Understanding the impact of context on migrant health: what we know from natural experiments. (Policy Brief)

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Understanding the Impact of Context on Migrant Health. What we know from natural experiments. (Policy Brief)

Biddle LR, Hintermeier M, Costa D, Wasko Z, Bozorgmehr K. Understanding the Impact of Context on Migrant Health. What we know from natural experiments. (Policy Brief). Evidence Synthesis Series. Vol 2023-02. Bielefeld: Fakultät für Gesundheitswissenschaften, AG Bevölkerungsmedizin und Versorgungsforschung, Rapid Review Response Unit (RRRUn).; 2023

Context, health and migration: a systematic review of natural experiments

Biddle LR, Hintermeier M, Costa D, Wasko Z, Bozorgmehr K. Context, health and migration: a systematic review of natural experiments. eClinicalMedicine. 2023: 102206.Background Migration health research pays little attention to the places into which people migrate. Studies on health effects of contextual factors are often limited because of the ability of individuals to self-select their environment, but natural experiments may allow for the causal effect of contexts to be examined. The objective was to synthesise the evidence on contextual health effects from natural experiments among migrant groups. Methods We performed a systematic review of natural experiments among migrant populations in PubMed/MEDLINE, The Cochrane Library, Web of Science, CINAHL and Google Scholar for literature published until 13 October 2022. 5870 articles were screened in duplicate using the following inclusion criteria: quantitative natural experiment design, migrant population, context factor as treatment variable and health or healthcare outcome variable. Synthesis without meta-analysis was performed following quality appraisal using the EPHPP tool for quantitative studies and data extraction (PROSPERO: CRD42020169236). Findings The 46 included articles provide evidence for negative effects of neighbourhood disadvantage on physical health and mortality, while finding mixed effects on mental health. Articles comparing migrants with those that stayed behind demonstrate detrimental effects of migration and adverse post-migratory contexts on physical health and mortality, while demonstrating favourable effects for mental and child health. Natural experiments of policy environments indicate the negative impacts of restrictive migration and social policies on healthcare utilization, mental health and mortality, as well as the positive health effects when restrictions are lifted. Interpretation Natural experiments complement observational studies and provide robust evidence to advocate for more inclusive migration, health and social policies as well as neighbourhood improvement programmes. In order to strengthen the methodological approach, future research utilising natural experiments should be more explicit in the mechanisms underlying the experiment and provide details on potential causal mechanisms for the observed effects.</br

Ethnic diversity and mortality in northwest Burkina Faso: An analysis of the Nouna health and demographic surveillance system from 2000 to 2012.

Ethnic diversity has been a topic of contention across the globe, contrasted with economic development, social security, and political stability. The link between health and ethnic diversity is not yet well established especially in low-middle- income countries. Our study aims to explore the association between ethnic diversity and all-cause mortality in rural areas of Burkina Faso. We used data from the Nouna Health & Demographic Surveillance System (HDSS) collected between 2000 and 2012. To derive Standardized Mortality Ratios (SMR), the observed number of deaths was compared to the expected deaths based on the entire HDSS taking into account sex, age, rainy season, calendar year, and village. SMR were calculated for ethnic and religious diversity on a village level (using the Simpson Index), sub-region, wealth, and distance to Healthcare Facilities (HCF). Furthermore, we modeled SMR with a multilevel random intercept Poisson regression considering individual ethnic and religious groups in addition to the above-mentioned village-level information. Village wealth (poorest fifth: SMR 1.07; 95% CI: 1.02-1.13, richest fifth: SMR 0.85; 95% CI: 0.82-0.88), distance to HCF (within the village: SMR 0.88; 95% CI: 0.85-0.91, further than 5km: SMR 1.13; 95% CI: 1.10-1.16), and sub-region showed significant associations with overall mortality. Villages belonging to the third with the highest ethnic diversity had lowered SMR (0.86; 95% CI: 0.84-0.89) compared to the entire HDSS, while those belonging to the lowest diversity third yielded elevated SMR (1.13; 95% CI: 1.09-1.17). The multilevel model confirmed the association. Our study showed that historically established ethnic diversity in rural areas of Burkina Faso was associated with lower all-cause mortality. Generally, the literature suffers from a lack of standardization in defining ethnic diversity, along with measuring it. More research is needed to understand this relation and to establish it in different settings

Pushback practices and violence towards migrants crossing European borders: A systematic review

Wasko Z, James R, Cloux A-J, et al. Pushback practices and violence towards migrants crossing European borders: A systematic review. In: Abstracts of the 13th European Congress on Tropical Medicine and International Health (ECTMIH 2023), Shaping the future of equitable and sustainable planetary health, 20–23 November 2023, Utrecht. Tropical Medicine and International Health . Vol 28. Hoboken: Wiley; 2023

Prevalence of major non-communicable diseases and their associated risk factors in Afghanistan: a systematic review and meta-analysis

Background: Non-communicable diseases (NCDs) are the leading cause of mortality worldwide, and increasingly so in low- and middle-income countries. Afghanistan is dealing with a double burden of diseases, yet there has been no evidence synthesis on the prevalence of major NCDs and their risk factors. Objective: This study aims to provide a comprehensive synthesis of the existing data on the prevalence of major NCDs and the common related risk factors in Afghanistan. Method: We systematically reviewed scientific articles from 2000 to 2022 that reported the prevalence of diabetes, chronic respiratory diseases (CRDs), cardiovascular diseases (CVDs) or cancer, and their risk factors in Afghanistan. Four online databases (PubMed, Web of Science, Cochrane and Google Scholar) and two local journals in Afghanistan (not indexed online) were systematically searched and screened. Two reviewers independently screened and appraised the quality of the articles. Data extraction and synthesis were performed using tabulated sheets. Results: Among 51 eligible articles, 10 (19.6%) focused on cancer, 10 (19.6%) on diabetes, 4 (7.8%) on CVDs, 4 (7.8%) on CRDs and 23 (45.1%) on risk factors as the primary outcome. Few articles addressed major NCD prevalence; no evidence of CVDs, cancer was 0.15%, asthma ranged between 0.3% and 17.3%, and diabetes was 12%. Pooled prevalence of hypertension and overweight were 31% and 35%, respectively. Central obesity was twice as prevalent in females (76% versus 40%). Similarly, gender differences were observed in smoking and snuff use with prevalence rates of 14% and 25% among males and 2% and 3% among females, respectively. A total of 14% of the population engaged in vigorous activity. Pooled prevalence for physical inactivity, general obesity, fruit and vegetable consumption, dyslipidaemia and alcohol consumption couldn’t be calculated due to the heterogeneity of articles. Conclusion: Only little evidence is available on the prevalence of major NCDs in Afghanistan; however, the NCD risk factors are prevalent across the country. The quality of the available data, especially those of the local resources, is poor; therefore, further research should generate reliable evidence in order to inform policymakers on prioritizing interventions for controlling and managing NCDs

Pushback practices and violence towards migrants crossing European borders: A systematic review

Wasko Z, James R, Cloux A-J, et al. Pushback practices and violence towards migrants crossing European borders: A systematic review. In: Abstracts of the 13th European Congress on Tropical Medicine and International Health (ECTMIH 2023), Shaping the future of equitable and sustainable planetary health, 20–23 November 2023, Utrecht. Tropical Medicine and International Health . Vol 28. Hoboken: Wiley; 2023: 376-377

sj-docx-1-taj-10.1177_20406223241229850 – Supplemental material for Prevalence of major non-communicable diseases and their associated risk factors in Afghanistan: a systematic review and meta-analysis

Supplemental material, sj-docx-1-taj-10.1177_20406223241229850 for Prevalence of major non-communicable diseases and their associated risk factors in Afghanistan: a systematic review and meta-analysis by Ahmad Siyar Noormal, Volker Winkler, Sneha Bansi Bhusari, Olaf Horstick, Valérie R. Louis, Andreas Deckert, Khatia Antia, Zahia Wasko, Pratima Rai, Aline Frare Mocruha and Peter Dambach in Therapeutic Advances in Chronic Disease</p