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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Global Health".

Deadline for manuscript submissions: closed (30 September 2021) | Viewed by 39077

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Special Issue Editors

Prof. Dr. Heiko Becher

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Guest Editor

Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
Interests: social epidemiology; migrant research; stroke; cancer; statistical methods in epidemiology
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. Volker Winkler

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Guest Editor

Heidelberg Institute of Global Health, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany
Interests: migrant health; non-communicable diseases; low- and middle-income countries

Prof. Dr. Hajo Zeeb

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Guest Editor

Leibniz Institute for Prevention Research and Epidemiology – BIPS, Achterstraße 30 28359 Bremen, Germany
Interests: migrant research; radiation epidemiology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The recent years have witnessed a substantial increase in scientific research on migration-related topics, including health. Numerous large population-based cohort studies have been implemented mainly in Europe and North America, and these studies usually include individuals with a migration background. Therefore, these cohorts allow a comparison to the autochthonous population with respect to chronic disease risk, genetic predispositions, epigenetic aspects, and preventive aspects including health literacy, health service use, and others. While these perspectives are critical to understand and improve the health situation of migrants in their host countries, the relationship between migration and health remains complex. Migration can increase health risks but also improve the health and wellbeing of the migrants themselves and that of their family members “left behind”. Today’s migration-related research often neglects the perspectives regarding the countries of origin and lower income countries.

This Special Issue of IJERPH focuses on research and experiences related to the broad topic of migration and health while recognizing its complexity. Results based on cohort studies are particularly welcome. Researchers and practitioners from social epidemiology, genetic epidemiology, public health, healthcare research, management, quality assurance, epidemiology, health economics, and other related disciplines are invited to submit high-quality original research manuscripts and systematic reviews related to the issues in this research area.

Prof. Dr. Heiko Becher
Prof. Dr. Volker Winkler
Prof. Dr. Hajo Zeeb
Guest Editors

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

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Keywords

migrants
refugees
people left behind
cohort studies
social sciences
social epidemiology
healthcare research

Published Papers (14 papers)

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Research

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13 pages, 357 KiB

Open AccessArticle

The Health Status and Healthcare Utilization of Ethnic Germans in Russia

by Charlotte Arena, Christine Holmberg, Volker Winkler and Philipp Jaehn

Int. J. Environ. Res. Public Health 2022, 19(1), 166; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19010166 - 24 Dec 2021

Viewed by 2198

Abstract

Ethnic German resettlers from the former Soviet Union are one of the largest migrant groups in Germany. In comparison with the majority of the German population, resettlers exhibit worse subjective health and utilize fewer preventive measures. However, there is little evidence on health among ethnic Germans who remained in Russia. Hence, the objective of this study was to determine the differences in subjective health, diabetes, smoking, and utilization of health check-ups between ethnic Germans and the majority population in Russia. We used data from the Russian Longitudinal Monitoring Survey II from 1994 to 2018 (general population of Russia n = 41,675, ethnic Germans n = 158). Multilevel logistic regression was used to calculate odds ratios (ORs) adjusted for age, sex, period, and place of residence. Analyses were furthermore stratified by the periods 1994–2005 and 2006–2018. Ethnic Germans in Russia rated their health less often as good compared with the Russian majority population (OR = 0.67, CI = 0.48–0.92). Furthermore, ethnic Germans were more likely to smoke after 2006 (OR = 1.91, CI = 1.09–3.37). Lower subjective health among ethnic Germans in Russia is in line with findings among minority populations in Europe. Increased odds of smoking after 2006 may indicate the deteriorating risk behavior of ethnic Germans in Russia. Full article

(This article belongs to the Special Issue Migration and Global Health)

12 pages, 342 KiB

Open AccessArticle

The Weight of Migration: Reconsidering Health Selection and Return Migration among Mexicans

by Aresha M. Martinez-Cardoso and Arline T. Geronimus

Int. J. Environ. Res. Public Health 2021, 18(22), 12136; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182212136 - 19 Nov 2021

Cited by 4 | Viewed by 1496

Abstract

While migration plays a key role in shaping the health of Mexican migrants in the US and those in Mexico, contemporary Mexican migration trends may challenge the health selection and return migration hypotheses, two prevailing assumptions of how migration shapes health. Using data from the Mexican Family Life Survey (2002; 2005), we tested these two hypotheses by comparing the cardiometabolic health profiles of (1) Mexico–US future migrants and nonmigrants and (2) Mexico–US return migrants and nonmigrants. First, we found limited evidence for health selection: the cardiometabolic health of Mexico–US future migrants was not measurably better than the health of their compatriots who did not migrate, although migrants differed demographically from nonmigrants. However, return migrants had higher levels of adiposity compared to those who stayed in Mexico throughout their lives; time spent in the US was also associated with obesity and elevated waist circumference. Differences in physical activity and smoking behavior did not mediate these associations. Our findings suggest positive health selection might not drive the favorable health profiles among recent cohorts of Mexican immigrants in the US. However, the adverse health of return migrants with respect to that of nonmigrants underscores the importance of considering the lived experience of Mexican migrants in the US as an important determinant of their health. Full article

(This article belongs to the Special Issue Migration and Global Health)

13 pages, 1520 KiB

Open AccessArticle

Health Patterns among Migrant and Non-Migrant Middle- and Older-Aged Individuals in Europe—Analyses Based on Share 2004–2017

by Nico Vonneilich, Daniel Bremer, Olaf von dem Knesebeck and Daniel Lüdecke

Int. J. Environ. Res. Public Health 2021, 18(22), 12047; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182212047 - 16 Nov 2021

Cited by 5 | Viewed by 1967

Abstract

Introduction: European populations are becoming older and more diverse. Little is known about the health differences between the migrant and non-migrant elderly in Europe. The aim of this paper was to analyse changes in the health patterns of middle- and older-aged migrant and non-migrant populations in Europe from 2004 to 2017, with a specific focus on differences in age and gender. We analysed changes in the health patterns of older migrants and non-migrants in European countries from 2004 to 2017. Method: Based on data from the Survey of Health, Ageing and Retirement in Europe (6 waves; 2004–2017; n = 233,117) we analysed three health indicators (physical functioning, depressive symptoms, and self-rated health). Logistic regression models for complex samples were calculated. Interaction terms (wave * migrant * gender * age) were used to analyse gender and age differences and the change over time. Results: Middle- and older-aged migrants in Europe showed significantly higher rates of depressive symptoms, lower self-rated health, and a higher proportion of limitations on general activities compared to non-migrants. However, different time trends were observed. An increasing health gap was identified in the physical functioning of older males. Narrowing health gaps over time were observed in women. Discussion: An increasing health gap in physical functioning in men is evidence of cumulative disadvantage. In women, evidence points towards the hypothesis of aging-as-leveler. These different results highlight the need for specific interventions focused on healthy ageing in elderly migrant men. Full article

(This article belongs to the Special Issue Migration and Global Health)

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14 pages, 1547 KiB

Open AccessArticle

Health Care Services Utilization of Persons with Direct, Indirect and without Migration Background in Germany: A Longitudinal Study Based on the German Socio-Economic Panel (SOEP)

by Thomas Grochtdreis, Hans-Helmut König and Judith Dams

Int. J. Environ. Res. Public Health 2021, 18(21), 11640; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182111640 - 05 Nov 2021

Cited by 4 | Viewed by 2047

Abstract

There is ambiguous evidence with regard to the inequalities in health care services utilization (HCSU) among migrants and non-migrants in Germany. The aim of this study was to analyze the utilization of doctors and hospitalization of persons with direct and indirect migration background as well as those without in Germany. This study was based on data of the German Socio-Economic Panel using the adult sample of the years 2013 to 2019. HCSU was measured by self-reported utilization of doctors and hospitalization. Associations between HCSU and migration background were examined using multilevel mixed-effects logistic regression and zero-truncated multilevel mixed-effects generalized linear models. The odds ratios of utilization of doctors and hospitalization for persons with direct migration background compared with persons without migration background were 0.73 (p < 0.001) and 0.79 (p = 0.002), respectively. A direct migration background was associated with a 6% lower number of doctoral visits within three months compared with no migration background (p = 0.023). Persons with direct migration background still have a lower HCSU than persons without migration background in Germany. Access to health care needs to be ensured and health policy-makers are called upon to keep focus on the issue of inequalities in HCSU between migrants and non-migrants in Germany. Full article

(This article belongs to the Special Issue Migration and Global Health)

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20 pages, 902 KiB

Open AccessArticle

Eritrean Refugees’ and Asylum-Seekers’ Attitude towards and Access to Oral Healthcare in Heidelberg, Germany: A Qualitative Study

by Yonas Semere Kidane, Sandra Ziegler, Verena Keck, Janine Benson-Martin, Albrecht Jahn, Temesghen Gebresilassie and Claudia Beiersmann

Int. J. Environ. Res. Public Health 2021, 18(21), 11559; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182111559 - 03 Nov 2021

Cited by 3 | Viewed by 2821

Abstract

Oral health concerns in Eritrean refugees have been an overlooked subject. This qualitative study explored the access of Eritrean refugees and asylum-seekers (ERNRAS) to oral health care services in Heidelberg, Germany, as well as their perceptions and attitudes towards oral health care. It involved 25 participants. We employed online semi-structured interviews (n = 15) and focus group discussions (n = 2). The data was recorded, transcribed, and analysed, using thematic analysis. The study found out that most of the participants have a relatively realistic perception and understanding of oral health. However, they have poor dental care practices, whilst a few have certain misconceptions of the conventional oral hygiene tools. Along with the majority’s concerns regarding psychosocial attributes of poor oral health, some participants are routinely consuming Berbere (a traditional spice-blended pepper) to prevent bad breath. Structural or supply-side barriers to oral healthcare services included: communication hurdles; difficulty in identifying and navigating the German health system; gaps in transculturally, professionally, and communicationally competent oral health professionals; cost of dental treatment; entitlement issues (asylum-seekers); and appointment mechanisms. Individual or demand-side barriers comprised: lack of self-sufficiency; issue related to dental care beliefs, trust, and expectation from dentists; negligence and lack of adherence to dental treatment follow-up; and fear or apprehension of dental treatment. To address the oral health burdens of ERNRAS, it is advised to consider oral health education, language-specific, inclusive, and culturally and professionally appropriate healthcare services. Full article

(This article belongs to the Special Issue Migration and Global Health)

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10 pages, 350 KiB

Open AccessArticle

Effects of Sociodemographic Variables and Depressive Symptoms on MoCA Test Performance in Native Germans and Turkish Migrants in Germany

by Görkem Anapa, Mandy Roheger, Ümran Sema Seven, Hannah Liebermann-Jordanidis, Oezguer A. Onur, Josef Kessler and Elke Kalbe

Int. J. Environ. Res. Public Health 2021, 18(12), 6335; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18126335 - 11 Jun 2021

Cited by 4 | Viewed by 2339

Abstract

The validity of the Montreal Cognitive Assessment (MoCA) in migrants is questionable, as sociodemographic factors and the migration process may influence performance. Our aim was to evaluate possible predictors (age, education, sex, depression, and migration) of MoCA results in Turkish migrants and Germans living in Germany. Linear regression models were conducted with a German (n = 419), a Turkish (n = 133), and an overall sample. All predictor analyses reached statistical significance. For the German sample, age, sex, education, and depression were significant predictors, whereas education was the only predictor for Turkish migrants. For the overall sample, having no migration background and higher education were significant predictors. Migration background and education had an impact on MoCA performance in a sample of German and Turkish individuals living in Germany. Thus, culture-specific normative data for the MoCA are needed, and the development of culture-sensitive cognitive screening tools is encouraged. Full article

(This article belongs to the Special Issue Migration and Global Health)

11 pages, 1706 KiB

Open AccessArticle

Genetic Variation and Cardiovascular Risk Factors: A Cohort Study on Migrants from the Former Soviet Union and a Native German Population

by Marianne Huebner, Daniela Börnigen, Andreas Deckert, Rolf Holle, Christa Meisinger, Martina Müller-Nurasyid, Annette Peters, Wolfgang Rathmann and Heiko Becher

Int. J. Environ. Res. Public Health 2021, 18(12), 6215; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18126215 - 08 Jun 2021

Cited by 1 | Viewed by 3512

Abstract

Resettlers are a large migrant group of more than 2 million people in Germany who migrated mainly from the former Soviet Union to Germany after 1989. We sought to compare the distribution of the major risk factors for cardiovascular disease (CVD) and to investigate the overall genetic differences in a study population which consisted of resettlers and native (autochthone) Germans. This was a joint analysis of two cohort studies which were performed in the region of Augsburg, Bavaria, Germany, with 3363 native Germans and 363 resettlers. Data from questionnaires and physical examinations were used to compare the risk factors for cardiovascular diseases between the resettlers and native Germans. A population-based genome-wide association analysis was performed in order to identify the genetic differences between the two groups. The distribution of the major risk factors for CVD differed between the two groups. The resettlers lead a less active lifestyle. While female resettlers smoked less than their German counterparts, the men showed similar smoking behavior. SNPs from three genes (BTNL2, DGKB, TGFBR3) indicated a difference in the two populations. In other studies, these genes have been shown to be associated with CVD, rheumatoid arthritis and osteoporosis, respectively. Full article

(This article belongs to the Special Issue Migration and Global Health)

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9 pages, 890 KiB

Open AccessArticle

Colorectal Cancer among Resettlers from the Former Soviet Union and in the General German Population: Clinical and Pathological Characteristics and Trends

by Melani Ratih Mahanani, Simone Kaucher, Hiltraud Kajüter, Bernd Holleczek, Heiko Becher and Volker Winkler

Int. J. Environ. Res. Public Health 2021, 18(9), 4547; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18094547 - 25 Apr 2021

Cited by 1 | Viewed by 2543

Abstract

This study examined time trends and clinical and pathological characteristics of colorectal cancer (CRC) among ethnic German migrants from the Former Soviet Union (resettlers) and the general German population. Incidence data from two population-based cancer registries were used to analyze CRC as age-standardized rates (ASRs) over time. The respective general populations and resettler cohorts were used to calculate standardized incidence ratios (SIRs) by time-period (before and after the introduction of screening colonoscopy in 2002), tumor location, histologic type, grade, and stage at diagnosis. Additionally, SIRs were modeled with Poisson regression to depict time trends. During the study period from 1990 to 2013, the general populations showed a yearly increase of ASR, but for age above 55, truncated ASR started to decline after 2002. Among resettlers, 229 CRC cases were observed, resulting in a lowered incidence for all clinical and pathological characteristics compared to the general population (overall SIR: 0.78, 95% CI 0.68–0.89). Regression analysis revealed an increasing SIR trend after 2002. Population-wide CRC incidence decreases after the introduction of screening colonoscopy. In contrast the lowered CRC incidence among resettlers is attenuating to the general population after 2002, suggesting that resettlers do not benefit equally from screening colonoscopy. Full article

(This article belongs to the Special Issue Migration and Global Health)

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12 pages, 738 KiB

Open AccessArticle

by Thomas Grochtdreis, Hans-Helmut König and Judith Dams

Int. J. Environ. Res. Public Health 2021, 18(7), 3665; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18073665 - 01 Apr 2021

Cited by 4 | Viewed by 2479

Abstract

Global migration towards and within Europe remains high, shaping the structure of populations. Approximately 24% of the total German population had a migration background in 2017. The aim of the study was to analyze the association between migration background and health-related quality of life (HrQoL) in Germany. The analyses were based on 2014 and 2016 data of the German Socio-Economic Panel. Differences in sociodemographic characteristics between migrant and non-migrant samples were equal by employment of the entropy balancing weights. HrQoL was measured using the physical (PCS) and mental (MCS) component summary scores of the SF-12v2. Associations between PCS and MCS scores and migration background were examined using Student’s t-test. The mean PCS and MCS scores of persons with migration background (n = 8533) were 51.5 and 50.9, respectively. Persons with direct migration background had a lower PCS score (−0.55, p < 0.001) and a higher MCS score (+1.08, p < 0.001) than persons without migration background. Persons with direct migration background differed with respect to both physical and mental HrQoL from persons without migration background in the German population. Differences in HrQoL for persons with indirect migration background had p = 0.305 and p = 0.072, respectively. Causalities behind the association between direct migration background and HrQoL are to be determined. Full article

(This article belongs to the Special Issue Migration and Global Health)

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12 pages, 844 KiB

Open AccessArticle

Association of Acculturation Status with Longitudinal Changes in Health-Related Quality of Life—Results from a Cohort Study of Adults with Turkish Origin in Germany

by Lilian Krist, Christina Dornquast, Thomas Reinhold, Heiko Becher, Karl-Heinz Jöckel, Börge Schmidt, Sara Schramm, Katja Icke, Ina Danquah, Stefan N. Willich, Thomas Keil and Tilman Brand

Int. J. Environ. Res. Public Health 2021, 18(6), 2827; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18062827 - 10 Mar 2021

Cited by 4 | Viewed by 2777

Abstract

Health-related quality of life (HRQL) among migrant populations can be associated with acculturation (i.e., the process of adopting, acquiring and adjusting to a new cultural environment). Since there is a lack of longitudinal studies, we aimed to describe HRQL changes among adults of Turkish descent living in Berlin and Essen, Germany, and their association with acculturation. Participants of a population-based study were recruited in 2012–2013 and reinvited six years later to complete a questionnaire. Acculturation was assessed at baseline using the Frankfurt acculturation scale (integration, assimilation, separation and marginalization). HRQL was assessed at baseline (SF-8) and at follow-up (SF-12) resulting in a physical (PCS) and mental (MCS) sum score. Associations with acculturation and HRQL were analyzed with linear regression models using a time-by-acculturation status interaction term. In the study 330 persons were included (65% women, mean age ± standard deviation 43.3 ± 11.8 years). Over the 6 years, MCS decreased, while PCS remained stable. While cross-sectional analyses showed associations of acculturation status with both MCS and PCS, temporal changes including the time interaction term did not reveal associations of baseline acculturation status with HRQL. When investigating HRQL in acculturation, more longitudinal studies are needed to take changes in both HRQL and acculturation status into account. Full article

(This article belongs to the Special Issue Migration and Global Health)

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13 pages, 1110 KiB

Open AccessArticle

Feasibility of a Culturally Adapted Dietary Weight-Loss Intervention among Ghanaian Migrants in Berlin, Germany: The ADAPT Study

by Stephen Amoah, Ruth Ennin, Karen Sagoe, Astrid Steinbrecher, Tobias Pischon, Frank P. Mockenhaupt and Ina Danquah

Int. J. Environ. Res. Public Health 2021, 18(2), 510; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18020510 - 09 Jan 2021

Cited by 8 | Viewed by 2748

Abstract

Background: Dietary weight-loss interventions often fail among migrant populations. We investigated the practicability and acceptability of a culturally adapted dietary weight-loss intervention among Ghanaian migrants in Berlin. Methods: The national guidelines for the treatment of adiposity were adapted to the cultural characteristics of the target population, aiming at weight-loss of ≥2.5 kg in 3 months using food-based dietary recommendations. We invited 93 individuals of Ghanaian descent with overweight or obesity to participate in a 12-weeks intervention. The culturally adapted intervention included a Ghanaian dietician and research team, one session of dietary counselling, three home-based cooking sessions with focus on traditional Ghanaian foods, weekly smart-phone reminders, and monthly monitoring of diet and physical activity. We applied a 7-domains acceptability questionnaire and determined changes in anthropometric measures during clinic-based examinations at baseline and after the intervention. Results: Of the 93 invitees, five participants and four family volunteers completed the study. Reasons for non-participation were changed residence (13%), lack of time to attend examinations (10%), and no interest (9%); 64% did not want to give any reason. The intervention was highly accepted among the participants (mean range: 5.3–6.0 of a 6-points Likert scale). Over the 12 weeks, median weight-loss reached −0.6 kg (range: +0.5, −3.6 kg); the diet was rich in meats but low in convenience foods. The median contribution of fat to daily energy intake was 24% (range: 16–40%). Conclusions: Acceptance of our invitation to the intervention was poor but, once initiated, compliance was good. Assessment centers in the participants’ vicinity and early stakeholder involvement might facilitate improved acceptance of the invitation. A randomized controlled trial is required to determine the actual effects of the intervention. Full article

(This article belongs to the Special Issue Migration and Global Health)

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13 pages, 682 KiB

Open AccessArticle

The Incidence of Intestinal Gastric Cancer among Resettlers in Germany—Do Resettlers Remain at an Elevated Risk in Comparison to the General Population?

by Anna Lindblad, Simone Kaucher, Philipp Jaehn, Hiltraud Kajüter, Bernd Holleczek, Lauren Lissner, Heiko Becher and Volker Winkler

Int. J. Environ. Res. Public Health 2020, 17(24), 9215; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17249215 - 09 Dec 2020

Cited by 2 | Viewed by 1543

Abstract

Objective: Previous studies have shown that the incidence of gastric cancer (GC), and particularly intestinal GC, is higher among resettlers from the former Soviet Union (FSU) than in the general German population. Our aim was to investigate if the higher risk remains over time. Methods: GC cases between 1994 and 2013, in a cohort of 32,972 resettlers, were identified by the respective federal cancer registry. Age-standardized rates (ASRs) and standardized incidence ratios (SIRs) were analyzed in comparison to the general population for GC subtypes according to the Laurén classification. Additionally, the cohort was pooled with data from a second resettler cohort from Saarland to investigate time trends using negative binomial regression. Results: The incidence of intestinal GC was elevated among resettlers in comparison to the general population (SIR (men) 1.64, 95% CI: 1.09–2.37; SIR (women) 1.91, 95% CI: 1.15–2.98). The analysis with the pooled data confirmed an elevated SIR, which was stable over time. Conclusion: Resettlers’ higher risk of developing intestinal GC does not attenuate towards the incidence in the general German population. Dietary and lifestyle patterns might amplify the risk of GC, and we believe that further investigation of risk behaviors is needed to better understand the development of disease pattern among migrants. Full article

(This article belongs to the Special Issue Migration and Global Health)

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Review

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14 pages, 2200 KiB

Open AccessReview

Parent Emigration, Physical Health and Related Risk and Preventive Factors of Children Left Behind: A Systematic Review of Literature

by Justina Račaitė, Jutta Lindert, Khatia Antia, Volker Winkler, Rita Sketerskienė, Marija Jakubauskienė, Linda Wulkau and Genė Šurkienė

Int. J. Environ. Res. Public Health 2021, 18(3), 1167; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18031167 - 28 Jan 2021

Cited by 12 | Viewed by 5226

Abstract

The aim of our study was to systematically review the literature on physical health and related consequences of internal and international parental migration on left-behind children (LBC). This review followed PRISMA guidelines. We searched the PubMed, Web of Science, Academic Search Complete, PsycINFO, and Cochrane databases and included studies reporting physical health-related outcomes of children affected by parental migration. The quality of the studies was assessed using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. We selected 34 publications from a total of 6061 search results. The study found that LBC suffer from poor physical health as compared with non-LBC. Physical health-related risk factors such as underweight, lower weight, stunted growth, unhealthy food preferences, lower physical activity, smoking, alcohol consumption, injuries, and incomplete vaccination tend to be more prevalent among LBC in China. Studies focussing on international migration argue that having migrant parents might be preventive for undernutrition. Overall, our study showed that children affected by internal or international migration tend to have similar physical health outcomes. Moreover, we identified a lack of evidence on international parental migration that may have influenced the overall impacts. Further studies addressing international migration would contribute to better understand the impacts of migration for LBC. Full article

(This article belongs to the Special Issue Migration and Global Health)

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11 pages, 908 KiB

Open AccessReview

Dental Caries among Refugees in Europe: A Systematic Literature Review

by Sneha Bhusari, Chiamaka Ilechukwu, Abdelrahman Elwishahy, Olaf Horstick, Volker Winkler and Khatia Antia

Int. J. Environ. Res. Public Health 2020, 17(24), 9510; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17249510 - 18 Dec 2020

Cited by 9 | Viewed by 3184

Abstract

Oral health is one of the most neglected aspects of refugee health. The study aimed to systematically review evidence on prevalence of dental caries and dental care services provided to refugees in Europe. Following PRISMA guidelines, we searched PubMed, Cochrane, WHOLIS, Web of Science, Medline Ovid, and Google Scholar identifying studies on dental caries among refugees in Europe after the 2015 refugee crisis. From 3160 records, fourteen studies were included in the analysis. Eight studies on oral health showed caries prevalence of between 50% and 100%, while it ranged from 3% to 65% in six general health studies. Caries prevalence was proportional to age and inversely associated with education, whereas gender and country of origin showed no significant association. Nowhere is oral health part of general health assessment on arrival and is complaint based. Primary focus on resettlement, language, cultural, and economic barriers emerged as explanatory models for limited access. Our study identified a high prevalence of caries and limited access to dental health services as main challenges. Integrating oral health check-ups may contribute in shifting towards preventive oral care. Further research is urgently needed to better understand the dental needs of refugees in Europe. Full article

(This article belongs to the Special Issue Migration and Global Health)

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