Prevention of War: A Scoping Review on Primary Preventive Measures in Public Health

Brake T-M, Razum O. Prevention of War: A Scoping Review on Primary Preventive Measures in Public Health. Public Health Reviews . 2023;44: 1606201.Objectives: Wars and armed conflicts have a major impact on population health. As the discipline of public health aims to increase the health at population level, professionals play a significant role in dealing with war and armed conflict. There is need for research on prevention. This study aims to map the literature on existing public health approaches addressing the primary prevention of war and/or armed conflict. Methods: We performed a scoping review in the databases Web of Science, PubMed and Google Scholar, followed by a narrative synthesis. Results: We included 15 studies. We identified three main themes regarding preventive measures: 1) research on root causes of conflicts, surveillance and documentation of its health consequences; 2) education and awareness raising on the consequences of conflicts; and 3) interventions to change socio-economic and political conditions conducive to conflicts. Conclusion: A two-tiered conceptual framework emerges: For primary prevention of war, public health should promote human rights and the rule of law. To prevent armed conflict within states, public health should address the social determinants of health and aim to reduce poverty and inequity. Copyright © 2024 Brake and Razum

Ein analytischer Rahmen für die Bewertung unterschiedlicher Typen von Flüchtlingsunterkünften unter gesundheitlichen Gesichtspunkten

Dudek V, Brake T-M, Razum O. An Analytical Framework for Assessing Types of Refugee Accommodation from a Health Perspective. Zeitschrift für Flüchtlingsforschung. 2022;6(2):211-248.Housing is an important social determinant of health. The type of housing in which refugees are accommodated varies widely. Measuring health-related attri-butes of accommodation poses methodological challenges. In this article, we develop a framework to describe health-relevant aspects of refugee accommoda-tion as a first step to assess how different types of facilities affect the health of their residents. Our starting point is a paradigmatic form of refugee accommoda-tion, the camp. With their often-extreme features, camps can help us to grasp the broad variety that accommodation-related health determinants can take. Research on refugee camps has been drawing from various fields and theoretical concepts – mainly the work of Arendt, Goffman, Foucault and Agamben. These concepts, interpreted from a social determinants of health perspective, provide the basis for our analytical framework of refugee accommodation in general. We show that housing in the context of refugee accommodation should be understood from (1), the broader political context; (2), the immediate surroundings of the accommoda-tion and its physical and social boundaries; and (3), the structures and processes inside the accommodation that may establish means of social control. A fourth, subjective dimension complements our analytical framework. This framework provides the basis for future research to establish the pathways between features of refugee accommodation and the health of their residents.Die Wohnsituation ist eine wichtige soziale Determinante der Gesundheit. Flüchtlinge werden auf sehr unterschiedliche Weise untergebracht. Die Messung gesundheitsrelevanter Eigenschaften von Unterkünften ist eine methodische Herausforderung. In diesem Artikel entwickeln wir einen Rahmen zur Beschreibung gesundheitsrelevanter Aspekte von Flüchtlingsunterkünften. Damit schaffen wir eine Grundlage für Studien, die untersuchen, wie sich verschiedene Arten von Unterbringung auf die Gesundheit ihrer Bewohner auswirken. Unser Ausgangspunkt ist eine paradigmatische Form der Flüchtlingsunterkunft, das Lager. Mit ihren oft extremen Merkmalen können Lager dabei helfen, die große Vielfalt der unterkunftsbezogenen Gesundheitsfaktoren zu erfassen. Die Forschung zu Flüchtlingslagern stützt sich auf verschiedene wissenschaftliche Fachrichtungen und theoretische Konzepte – insbesondere auf die Arbeiten von Arendt, Goffman, Foucault und Agamben. Diese Konzepte, interpretiert aus der Perspektive der sozialen Determinanten von Gesundheit, bilden die Grundlage für unseren analytischen Rahmen für alle Arten von Flüchtlingsunterkünften. Wir zeigen, dass Wohnen im Kontext von Flüchtlingsunterkünften unter folgenden Gesichts-punkten betrachtet werden muss: (1) dem breiteren politischen Kontext; (2) der unmittelbaren Umgebung der Unterkunft sowie ihren physischen und sozialen Abgrenzungen; und (3) die Strukturen und Prozesse innerhalb der Unterkunft, die Mittel der sozialen Kontrolle schaffen können. Eine vierte, subjektive Dimension ergänzt unseren analytischen Rahmen. Dieser Rahmen bildet die Grundlage für künftige Forschungsarbeiten zur Ermittlung der Zusammenhänge zwischen den Merkmalen von Flüchtlingsunterkünften und der Gesundheit ihrer Bewohner

[Health Situation in Ukraine Before Onset of War and Its Relevance for Health Care for Ukrainian Refugees in Germany: Literature Review, Risk Analysis, and Priority Setting

Butenop J, Brake T, Mauder S, Razum O. Gesundheitliche Lage in der Ukraine vor Kriegsbeginn und ihre Relevanz für die Versorgung ukrainischer Geflüchteter in Deutschland: Literaturdurchsicht, Risikoanalyse und Prioritätensetzung. Gesundheitswesen . 2022

Psychosocial attributes of housing and their relationship with health among refugee and asylum-seeking populations in high-income countries: systematic review

Brake T-M, Dudek V, Sauzet O, Razum O. Psychosocial attributes of housing and their relationship with health among refugee and asylum-seeking populations in high-income countries: systematic review. bioRxiv. 2022.Introduction Housing as a social determinant of health should provide not only shelter, but also a feeling of home. We explored psychosocial pathways creating a sense of home and influencing the relationship between housing and health among asylum seekers and refugees (ASR) in high-income countries. Methods We performed a systematic review. To be included, studies had to be peer-reviewed, published between 1995 and 2022, and focus on housing and health of ASR in high-income countries. We conducted a narrative synthesis. Results 32 studies met the inclusion criteria. The psychosocial attributes influencing health most often identified were control, followed by expressing status, satisfaction, and demand. Most attributes overlap with material/physical attributes and have an impact on ASR’s mental health. They are closely interconnected with each other. Conclusions Psychosocial attributes of housing play an important role in the health of ASR; they are closely associated with material/physical attributes. Therefore, future research on housing and health of ASR should routinely examine psychosocial attributes, but always in association with physical attributes. The connections between these attributes are complex and need to be further explored

Associations between postmigration living situation and symptoms of common mental disorders in adult refugees in Europe: updating systematic review from 2015 onwards

Nowak AC, Nutsch N, Brake T-M, Gehrlein L-M, Razum O. Associations between postmigration living situation and symptoms of common mental disorders in adult refugees in Europe: updating systematic review from 2015 onwards. BMC Public Health. 2023;23(1): 1289.Background Refugees and asylum seekers have a high prevalence of psychiatric disorders such as post-traumatic stress disorder (PTSD), anxiety, and depression. The postmigration context inheres different risk and protective factors for mental health of refugees and asylum seekers in host countries. We conducted a systematic review to update knowledge on the association between characteristics of the postmigration living situation (PMLS) and mental health outcomes in Europe since 2015. Methods We searched in five databases according to the PRISMA statement. From a total of 5,579 relevant studies published in 2015–22, 3,839 were included for title and abstract screening, and 70 full texts screened for eligibility. Out of these, 19 studies on refugees and asylum seekers conducted in European countries after 2014 were included in this systematic review. The quality of studies was assessed by using the Mixed Methods Appraisal Tool (MMAT) – version 2018. We performed a narrative synthesis using the four layers of the social determinants of health framework. Results A wide range of risk and protective factors for mental health in the PMLS were identified as exposure measures, which included individual factors (e.g., language skills), social and community networks (e.g., family concerns, loneliness and social support, discrimination), living and working conditions (e.g., legal status, duration of residence, unemployment and financial hardship, housing) as well as general socio-economic, cultural and environmental factors (e.g., social status, acculturation). We found postmigration stressors are positively associated with symptoms of depression, anxiety, and PTSD, albeit not consistently so. Especially, the general socio-economic, cultural and environmental factors showed weak associations with mental health. Conclusions Heterogenous study characteristics likely explain the inconsistent associations between characteristics of the PMLS and mental health outcomes. However, broken down in its component layers, most risk and protective factors of the PMLS were significantly associated with symptoms of mental disorders showing the same direction of association across the included studies, while the association between some stressors or resources of the PMLS and mental health turns out to be less homogeneous than expected. Characteristics of the PMLS contribute to the high prevalence of mental diseases of refugees and asylum seekers. Disadvantages in general socio-economic conditions, living and working conditions, in access to social and community networks need to be redressed, in addition to better access to health care