature age, female sex, and common cultural background) were facilitators for both recruitment and carrying out the survey appointments. Family and community members' perceptions influenced participation. Reception center personnel's attitudes influenced logistics of the recruitment process and the conduct of the survey. Incentives for participation were perceived both as facilitators and barriers.
Conclusions
It is feasible to obtain a high response rate among asylum seekers through investing in planning and dissemination of information about the study. Findings of this study can be benefited by other countries planning a survey among asylum seekers.
Key messages
Challenges in data collection among asylum seekers can be solved with careful planning and flexible fieldwork protocols. Sharing good practices about data collection among asylum seekers on a European level will inform researchers intending to conduct health surveys among asylum seekers and other forced migrants.
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Affiliation(s)
| | - H a j i Omar
- Department of Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - A E Castaneda
- Department of Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - K-L Klemettilä
- Department of Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - F Garoff
- Department of Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - N Skogberg
- Department of Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
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15
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Skogberg N, Garoff F, Ahmed Haji Omar A, Koponen P, Klemettilä KL, Castaneda AE. Developing the health examination protocol for asylum seekers in Finland: project results. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Issue
Initial health assessment is crucial for identification of healthcare needs and screening of acute health problems among new asylum seekers. As in other countries, practices across reception centres in Finland varied and health data was inconsistently recorded, making systematic monitoring through the electronic health record system (EHR) challenging.
Description of the issue
The main objectives of the national Developing the health examination protocol for asylum seekers in Finland project (TERTTU, 2017-2019) were to unify practices across reception centres through development of health assessment content and the quality of EHR recordings. The project consisted of three phases: 1) baseline evaluation; 2) conduct of a population-based health examination survey among asylum seeking adults and children; 3) development work guided by findings of stages 1 and 2, supplemented with thematic qualitative interviews with end-users (reception centre nurses, asylum seekers and authorities supervising services).
Results
The project exceeded expectations. Altogether 1087 adults and children participated in the survey (participation rate 76 %). Survey findings were published in a national report, providing the main evidence-base for development work. This was complemented by thematic interviews with 15 reception centre nurses, 19 asylum seekers and 3 authority representatives. Health assessment protocol was piloted and further developed based on feedback from end-users and transferred into the reception centres EHR. A handbook for the health assessment was published, supported with educational short videos.
Lessons
Successful implementation required close collaboration with authorities responsible for providing services for asylum seekers and involvement of end users at all stages. Results of this project benefit all other countries receiving asylum seekers. The study protocol is available in English, Somali, Kurdish (Sorani), Dari, Arabic, Russian, French and Finnish.
Key messages
The initial health assessment protocol for asylum seekers and supporting materials developed in the TERTTU project benefits all receiving countries. Systematic recording of health data was also developed, which will be used for planning health system response according to the health care needs of new asylum seekers.
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Affiliation(s)
- N Skogberg
- Department of Welfare, Finnish National Institute for Health and Welfare, Helsinki, Finland
| | - F Garoff
- Department of Welfare, Finnish National Institute for Health and Welfare, Helsinki, Finland
| | - A Ahmed Haji Omar
- Department of Welfare, Finnish National Institute for Health and Welfare, Helsinki, Finland
| | - P Koponen
- Department of Public Health Solutions, Finnish National Institute for Health and Welfare, Helsinki, Finland
| | - K-L Klemettilä
- Department of Welfare, Finnish National Institute for Health and Welfare, Helsinki, Finland
| | - A E Castaneda
- Department of Welfare, Finnish National Institute for Health and Welfare, Helsinki, Finland
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Castaneda AE, Çilenti K, Rask S, Lilja E, Skogberg N, Kuusio H, Salama E, Lahti J, Elovainio M, Suvisaari J, Koskinen S, Koponen P. Migrants Are Underrepresented in Mental Health and Rehabilitation Services-Survey and Register-Based Findings of Russian, Somali, and Kurdish Origin Adults in Finland. Int J Environ Res Public Health 2020; 17:ijerph17176223. [PMID: 32867157 PMCID: PMC7504052 DOI: 10.3390/ijerph17176223] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 08/13/2020] [Accepted: 08/21/2020] [Indexed: 12/21/2022]
Abstract
Mounting evidence suggests that migration background increases the risk of mental ill health, but that problems exist in accessing healthcare services in people of migrant origin. The present study uses a combination of register- and survey-based data to examine mental health-related health service use in three migrant origin populations as well as the correspondence between the need and use of services. The data are from the Finnish Migrant Health and Wellbeing Study (Maamu), a comprehensive cross-sectional interview and a health examination survey. A random sample consisted of 5909 working-aged adults of Russian, Somali, and Kurdish origin of which 3000 were invited to participate in the survey and the rest were drawn for a register-based approach. Some of the mental health services, based on registers, were more prevalent in the Kurdish origin group in comparison with the general population and less prevalent in the Russian and Somali origin groups. All the migrant origin groups were underrepresented in rehabilitation services. When affective symptoms were taken into account, all the migrant origin groups were underrepresented in all of the services. This calls for actions to promote mental health, diminish the barriers to access services, and improve the service paths for migrants.
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Affiliation(s)
- Anu E. Castaneda
- Finnish Institute for Health and Welfare, 00271 Helsinki, Finland; (K.Ç.); (S.R.); (E.L.); (N.S.); (H.K.); (M.E.); (J.S.); (S.K.); (P.K.)
- Department of Psychology and Logopedics, University of Helsinki, 00014 Helsinki, Finland;
- Correspondence: ; Tel.: +358-29-524-7848
| | - Katja Çilenti
- Finnish Institute for Health and Welfare, 00271 Helsinki, Finland; (K.Ç.); (S.R.); (E.L.); (N.S.); (H.K.); (M.E.); (J.S.); (S.K.); (P.K.)
- Department of Psychology and Logopedics, University of Helsinki, 00014 Helsinki, Finland;
| | - Shadia Rask
- Finnish Institute for Health and Welfare, 00271 Helsinki, Finland; (K.Ç.); (S.R.); (E.L.); (N.S.); (H.K.); (M.E.); (J.S.); (S.K.); (P.K.)
| | - Eero Lilja
- Finnish Institute for Health and Welfare, 00271 Helsinki, Finland; (K.Ç.); (S.R.); (E.L.); (N.S.); (H.K.); (M.E.); (J.S.); (S.K.); (P.K.)
| | - Natalia Skogberg
- Finnish Institute for Health and Welfare, 00271 Helsinki, Finland; (K.Ç.); (S.R.); (E.L.); (N.S.); (H.K.); (M.E.); (J.S.); (S.K.); (P.K.)
| | - Hannamaria Kuusio
- Finnish Institute for Health and Welfare, 00271 Helsinki, Finland; (K.Ç.); (S.R.); (E.L.); (N.S.); (H.K.); (M.E.); (J.S.); (S.K.); (P.K.)
| | - Essi Salama
- Doctoral Programme in Clinical Research, Faculty of Medicine, University of Turku, FI-20014 Turku, Finland & Child Psychiatry, Turku University Hospital, 20521 Turku, Finland;
| | - Jari Lahti
- Department of Psychology and Logopedics, University of Helsinki, 00014 Helsinki, Finland;
| | - Marko Elovainio
- Finnish Institute for Health and Welfare, 00271 Helsinki, Finland; (K.Ç.); (S.R.); (E.L.); (N.S.); (H.K.); (M.E.); (J.S.); (S.K.); (P.K.)
- Department of Psychology and Logopedics, University of Helsinki, 00014 Helsinki, Finland;
| | - Jaana Suvisaari
- Finnish Institute for Health and Welfare, 00271 Helsinki, Finland; (K.Ç.); (S.R.); (E.L.); (N.S.); (H.K.); (M.E.); (J.S.); (S.K.); (P.K.)
| | - Seppo Koskinen
- Finnish Institute for Health and Welfare, 00271 Helsinki, Finland; (K.Ç.); (S.R.); (E.L.); (N.S.); (H.K.); (M.E.); (J.S.); (S.K.); (P.K.)
| | - Päivikki Koponen
- Finnish Institute for Health and Welfare, 00271 Helsinki, Finland; (K.Ç.); (S.R.); (E.L.); (N.S.); (H.K.); (M.E.); (J.S.); (S.K.); (P.K.)
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17
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Rask S, Koponen P, Skogberg N, Kuusio H, Castaneda A. Collecting high-quality survey data on hard-to-reach populations: lessons from Finland. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz185.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Issue
Hard-to-reach populations refer to groups that may be difficult to involve in research. Minorities and persons with migration background (PMB) are often underrepresented in population-based surveys. This may lead to serious bias. Description of the problem: Several surveys on the health and wellbeing of hard-to-reach populations have been conducted in Finland since 2010. Strategies for collecting high-quality data have been identified in five surveys focused on specific migrant groups (Maamu n = 3000), the foreign-origin population (UTH n = 6000; FinMONIK n = 13650), newly-arrived asylum seekers (TERTTU n = 1087) and Finnish Roma (ROOSA n = 365). Also few routinely collected studies include indicators of ethnic background or origin (e.g. School Health Promotion study).
Results
Country of birth and foreign origin can be identified in Finland using register-based sampling. Snowball sampling was needed for the Roma population. Strategies to reach participants included information dissemination, translated questionnaires, multilingual personnel, telephone contacts and door-to-door visits. Stakeholders and participants were involved in planning and reporting. Participation rates as high as 70-80% were reached from register-based samples. Lessons: High-quality survey data can be collected on hard-to-reach populations. This requires adequate resources including multilingual personnel and researcher-participant trust. The cross-cultural validity of survey questions is critical; cognitive interviews can be used to improve cultural sensitivity. Researchers should be sensitive of sense of belonging, e.g. PMB may object being seen as “migrants”. Members of hard-to-reach populations should be involved in research, and not merely objects of a study.
Main messages
High participation rates can be achieved with adequate time, financial resources and established researcher-participant trust. Data collection should be inclusive and clearly benefit the individuals and populations in concern.
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Kinnunen TI, Skogberg N, Härkänen T, Lundqvist A, Laatikainen T, Koponen P. Overweight and abdominal obesity in women of childbearing age of Russian, Somali and Kurdish origin and the general Finnish population. J Public Health (Oxf) 2019; 40:262-270. [PMID: 28505378 DOI: 10.1093/pubmed/fdx053] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 05/02/2017] [Indexed: 12/31/2022] Open
Abstract
Background Migrant background and higher parity may increase the risk of being overweight. We compared the prevalence of overweight (body mass index ≥25 kg/m2) and abdominal obesity (waist-to-height ratio ≥0.5) between non-pregnant migrant and Finnish women aged 18-45 years. Methods The participants were 165 Russian, 164 Somali and 179 Kurdish origin women from the cross-sectional Migrant Health and Wellbeing study. The reference group included 388 women from the general Finnish population. Body anthropometrics were measured. The main statistical methods were logistic regression adjusted for sociodemographic and reproductive variables. Results The unadjusted prevalence of overweight and obesity, respectively, were higher among Somali (32.9%, 30.9%, P < 0.001) and Kurdish women (41.1%, 19.5%, P < 0.001) than among Finnish women (19.9%, 9.8%). The adjusted odds ratios (95% CI) for overweight (including obesity) were 0.54 (0.33; 0.89) for Russian, 2.89 (1.66; 5.03) for Somali and 2.56 (1.64; 4.00) for Kurdish women compared with Finnish women. Kurdish women had 2.96-fold (1.75; 5.00) adjusted odds ratio for abdominal obesity compared with Finnish women. Being parous was associated with overweight and abdominal obesity among Kurdish women. Conclusions Overweight and obesity were very common among Somali and Kurdish origin women. Information on diet and physical activity in these groups is needed.
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Affiliation(s)
- Tarja I Kinnunen
- Faculty of Social Sciences/Health Sciences, University of Tampere, Tampere, Finland
| | - Natalia Skogberg
- Department of Welfare, National Institute for Health and Welfare, Helsinki, Finland
| | - Tommi Härkänen
- Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
| | - Annamari Lundqvist
- Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
| | - Tiina Laatikainen
- Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland.,Institute of Public Health and Clinical Nutrition, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.,Primary Health Care Unit, Hospital District of North Karelia, Joensuu, Finland
| | - Päivikki Koponen
- Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
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19
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Skogberg N, Koponen P, Lilja E, Mustonen KL, Garoff F, Ahmed A, Castaneda AE. The health of asylum seekers in Finland: a total population health examination survey (TERTTU). Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz185.577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
There is scarcity of representative population-based data on the health and wellbeing of asylum seekers in Europe. The Asylum Seekers Health and Wellbeing Survey (TERTTU) was launched to provide the evidence-base for developing services for asylum seekers as well as for planning and allocation of healthcare resources at a national level.
Methods
A sample of all first-time asylum applicants between 19.2-30.11.2018 was drawn from the Finnish Immigration Services electronic asylum database. Altogether 784 adults aged 18 years and older took part in the standardised health examination and face-to-face interview with participation rate of 79%. Interviewed health measures included the Minimum European Health Module, conditions previously diagnosed by a physician, permanent injury due to violence or accident and somatization.
Results
Self-rated health was good among 66% (95% CI 62,5-69,1) and 42% (95% CI 38,5-45,4) reported having some self-reported long-term illness or health problem. The most common previously diagnosed conditions were diseases of the circulatory system (19%, 95% CI 16,5-22,0), musculoskeletal system (18%, 95% CI 15,6-21,1), mental and behavioural disorders (13%, 95% CI 10,9-15,6) and diseases of the respiratory system (10%, 95% CI 8,0-12,2 ). Nearly half (47%, 95% CI 43,7-50,8) reported having a permanent injury due to violence or accident. Somatisation was common: 23% (95% CI 20,3-26,2) reported having headache, 23% (95% CI 19,9-25,8) back ache and 13% (95% CI 10,8-15,6) other pains at least several times a week.
Conclusions
The overall health of newly-arrived asylum seekers was poorer compared with the general Finnish population and migrant origin populations from similar countries of origin permanently living in Finland. Significant differences in asylum seekers health were found by sex and region of origin. Survey data will be used for developing the national initial health assessment protocol for asylum seekers during 2019.
Key messages
The TERTTU Survey is the largest population-based health examination survey among newly-arrived asylum seekers in Europe to date. The extensive data gathered over the course of the survey will be used for developing services for asylum seekers at a national level and is of high relevance also to other European countries.
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Affiliation(s)
- N Skogberg
- Equality and Inclusion, National Institute for Health and Welfare, Helsinki, Finland
| | - P Koponen
- Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
| | - E Lilja
- Equality and Inclusion, National Institute for Health and Welfare, Helsinki, Finland
| | - K-L Mustonen
- Equality and Inclusion, National Institute for Health and Welfare, Helsinki, Finland
| | - F Garoff
- Equality and Inclusion, National Institute for Health and Welfare, Helsinki, Finland
| | - A Ahmed
- Equality and Inclusion, National Institute for Health and Welfare, Helsinki, Finland
| | - A E Castaneda
- Equality and Inclusion, National Institute for Health and Welfare, Helsinki, Finland
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Skogberg N, Koponen P, Lilja E, Mustonen KL, Garoff F, Ahmed A, Castaneda AE. Health of asylum seeker children in Finland: a total population health examination survey (TERTTU). Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz185.421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
There is scarcity of representative population-based data on the health and wellbeing of asylum seekers in Europe, especially children and adolescents. The Asylum Seekers Health and Wellbeing Survey (TERTTU) was launched to inform evidence-based policy-making and development of services.
Methods
A sample of all first-time asylum applicants was drawn from the Finnish Immigration Services electronic asylum database. Data on 303 children aged 0-17 years was gathered with a standardised health examination (including a dental assessment for 7-17 year-olds) and face-to-face-interview including the Minimum European Health Module and somatic and behavioural symptoms over the past 30 days. Guardians of 0-12 year-olds were interviewed, 13-17 year-olds responded themselves. Participation rate was 72%.
Results
62% (95% CI 49,4-73,0) of 13-17 year-olds have had their growth and development monitored compared with 91% (95% CI 83,6-95,6) of 7-12 year-old and 86% (95% CI 79,4-91,0) of 0-6 year-olds. Long-standing health problems were more common among 13-17 year-olds (28%, 95% CI 18,2-39,7) and 7-12 year-olds (25%, 95% CI 16,8-34,2) compared 0-6 year-olds (13%, 95% CI 8,2-19,5). Sleep disturbances were more common among 13-17 year-olds (35%, 95% CI 24,2-47,4) and 7-12 year-olds (28%, 95% CI 19,6-37,5) than 2-6 year-olds (18%, 95% CI 11,3-26,7). Approximately fifth of children aged 7-17 years and slightly more than tenth of younger children had fears and anxieties. Signs of dental caries were found in 46% (95% CI 35,4-55,9) of 7-12 year-olds and in 23% (95% CI 14,1-35,1) of 13-17 year-olds.
Conclusions
Timely and accurate assessment of healthcare needs is crucial to support and improve the health and wellbeing of children and adolescents. Survey data will be used for developing the national initial health assessment protocol for asylum seeking children and adolescents.
Key messages
The TERTTU Survey is the largest population-based health examination survey among newly-arrived asylum seeking adults, adolescents and children in Europe, allowing for examining family units. Health information on asylum seeking children and adolescents in Finland, is relevant for service development, also for other European countries.
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Affiliation(s)
- N Skogberg
- Equality and Inclusion, National Institute for Health and Welfare, Helsinki, Finland
| | - P Koponen
- Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
| | - E Lilja
- Equality and Inclusion, National Institute for Health and Welfare, Helsinki, Finland
| | - K-L Mustonen
- Equality and Inclusion, National Institute for Health and Welfare, Helsinki, Finland
| | - F Garoff
- Equality and Inclusion, National Institute for Health and Welfare, Helsinki, Finland
| | - A Ahmed
- Equality and Inclusion, National Institute for Health and Welfare, Helsinki, Finland
| | - A E Castaneda
- Equality and Inclusion, National Institute for Health and Welfare, Helsinki, Finland
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Doupi P, Skogberg N, Castaneda A, Garoff F. Injuries of adult asylum seekers in Finland: results of the 2018 TERTTU-health and well-being survey. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz185.420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Injuries in refugees and asylum seekers result of accidents, violence or most extremely torture. Research in Finland has shown that many refugees experienced major traumatic events in their former home country, incl. permanent injuries. Our study provides new evidence on asylum seekers, a scarcely studied group.
Methods
Data was collected by structured face-to-face interviews. Healthcare staff asked adult participants if they had a bodily injury or scar. If yes, they pointed the location on a pictogram. Interviewers inquired if the injury was accidental or result of violence and if it happened before or during the fleeing trip. Injuries were classified as head (incl. brain) injuries, injuries of torso/extremities or other body areas.
Results
About half (47, 2 %) of 779 adults reported injuries, men more often than women (55,1 % vs. 35,3 %). Frequency was highest in 18-29-year olds. Close to all respondents (94 %) sustained injuries prior to their journey. Over one in five attributed injuries to accident (men 27 %, women 16 %). 16,6 % reported the torso/extremities as injury location, while 9,4 % had head injuries. Violence was cause of injury in over one fourth of cases (28 %). Every third male and every fifth female were violence victims, with no significant age difference. In both genders odds of violence exposure was highest in asylum seekers from sub-Saharan Africa - over 50 % attributed injury to violence. Violence victims had injuries of torso/extremities in 20,5%, and of the head in 15,3%. Head injuries were more frequent in > 40 year-old violence victims of both genders.
Conclusions
Injuries are common among adult asylum seekers in Finland. Prevalence of violence induced injury, especially in sub-Saharan Africans, is alarming. Training in violence victims’ management is required for professionals receiving asylum seekers. Information on injury severity and functional ability is needed for full impact assessment and service planning (incl. rehabilitation).
Key messages
Injuries are common among adult asylum seekers and often a result of violence, thus requiring of receiving services’ professionals skills and knowledge in violence victims’ management. Health examination protocols of asylum seekers should include injury severity assessment and impact on functional ability.
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Affiliation(s)
- P Doupi
- Welfare and Health Promotion, National Institute for Health and Welfare, Helsinki, Finland
| | - N Skogberg
- Equality and Inclusion, National Institute for Health and Welfare, Helsinki, Finland
| | - A Castaneda
- Equality and Inclusion, National Institute for Health and Welfare, Helsinki, Finland
| | - F Garoff
- Equality and Inclusion, National Institute for Health and Welfare, Helsinki, Finland
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Castaneda AE, Lilja E, Garoff F, Mustonen KL, Ahmed A, Skogberg N. Asylum seekers’ mental health in the Finnish Asylum Seekers Health and Wellbeing Survey (TERTTU). Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Asylum seekers have major health and well-being burdens, including mental health. However, there is a lack of population-based survey data on the health status and service needs of asylum seekers in Europe. The TERTTU-project was launched to fill these information gaps and to develop the current health examination protocol for assessing the health, well-being and need for health care services, including mental health, of newly arrived asylum seekers.
Methods
As part of the TERTTU-project, systematic, nationally representative data was collected in 2018 by conducting a health examination and a face-to-face interview survey in reception centers in Finland (n = 1087). The sample was drawn from the Finnish Immigration Services electronic asylum database. Mental health was assessed with the HSCL and PROTECT questionnaires (SDQ among the children), along with questions of potentially traumatic experiences.
Results
39% (95% CI 35,6-42,6) of the adults had current severe depressive and anxiety symptoms, 50% (95% CI 46,9-53,9) had an increased risk for PTSD, and 83% (95% CI 80,0-85,3) had experienced at least one potentially traumatic event before arriving to Finland. The most common psychosocial symptoms among 2-6 year-olds were behavioral symptoms (49%) and difficulties in peer relationships (37%). Difficulties in peer relationships were also common among 7-17 year-olds (49%), followed by challenges in the emotional domain (42%).
Conclusions
Potentially traumatic experiences and mental health problems are common among asylum seekers in Finland. Based on the survey-data, a national health examination protocol will be developed in 2019 to improve assessment and identification and to enable systematic health monitoring and evidence-based development of services for asylum seekers. A common health examination protocol will also unify practices across reception centers all over the country.
Key messages
Potentially traumatic experiences and mental health problems are common among asylum seekers in Finland. A national health examination protocol allows for the early identification of vulnerable groups and individuals.
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Affiliation(s)
- A E Castaneda
- Equality and Inclusion, National Institute for Health and Welfare, Helsinki, Finland
| | - E Lilja
- Equality and Inclusion, National Institute for Health and Welfare, Helsinki, Finland
| | - F Garoff
- Equality and Inclusion, National Institute for Health and Welfare, Helsinki, Finland
| | - K L Mustonen
- Equality and Inclusion, National Institute for Health and Welfare, Helsinki, Finland
| | - A Ahmed
- Equality and Inclusion, National Institute for Health and Welfare, Helsinki, Finland
| | - N Skogberg
- Equality and Inclusion, National Institute for Health and Welfare, Helsinki, Finland
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Skogberg N, Laatikainen T, Lilja E, Lundqvist A, Härkänen T, Koponen P. The association between anthropometric measures and glycated haemoglobin (HbA1c) is different in Russian, Somali and Kurdish origin migrants compared with the general population in Finland: a cross-sectional population-based study. BMC Public Health 2019; 19:391. [PMID: 30971258 PMCID: PMC6458679 DOI: 10.1186/s12889-019-6698-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Accepted: 03/25/2019] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Persons of African and Middle-Eastern origin living in European countries have a high prevalence of type 2 diabetes, accompanied by high prevalence of obesity among women but not always among men. The aim of this study was to examine whether there are differences in the association between anthropometric measures and glucose levels measured with glycated haemoglobin and fasting blood glucose among persons of migrant origin in Finland. METHODS Cross-sectional population-based data of the 30-64 year-old participants in the health examination of the Migrant Health and Wellbeing Study was used, selecting persons without diabetes (Russian origin n = 293, Somali origin n = 184, Kurdish origin n = 275). The reference group were non-diabetic participants in the Health 2011 Survey (n = 653), representative of the general Finnish population. Anthropometric measures included body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR) and waist-to-hip ratio (WHR, available for Maamu Study participants only). RESULTS Depending on whether continuous or categorical anthropometric measures were used, age, sex and anthropometrics explained 13-18% of variation in HbA1c among persons of Russian origin, 5-10% among persons of Somali origin, 1-3% among persons of Kurdish origin and 11-13% among the general population. Also depending on whether continuous or categorical anthropometric measures were used, age, sex and anthropometrics explained 13-19% of variation in fasting blood glucose among persons of Russian origin, 15-20% among persons of Somali origin, 13-17% among persons of Kurdish origin and 16-17% among the general population. With exception for BMI, strength of the association between continuous anthropometric measures and HbA1c was significantly lower among persons of Kurdish origin compared with the general Finnish population (p = 0.044 for WC and p = 0.040 for WHtR). CONCLUSIONS A low degree of association between anthropometric measures and HbA1c was observed among persons of Kurdish origin. Findings of this study suggest caution is warranted when using HbA1c as a screening tool for glucose impairment among persons without diabetes in populations of diverse origin.
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Affiliation(s)
- Natalia Skogberg
- Department of Welfare, National Institute for Health and Welfare, Mannerheimintie 166, PL 30, 00271, Helsinki, Finland.
| | - Tiina Laatikainen
- Department of Public Health Solutions, National Institute for Health and Welfare, Mannerheimintie 166, PL 30, 00271, Helsinki, Finland.,Institute of Public Health and Clinical Nutrition, University of Eastern Finland, PL 1627, 70211, Kuopio, Finland.,Joint municipal authority for North Karelia social and health services, Tikkamäentie 16, 80210, Joensuu, Finland
| | - Eero Lilja
- Department of Welfare, National Institute for Health and Welfare, Mannerheimintie 166, PL 30, 00271, Helsinki, Finland
| | - Annamari Lundqvist
- Department of Public Health Solutions, National Institute for Health and Welfare, Mannerheimintie 166, PL 30, 00271, Helsinki, Finland
| | - Tommi Härkänen
- Department of Public Health Solutions, National Institute for Health and Welfare, Mannerheimintie 166, PL 30, 00271, Helsinki, Finland
| | - Päivikki Koponen
- Department of Public Health Solutions, National Institute for Health and Welfare, Mannerheimintie 166, PL 30, 00271, Helsinki, Finland
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Skogberg N, Koponen P, Tiittala P, Mustonen KL, Lilja E, Snellman O, Castaneda A. Asylum seekers health and wellbeing (TERTTU) survey: study protocol for a prospective total population health examination survey on the health and service needs of newly arrived asylum seekers in Finland. BMJ Open 2019; 9:e027917. [PMID: 30962242 PMCID: PMC6500271 DOI: 10.1136/bmjopen-2018-027917] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION Health, well-being and health service needs of asylum seekers have emerged as urgent topics following the arrival of 2.5 million asylum seekers to the European Union (EU) between 2015 and 2016. However, representative information on the health, well-being and service needs of asylum seekers is scarce. The Asylum Seekers Health and Wellbeing (TERTTU) Survey aims to: (1) gather population-based representative information; (2) identify key indicators for systematic monitoring; (3) produce the evidence base for development of systematic screening of asylum seekers' health, well-being and health service needs. METHODS AND ANALYSIS TERTTU Survey is a population-based prospective study with a total population sample of newly arrived asylum seekers to Finland, including adults and children. Baseline data collection is carried out in reception centres in 2018 and consists of a face-to-face interview, self-administered questionnaire and a health examination following a standardised protocol. Altogether 1000 asylum seekers will be included into the study. Baseline data will be followed up with national electronic health record data encompassing the entire asylum process and later with national register data among persons who receive residency permits. ETHICS AND DISSEMINATION Ethical approval has been granted by the Coordinating Ethics Committee of the Helsinki and Uusimaa Hospital District. Participation is voluntary and based on written informed consent. Results will be widely disseminated on a national and international level to inform health and welfare policy as well as development of services for asylum seekers. Results of the study will constitute the evidence base for development and implementation of the initial health assessment for asylum seekers on a national level.
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Affiliation(s)
- Natalia Skogberg
- Department of Welfare, National Institute for Health and Welfare, Helsinki, Finland
| | - Päivikki Koponen
- Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
| | - Paula Tiittala
- Department of Health Security, National Institute for Health and Welfare, Helsinki, Finland
| | - Katri-Leena Mustonen
- Department of Welfare, National Institute for Health and Welfare, Helsinki, Finland
| | - Eero Lilja
- Department of Welfare, National Institute for Health and Welfare, Helsinki, Finland
| | | | - Anu Castaneda
- Department of Welfare, National Institute for Health and Welfare, Helsinki, Finland
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25
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Skogberg N, Laatikainen T, Lundqvist A, Lilja E, Härkänen T, Koponen P. Which anthropometric measures best indicate type 2 diabetes among Russian, Somali and Kurdish origin migrants in Finland? A cross-sectional study. BMJ Open 2018; 8:e019166. [PMID: 29773697 PMCID: PMC5961561 DOI: 10.1136/bmjopen-2017-019166] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES To compare the performance of body mass index (BMI), waist-to-height ratio (WHtR), waist circumference (WC) and waist-to-hip ratio (WHR) in detecting type 2 diabetes among Russian, Somali and Kurdish (born in Iraq/Iran) origin migrants and Finns. DESIGN AND PARTICIPANTS Cross-sectional study comparing health examination survey data of Russian, Somali and Kurdish origin migrants (n=917) aged 30-64 years who took part in the Migrant Health and Wellbeing Survey with the general Finnish population in the Health 2011 Survey (n=887). Participants were randomly selected from the National Population Register. SETTING Six cities in Finland, where a substantial majority of migrants live. OUTCOME MEASURES Anthropometric measures included objectively measured BMI, WHtR, WC and WHR. Type 2 diabetes was defined based on self-report, laboratory measures of glycated haemoglobin and register data. Test performance was assessed using receiver operating characteristics curves, using area under the curve (AUC) as a measure of accuracy. RESULTS Among Finns, test performance was highest for WC (AUC=0.81, 95% CI 0.74 to 0.87) and WHtR (AUC=0.81, 95% CI 0.75 to 0.87). Test performance was similar for BMI (AUC=0.80, 95% CI 0.67 to 0.92), WC (AUC=0.79, 95% CI 0.67 to 0.91) and WHtR (AUC=0.70, 95% CI 0.66 to 0.93) among Russians. WC and WHtR had highest test performance also among Somali (AUC=0.74, 95% CI 0.64 to 0.84 for WC and AUC=0.75, 95% CI 0.65 to 0.85 for WHtR) and Kurds (AUC=0.71, 95% CI 0.61 to 0.81 for WC and AUC=0.70, 95% CI 0.59 to 0.80 for WHtR).Among migrants, WHR had the poorest test performance. CONCLUSION WC and WHtR performed overall the best across all study groups, however, accuracy of detection was lower particularly among Somali and Kurds. Currently used diabetes risk assessment tools assume a strong association between anthropometrics and diabetes. These tools need to be validated among non-Western populations.
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Affiliation(s)
- Natalia Skogberg
- Department of Public Health, University of Helsinki, Helsinki, Finland
- Department of Welfare, National Institute for Health and Welfare, Helsinki, Finland
| | - Tiina Laatikainen
- Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Joint Municipal Authority for North Karelia Social and Health Services, Joensuu, Finland
| | - Annamari Lundqvist
- Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
| | - Eero Lilja
- Department of Welfare, National Institute for Health and Welfare, Helsinki, Finland
| | - Tommi Härkänen
- Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
| | - Päivikki Koponen
- Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
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26
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Skogberg N. Developing the health examination protocol for asylum seekers in Finland: A national development project (TERTTU). Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx187.535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- N Skogberg
- National Institute for Health and Welfare, Helsinki, Finland
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27
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Skogberg N, Laatikainen T, Lilja E, Lundqvist A, Koponen P. Which anthropometric measures best indicate the risk for type 2 diabetes among migrants in Finland? Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx189.269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- N Skogberg
- Department of Welfare, National Institute for Health and Welfare (THL), Helsinki, Finland
| | - T Laatikainen
- Department of Welfare, National Institute for Health and Welfare (THL), Helsinki, Finland
| | - E Lilja
- Department of Welfare, National Institute for Health and Welfare (THL), Helsinki, Finland
| | - A Lundqvist
- Department of Public Health Solutions, National Institute for Health and Welfare (THL), Helsinki, Finland
| | - P Koponen
- Department of Public Health Solutions, National Institute for Health and Welfare (THL), Helsinki, Finland
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Kemppainen L, Kemppainen T, Skogberg N, Kuusio H, Koponen P. Immigrants' use of health care in their country of origin: the role of social integration, discrimination and the parallel use of health care systems. Scand J Caring Sci 2017; 32:698-706. [PMID: 28869656 DOI: 10.1111/scs.12499] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 05/28/2017] [Indexed: 11/28/2022]
Abstract
AIMS The objective of this study was to elucidate the utilisation of Russian health care by immigrants of Russian origin living in Finland (cross-border health care). The study examined the association of cross-border health care with social integration and discrimination. Moreover, it studied whether cross-border health care was used as an alternative to the host-country's healthcare system. METHODS Data from the Finnish Migrant Health and Wellbeing Survey (Maamu) were utilised. The number of respondents of Russian origin was 545. The main analytical method was logistic regression. The outcome variable was based on a survey item on seeking physician's treatment or help abroad during the last 12 months. Social integration was measured multi-dimensionally, and the indicator was extracted by multiple correspondence analysis. Ethical approval for the study was obtained from the Ethical Committee of the Uusimaa Hospital Region. RESULTS We found that 15.4% of the respondents had visited a physician in Russia during the last 12 months. 10.4% had experienced discrimination in Finnish health services during their stay in Finland. Stronger social integration predicted less frequent utilisation of cross-border health care. Experiences of discrimination or unfairness were associated with higher odds for seeking cross-border health care. Cross-border health care was typically used in parallel to the Finnish services. CONCLUSIONS Our findings on integration and discrimination emphasise the importance of general integration policy as well as cultural competence in health care. Parallel use of healthcare systems entails both risks (e.g double medication, problems of follow-up) and opportunities (e.g. sense of agency), which should be further investigated.
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Affiliation(s)
- Laura Kemppainen
- Department of Social Research, Unit of Social Policy, University of Turku, Turku, Finland
| | - Teemu Kemppainen
- Department of Social Research, Unit of Social Policy, University of Turku, Turku, Finland.,Department of Social Research, Unit of Sociology, University of Helsinki, Helsinki, Finland
| | - Natalia Skogberg
- Department of Welfare, National Institute for Health and Welfare, THL, Helsinki, Finland
| | - Hannamaria Kuusio
- Department of Welfare, National Institute for Health and Welfare, THL, Helsinki, Finland
| | - Päivikki Koponen
- Department of Public Health Solutions, National Institute for Health and Welfare, THL, Helsinki, Finland
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Skogberg N, Laatikainen T, Jula A, Härkänen T, Vartiainen E, Koponen P. Contribution of sociodemographic and lifestyle-related factors to the differences in metabolic syndrome among Russian, Somali and Kurdish migrants compared with Finns. Int J Cardiol 2017; 232:63-69. [PMID: 28108130 DOI: 10.1016/j.ijcard.2017.01.051] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 12/04/2016] [Accepted: 01/04/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUND Metabolic syndrome (MetS) is associated with a substantially increased risk for cardiovascular disease and diabetes. We examined the contribution of length of residence, socioeconomic position and lifestyle-related factors to the differences in the prevalence of MetS among migrants compared with Finns. METHODS Cross-sectional data from randomly sampled 30-64year-old health examination participants (318 Russian, 212 Somali, and 321 Kurdish origin migrants) of the Migrant Health and Wellbeing Survey (2010-2012) were used. Health 2011 Survey participants (n=786) were the reference group. RESULTS Compared with Finns, prevalence of MetS was significantly higher among all migrants except for Somali men. Among men, age-adjusted prevalence ratio (PR) of MetS compared with Finns was 1.71, 95% confidence interval (CI) 1.19-2.46 for Russians, PR 0.95 (95% CI 0.54-1.67) for Somali, and PR 2.10 (95% CI 1.51-2.93) for Kurds. Among women, respective PRs were 1.45 (95% CI 1.08-1.97) for Russians, PR 2.34 (95% CI 1.75-3.14) for Somali and PR 2.22 (95% CI 1.67-2.97) for Kurds. Adjustment for sociodemographic and lifestyle-related factors attenuated the differences in MetS among women but not men. CONCLUSIONS Further studies should aim at identifying factors related to elevated risk for MetS among Russian and Kurdish men. Interventions aiming at improving lifestyle-related factors are needed for reducing inequalities in the prevalence of MetS among migrant women. Effectiveness of interventions focusing on reducing overweight and obesity among Somali and Kurdish women should be evaluated.
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Affiliation(s)
- N Skogberg
- Department of Welfare, National Institute for Health and Welfare, Helsinki, Finland.
| | - T Laatikainen
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland; Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland; Hospital District of North Karelia, Joensuu, Finland
| | - A Jula
- Department of Health, National Institute for Health and Welfare, Turku, Finland
| | - T Härkänen
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - E Vartiainen
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - P Koponen
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
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Castaneda AE, Junna L, Lilja E, Skogberg N, Kuusio H, Maki Opas J, Koponen P, Suvisaari J. The Prevalence of Potentially Traumatic Pre-Migration Experiences: A Population- Based Study of Russian, Somali and Kurdish Origin Migrants in Finland. ACTA ACUST UNITED AC 2017. [DOI: 10.4172/2324-8947.1000165] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Castaneda AE, Kuusio H, Skogberg N, Tuomisto K, Kytö S, Salmivuori E, Jokela S, Mäki-Opas J, Laatikainen T, Koponen P. Health promotion among the population of foreign origin in Finland involves special issues. Duodecim 2017; 133:993-1001. [PMID: 29239582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The population of foreign origin in Finland is a heterogenic group, diverse for example with respect to reasons for and age at migration. While migration to Finland is a recent phenomenon, the size of the population of foreign origin has grown rapidly and will continue to increase. Changes in the population structure need to be taken into account in health promotion. For example lifestyle, health status, functional capacity, mental health, infectious diseases and reproductive health differ in foreign origin population compared with the general Finnish population. These differences may provide opportunities but also create challenges for service provision and health promotion planning.
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Skogberg N, Wikström K, Koponen P, Laatikainen T. Overweight and obesity among Kurdish and Somali origin adolescents in Finland. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw173.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Skogberg N, Härkänen T, Koponen P, Laatikainen T. Diabetes and diabetes risk estimation among Russian, Somali, and Kurdish migrants in Finland. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw167.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Skogberg N, Laatikainen T, Koskinen S, Vartiainen E, Jula A, Leiviskä J, Härkänen T, Koponen P. Cardiovascular risk factors among Russian, Somali and Kurdish migrants in comparison with the general Finnish population. Eur J Public Health 2016; 26:667-73. [DOI: 10.1093/eurpub/ckw041] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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35
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Skogberg N, Koponen P, Jula A, Laatikainen T. Association between socioeconomic position and health behavior with metabolic syndrome among migrants of Russian, Somali and Kurdish origin in Finland. Eur J Public Health 2014. [DOI: 10.1093/eurpub/cku165.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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