The association of self-reported discrimination to all-cause mortality : A population-based prospective cohort study

Discrimination has is an important social determinant of health and though some research has been carried out on this it is mostly from the United States, which may not be generalisable to Europe and Sweden. This study investigated the association between self-reported experiences of repeated discrimination and all-cause mortality in Scania, Sweden. The Scania Public Health survey was sent out in 2008 with a follow-up in 2013 through the Swedish national cause of death register (N=28,062). The exposure variable under investigation was self-reported discrimination and the outcome variable was all-cause mortality. Additional variables included demographics (age, sex, marital status, immigrant status), health behaviours (smoking, alcohol consumption, physical exercise), BMI, social participation, economic stress, and mental health. Time was measured as total number of days. Statistical analysis included association of the different variables to discrimination (ORs) and to all-cause mortality (HRs) adjusting for different covariates. Effect modification was tested for social participation, economic stress and mental health. The odds of discrimination was higher among the most vulnerable groups in society. All-cause mortality was strongly associated to age and sex, with a much higher risk among men than women. The association of repeated discrimination to all-cause mortality remained significant after adjusting for demographic variables, health behaviours and either social participation or economic stress, but not both. The association was non-significant after adjusting for demographic variables and mental health. Social participation was found to be an effect modifier with low participation strengthening the effect of the association of repeated discrimination to all-cause mortality. Repeated discrimination clearly has a strong impact on mental health but also on economic stress and social participation which in turn have a strong impact on mortality

No evidence, no problem? A critical interpretive synthesis of the vulnerabilities to and experiences of sexual violence among young migrants in Europe

Background Growing evidence indicates that young migrants are particularly vulnerable to sexual violence, however most research has focused on instances of sexual violence occurring in conflict zones and during transit. Much less attention has been given to the vulnerabilities to and experiences of sexual violence among young migrants in Europe. Objectives To understand the scientific evidence regarding the experiences of and vulnerabilities to sexual violence among young migrants (aged 11–30 years) in Europe. Methods A search of three databases resulted in 1279 peer reviewed articles published between 2002 and 2022. Of these, 11 were included in this review. A critical interpretive synthesis methodology was applied. Results Few studies investigate sexual violence among young migrants in Europe. The existing studies focus on very specific sub-groups of migrants, and as such, experiences of persons outside these groups are largely absent from the academic discourse. How sexual violence is understood varies across studies, often conflated with other forms of violence, hampering comparisons. However, the results of this review indicate that young migrants in Europe, both male and female, experience sexual violence and there are multiple sources of vulnerabilities at all levels of the socioecological model. Conclusion The scarcity of research regarding sexual violence among young migrants in Europe could give rise to the perception that no evidence means no problem, resulting in a continued lack of attention to this issue. There is a critical need to address this gap to inform prevention interventions, to identify victims, and to facilitate access to care

Coming across a hidden problem in an excluded population in Sweden: professionals’ experiences of young migrants’ disclosures of sexual violence

Growing evidence suggests that young migrants are particularly vulnerable to sexual violence. As young migrants often lack family and social networks, professionals are often the recipients of disclosures of sexual violence. This study aimed to explore how professionals experience young migrants’ disclosures of sexual violence. A qualitative design was used, based on 14 semi-structured interviews with a range of professionals from the public sector and civil society in southern Sweden. The data were analysed using qualitative content analysis. The overarching theme developed was ‘coming across the hidden problem of sexual violence in an excluded population’ supported by three sub-themes: ‘linking structural marginalisation and vulnerability to sexual violence’; ‘realising that sexual violence is one among many other concerns’; and ‘taking pride in backing up young people betrayed by society’. Professionals expressed a strong sense of responsibility due to the complex vulnerabilities of young migrants and their lack of access to services. This, coupled with the lack of clarity about how to respond to disclosures of sexual violence, can lead to moral distress. There is a need to strengthen support for professionals, including recognition of ethical dilemmas and the establishment of formal connections between organisations making access more straightforward and predictable