Inequalities in health literacy between European population and newly arrived male sub-Saharan migrants in Europe.

Increases in migration pressure from sub-Saharan Africa to Europe have increased in recent years. Despite this trend, the health literacy needs of migrants in host communities have not been sufficiently studied. This research aims to explore the health literacy of migrants newly arriving in Europe and compare it with the health literacy levels of the European population, utilizing data obtained from the European health literacy survey. A convenience sampling cross-sectional study was conducted at the Temporary Immigrant Stay Center in Melilla (Spain) in June 2022 using a validated French and Arabic version of the 16-item European health literacy survey questionnaire. A total of 106 sub-Saharan migrants ≥ 18 years of age were surveyed. The general health literacy index of the migrants was 30.02 points (on a scale of 50), placing it in the 'problematic' level. Of the participants, 57.54% had a limited ability to obtain, understand and apply health information and make appropriate health-related decisions. The largest gap compared to European citizens was observed in skills to understand information related to disease prevention. These results reinforce that migrant status is a social determinant of low health literacy and suggest that health professionals should extend their educational role to this vulnerable group.

The Tulumbe! Partnership: a case study in developing a community-led research agenda to address HIV among African immigrants in the United States.

Grassroots, community organizations are trusted resources within communities, which puts them in an ideal position to effectively engage individuals impacted by health inequities in defining meaningful research priorities. A community-centered approach to HIV research is critical for African immigrants living in the United States, who experience stigma and other socio-structural barriers to HIV prevention, care, and research engagement. Supporting community organizations with financial resources and capacity building activities to lead the development of research agendas ensures better alignment with community interests and fosters sustainability. We developed a community-initiated and -led research engagement project-Tulumbe!, which prioritized community leadership in all project activities. Community forums, health care provider and community questionnaires, interviews, and report-back sessions were held to examine the research interests and health concerns voiced by African immigrants. The iterative, community-led engagement process of more than 200 African immigrants, health providers, and researchers resulted in a community-defined research agenda with six areas of focus: family communication; self-efficacy for African immigrant women; deconstructing masculinity for African immigrant men; sexual health education for African immigrant youth; HIV stigma; and health literacy. Time, resources, and flexibility are needed to develop a viable community-led research partnership. Investing in community leadership not only produced a patient-centered research agenda but also led to community ownership of the process and results; thus, all partners were committed to sustaining the work.

Determinants for the humanitarian workforce in migrant health at the US-Mexico border: optimizing learning from health professionals in Matamoros and Reynosa, Mexico.

Introduction: Shortages of health professionals is a common problem in humanitarian settings, including among migrants and refugees at the US-Mexico border. We aimed to investigate determinants and recruitment recommendations for working with migrants to better understand how to improve health professional participation in humanitarian efforts. Methods: Semi-structured interviews were conducted with health professionals working with migrants at the US-Mexico border in Matamoros and Reynosa, Mexico. The study aimed to identify motivations, facilitators, barriers, and sacrifices to humanitarian work, and recommendations for effective learning approaches to increase participation. Participants included health professionals working within humanitarian organizations to deliver healthcare to migrants living in non-permanent encampments. Interviews lasted approximately 45 min and were analyzed in NVivo14 using a validated codebook and team-based methodology. Results: Among 27 participants, most were female (70%) with median age 32. Health professionals included nurses (41%), physicians (30%), logisticians (11%), social workers (7%), an EMT (4%), and a pharmacist (4%) from the US (59%), Mexico (22%), Cuba (11%), Peru (4%), and Nicaragua (4%) working for four organizations. Participants expressed internal motivations for working with migrants, including a desire to help vulnerable populations (78%), past experiences in humanitarianism (59%), and the need to address human suffering (56%). External facilitators included geographic proximity (33%), employer flexibility (30%), and logistical support (26%). Benefits included improved clinical skills (63%), sociocultural learning (63%), and impact for others (58%). Negative determinants included sacrifices such as career obligations (44%), family commitments (41%), and safety risks (41%), and barriers of limited education (44%) and volunteer opportunities (37%). Participants criticized aspects of humanitarian assistance for lower quality care, feeling useless, and minimizing local capacity. Recommendations to increase the health workforce caring for migrants included integration of humanitarian training for health students (67%), collaborations between health institutions and humanitarian organizations (52%), and improved logistical and mental health support (41%). Conclusion: Health professionals from diverse roles and countries identified common determinants to humanitarian work with migrants. Recommendations for recruitment reflected feasible and collaborative approaches for professionals, organizations, and trainees to pursue humanitarian health. These findings can be helpful in designing interventions to address workforce shortages in humanitarian migrant contexts.

Building a healthy migrant workforce in Singapore - A cross-sectional study to understand health-seeking behaviours of male migrant workers.

Background: The healthcare policies for migrant workers in Singapore had a traditional focus on improving occupational health and preventing workplace injuries. The COVID-19 pandemic led to a rapid paradigm shift in the provision of healthcare for migrant workers, with an urgent focus on improving the accessibility and affordability of primary and preventive health services and strengthening public health surveillance. The purpose of this study is to identify areas for improvement, so that policy makers can improve the implementation effectiveness of healthcare policies for migrant workers. This is achieved by establishing a baseline understanding of (a) the health-seeking behaviours of migrant workers in Singapore, (b) how they consume primary and preventive health services, and (c) systemic gaps in the delivery of services. Methods: A cross-sectional study was conducted at five migrant worker dormitories and two community spaces in Singapore, between August and November 2022. 1101 male migrant workers participated in a survey and 1089 valid responses were analysed. Multivariable logistic regression was used to identify sociodemographic factors associated with health service utilisation and awareness of the new healthcare financing plan introduced for migrant workers, called the Primary Care Plan (PCP). Results: The mean age of participants was 34 years. Most of them were of Indian or Bangladeshi nationality. At least 82 % of participants reported that they could access varying health services in Singapore and 73 % were satisfied with the costs of healthcare. However, a lower percentage of the participants (54 %) had seen a doctor, mostly for respiratory, fever or musculoskeletal conditions, and only 7 % saw a dentist at least once in a year. This was attributable to their low perceived need to see a doctor (91 %) or dentist (71 %). While the prevalence of chronic diseases (4 %) was low among the participants, about one-third of participants smoked (26 %), consumed alcohol (32 %), or resorted to self-treatment or medication (39 %). Conclusion: This study corroborated with previous observational studies where migrant workers in Singapore only sought care during an acute episode of illness. While participants perceived healthcare in Singapore to be accessible and affordable, there was limited evidence to suggest that preventive health care was prioritised. This indicates possible gaps in current outreach programmes and further development of new targeted programmes to increase the health literacy and awareness of primary and preventive health services among migrant workers in Singapore.

The interplay of sex/gender and migration: implications for health and healthcare access.

This intervention explores the intricate relationship among sex, gender, migratory status, and health outcomes in migrant populations. It emphasizes the distinction between sex (biological characteristics) and gender (socially constructed roles), highlighting how they intersect throughout the migration journey. The impact of gender dynamics on migration decisions, experiences, and outcomes is examined, with specific attention to sex/gender differences in the health and lifestyles of immigrant populations. Furthermore, it underscores how sex and gender disparities may affect access to healthcare. The importance of sex- and gender-inclusive healthcare services and cultural sensitivity in addressing these disparities is emphasized. Additionally, the intervention calls for research that considers diverse gender identities and country-specific factors. Ultimately, it asserts the need for sex- and gender-sensitive policies, collaborative efforts, and tailored interventions to promote health equity, gender equality, and human rights in migrant populations, aligning with global policy goals.

Comparing the Health Status of Immigrant and New Zealand-Born Older Adults in Aotearoa New Zealand: The Role of Socioeconomic Position.

OBJECTIVES: The study investigated the health status of older migrants relative to their New Zealand-born peers. We adopted a holistic view of health (physical, mental, and social) and a structural approach to health disparities based on migrant status and socioeconomic position. METHODS: Using case-control matching based on age, gender, and education, the health status of 357 older migrants and 357 New Zealand-born older adults was compared. RESULTS: Older migrants reported significantly poorer social health. Health inequities were patterned by socioeconomic status. Working class older migrants had significantly poorer physical, mental, and social health than their New Zealand-born peers. Inequities in social wellbeing persisted even at the upper end of the social gradient. DISCUSSION: Migrant background is an important social determinant of health in older age. The reduced social wellbeing of economically advantaged migrants highlights vulnerabilities regardless of socioeconomic position and the need for targeted social policies.

Health effects and user perceptions of the US Customs and Border Patrol One™ mobile application: A qualitative analysis among asylum seekers at the Mexico-US border.

Background: The number of migrants at the Mexico-US border has increased to historic levels, and frequently changing immigration policy impacts this population as they await entry into the US. This study evaluated the usability and health effects of the Customs and Border Protection (CBP) One™ mobile application among asylum seekers near the US port of entry in Reynosa, Mexico. Methods: We conducted semi-structured qualitative interviews with 20 asylum seekers in Reynosa, Mexico, in February 2023. Our objective was to explore the subjective experiences of migrants, usability of CBP One™, and presence of perceived health effects from using the application. Interviews were conducted until saturation occurred, transcribed verbatim into Word, coded in NVivo using a validated, team-based coding methodology, and analyzed according to internal domains, external domains, and health effects regarding CBP One™. Results: Twenty participants originated from eight countries throughout Latin America and the Caribbean. In total, 18 subthemes were identified among internal, external, and effects domains. Internal themes included a confusing application interface (80%), technical malfunction (60%), and perceived racial bias from the photo-capture features (15%). External themes challenging CBP One™ use included unavailable appointment slots (80%), inequity and inaccessibility (35%), and inadequate internet (25%). Most perceived effects were negative (85%), including worsening mental health effects (40%), exacerbation of pre-existing physical conditions (35%), and forgoing health expenditures to pay for internet (25%). Conclusions: Our findings suggest that asylum seekers at the Reynosa port of entry perceive CBP One™ negatively, with detrimental effects towards their mental and physical health. This study highlights how immigration policy can influence health and suggests that more creative and humane approaches are needed for people seeking asylum at the Mexico-US border.

Socioecologies in shaping migrants and refugee youths' sexual and reproductive health and rights: a participatory action research study.

OBJECTIVE: This study explores socioecological factors facilitating the sexual and reproductive health and rights (SRHR) experiences of migrant and refugee youth (MRY) in Greater Western Sydney, Australia. MRY may be at higher risk for poorer SRH outcomes due to cultural, linguistic, and systemic barriers. METHODS: Using participatory action research, 17 focus groups were conducted with 87 MRY aged 15-29 from diverse cultural backgrounds. Data were analysed thematically, using socioecological framework. RESULTS: Key facilitators of MRY's SRHR were identified at the microsystem and exosystem levels, including (1) Peer dynamics and support, with friends serving as trusted confidants and sources of advice; (2) Safety and contraceptive choices, highlighting the importance of access to contraception and STI prevention; and (3) Digital platforms for SRHR information access, with online resources filling knowledge gaps. CONCLUSION: Findings suggest the need for SRHR interventions to leverage peer support networks, expand access to contraceptive options, and develop culturally appropriate digital resources for MRY. Further research is needed to identify and enhance facilitators across all socioecological levels to comprehensively support MRY's SRHR needs.

Migrants and refugee youth often struggle to access sexual and reproductive health information and services in their new countries. This study is an attempt to understand what helps young migrants and refugee maintain their sexual and reproductive health and rights in Greater Western Sydney, Australia. Our aim was to identify the positive factors in their environment that make it easier for them to access and use sexual health resources. We talked to 87 migrants and refugee youth aged 15­29 from various cultural backgrounds, conducting 17 group discussions about their experiences with sexual health. Our main results show three important factors that help these young people. The results were, that (1) Many young people trust their friends for advice and information about sexual health, (2) Having choices about contraception and ways to prevent sexually transmitted infections was important, and (3) The internet, especially social media and search engines, is a major source of sexual health information for young people. Understanding these helpful factors can guide better support for young migrants and refugees. It shows sexual health programs need to use peer support in sexual health programs, make sure young people can easily access contraception and protection and create trustworthy online resources about sexual health that are culturally appropriate. Our findings show more research is needed to find other ways to support young migrants and refugees with their sexual and reproductive health. This will help create better health services and education programs for these young people.

A Case Study on the Dietary Shifts in an Older Tongan Migrant to the United States.

This case study, anchored in the Social Ecological Model (SEM), delves into the dietary behaviors of a 67-year-old first-generation Tongan woman in Utah. It uncovers pivotal themes through narrative and thematic analysis: cultural identity, economic constraints, environmental adaptation, and health perceptions. The study underscores the importance of cultural preservation, economic stability, and the centrality of traditional Tongan foods, revealing a complex interplay between cultural adaptation and health awareness. Community support and engagement emerged as crucial in sustaining healthy dietary practices amid cultural changes. The study advocates for an SEM-based framework to guide future research and develop culturally sensitive interventions to improve dietary behaviors among first-generation Tongan immigrants and similar groups and offers valuable insights. The limited generalizability of this study due to its single-case design necessitates future investigations to incorporate broader and more diverse samples to validate the findings and tailor more precise interventions.

Determinants of Mental Health Inequalities Among People With Selected Citizenships in Germany.

Objectives: Mental health is essential for overall health and is influenced by different social determinants. The aim of this paper was to examine which determinants are associated with mental health inequalities among people with selected citizenships in Germany. Methods: Data were derived from the multilingual interview survey "German Health Update: Fokus (GEDA Fokus)" among adults with Croatian, Italian, Polish, Syrian, or Turkish citizenship (11/2021-05/2022). Poisson regressions were used to calculate prevalence ratios for symptoms of depression (PHQ-9) and anxiety disorder (GAD-7). Results: Sociodemographic (sex, income, age, household size) and psychosocial (social support and self-reported discrimination) determinants were associated with symptoms of depression and/or anxiety disorder. The prevalence of mental disorders varied most by self-reported discrimination. Conclusion: Our findings suggest mental health inequalities among people with selected citizenships living in Germany. To reduce these, social inequities and everyday discrimination need to be addressed in structural prevention measures as well as in interventions on the communal level. Protective factors (e.g., social support) are also important to reduce mental health inequalities on the individual and community level.

Understand nurse's perspectives on communication with Chinese-speaking cardiac patients.

OBJECTIVES: To explore communication experiences, resource accessibility/quality, and communication strategies cardiac nurses use when caring for Chinese-speaking patients. METHODS: In this exploratory qualitative study, nurses were recruited from professional association members and interviewed on communication barriers/facilitators, resource accessibility/quality, and communication strategies used when caring for Chinese-speaking cardiac patients. Transcripts were thematically analysed. RESULTS: Nurses (n = 11) were primarily female (7/11), with 2/11 Chinese-speaking. The themes discussed centred on two areas that created difficulty in communication, including the lack of a common language and uncertainty of the Chinese culture. Dependence on interpreters was highlighted and challenges noted included limited availability and difficulty scheduling, variable quality and approaches, and lack of communication resources leading to a dependence on poor quality materials. Nurses were uncertain about Chinese culture and how to communicate, particularly in relation to family-centred beliefs, mental and sexual health, medication, and diet. CONCLUSIONS: Health communication with Chinese-speaking patients needs to address multiple challenges to be effective. PRACTICE IMPLICATIONS: The findings emphasise the need to optimise interpreting services and provide nurses with cultural competency training and tailored resources to improve their understanding of Chinese immigrants' needs. These recommendations will support nurses to address identified language and cultural uncertainties.

Strengthening life-course immunisation in migrant populations: access, equity, and inclusion.

Adult and adolescent migrants worldwide, and those arriving in Europe, are an under-immunised group for routine vaccinations due to missed childhood vaccines and doses in their countries of origin, and their subsequent marginalisation from health and vaccination systems. Declining population-level coverage for routine vaccines across Europe, which has accelerated post-pandemic, places these and other under-immunised populations at even greater risk of vaccine-preventable diseases. However, despite clear guidelines around the importance of delivering 'catch-up' vaccination throughout the life-course, migrants are rarely effectively incorporated into routine vaccination programmes on arrival to Europe. These populations have subsequently been involved in outbreaks, including measles and diphtheria, and are missing opportunities to receive more recently introduced vaccines such as HPV to align them with European vaccine schedules. WHO's new Immunization Agenda 2030 places a renewed emphasis on equitable access to vaccine systems and integrating catch-up vaccination for missed vaccines and doses throughout the life-course. In addition, lessons learned and innovations from the COVID-19 pandemic merit further consideration in the design and delivery of more inclusive vaccination programmes. We describe current gaps in policy and practice around life-course vaccination in migrant populations, key factors that drive low vaccine uptake and coverage, and explore the benefits of participatory approaches to designing and delivering interventions with impacted communities, to define new strategies to advance vaccine equity across the Region.

Psychological Distress and Associated Factors among Technical Intern Trainees in Japan: A Cross-Sectional Study.

Japan is experiencing significant demographic shifts due to an aging and declining population. In 1993, the Japanese Government introduced the Technical Intern Training Program (TITP) to accept foreign national workers. While the number of technical intern trainees under this program has constantly increased, many of them face challenges in their daily lives, such as stress, health insecurities and limited access to healthcare. Therefore, we conducted a cross-sectional study to assess the mental well-being of technical intern trainees, focusing on psychological distress and its related factors. This study included 304 technical intern trainees from 12 prefectures in Japan, and was conducted from August 2021 to October 2021. We used self-administered questionnaires in the participants' native languages to assess their sociodemographic conditions, health-related conditions such as health insecurities and healthcare-seeking behaviors, and psychological distress. The K6 Kessler Psychological Distress Scale was applied to evaluate the levels of psychological distress. Among the participants, 26.3% had moderate psychological distress and 2.3% had severe psychological distress. In addition, about 15% of the participants reported health insecurities and did not see a doctor despite wanting to. The multivariate model of logistic regression revealed significant associations between psychological distress and female gender (AOR 2.62, 95% CI 1.12-6.12), nationality other than Vietnamese (AOR 4.85, 95% CI 2.60-9.07), tough financial conditions (AOR 2.23, 95% CI 1.18-4.19), experiencing health insecurity (AOR 2.21, 95% CI 1.04-4.66) and the health behavior of refraining from seeking medical care (AOR 3.06, 95% CI 1.49-6.30). The top reasons for refraining from seeking medical care were the participants' limited knowledge about the healthcare system in Japan and their worries about medical bills. These findings highlight the necessity to extend mental health support services, including counseling services, and share information about Japan's healthcare system to supply medical services to the targeted technical intern trainee population.

Migrant workers' perception and awareness of health insurance coverage in Brunei Darussalam.

BACKGROUND: Migrant workers are recognized as a vulnerable group of population in the context of accessibility to healthcare services as they are likely to experience multiple challenges and barriers. This study aimed to assess the awareness and perceived knowledge on health insurance coverage among documented migrant workers in Brunei Darussalam. METHODS: This cross-sectional, interviewer-administered study used a pre-designed questionnaire on migrant workers attending the Foreign Worker Health Screening Centre from June until September 2019. Data were analyzed for association between perceived insurance status on health-seeking behavior. RESULTS: The study obtained responses from 469 documented migrant workers (93.8%). 75.1% reported being aware of and having health insurance coverage; and of these, 57.1% were aware of the type of health insurance cover they had. 45.5% and 50.6% had poor knowledge whether their health insurance covered for hospitalization or outpatient expenses, respectively. No significant association was found between the migrant workers' perceived status of insurance and not seeking medical care due to financial barriers (p > 0.05). CONCLUSIONS: A high proportion of documented migrant workers in Brunei Darussalam reported knowledge of having health insurance; however, there was lack of awareness on its actual coverage. By including migrants' health in a nation's healthcare governance, the health rights of migrant workers can be addressed thus aiming to achieve universal health coverage for all individuals.

The dynamics of intercultural clinical encounters in times of pandemic crisis. Swedish healthcare providers' reflections on social norms in relation to sexual and reproductive healthcare.

BACKGROUND: Experiences from the COVID-19 pandemic may help to better understand resilience, competences and skills for healthcare providers and the healthcare system. Within sexual and reproductive health inequalities for migrants exist and it is an area where promoting both cultural competency and healthcare equity in the clinical encounter is expected of healthcare providers yet can create tension. The aim is to explore healthcare providers experiences of encounters with migrants in the context of the pandemic and the subsequent changes in routines and norms. METHODS: A qualitative study based on semi-structured interviews with 31 healthcare providers working in sexual and reproductive healthcare in southern Sweden. Interviews were conducted during the COVID-19 pandemic influencing how healthcare providers reflected on their experiences. Analysis was done using reflexive thematic data analysis. FINDINGS: Healthcare providers reflected on how changes in routines increased the understanding of challenges and enablers in the intercultural encounter including the impact on communication and role of relatives and male partners. They emphasized the dynamics of culture in the clinical encounter and healthcare system through highlighting the importance of structural awareness, self-reflection and the flexibility of conducts and norms, often given a cultural connotation. CONCLUSION: The COVID-19 pandemic resulted in changes of previously established routines directly affecting clinical encounters, which provided a unique opportunity for healthcare providers to reflect, with communication and self-reflection being discussed as central in complex encounters. It highlighted the dynamics of presumed deeply rooted cultural norms and the interplay with social factors affecting healthcare providers and patients alike.

Navigating the Complexities of Disseminated Histoplasmosis Diagnosis and Management in the Migrant Population: A Case Report.

Histoplasma capsulatum is a dimorphic fungus that grows in nature as a mold or in culture but converts to a small yeast during cellular invasion. While most histoplasmosis infections are primarily asymptomatic or mildly symptomatic, disseminated histoplasmosis is a relentlessly progressive granulomatous disease that can mimic other granulomatous diseases, such as tuberculosis, sarcoidosis or coccidioidomycosis, more so in the proper context of immunosuppression. The current global migrant crisis, particularly the United States migrant crisis conversation is mostly socio-political; however, it also has a public health implication as exemplified by the case of a 35-year-old male who migrated from Haiti via Chile and Mexico to the United States. He presented with a four-day history of fever, generalized body aches, and cough. This case underscores the importance of entertaining a myriad of differentials and avoiding the tendency for anchoring, especially when initial therapy yields little clinical response.

Health literacy strengths and needs among migrant communities from Portuguese-speaking African countries in Portugal: a cross-sectional study.

Introduction: Health literacy among migrants is a matter of public health and social justice. Migrants from diverse backgrounds encounter challenges such as linguistic barriers, cultural disparities, restricted access to health services, and heterogeneous migration statuses. Addressing these challenges requires careful consideration of their unique experiences and needs to promote equitable health outcomes. This can hinder their ability to navigate the healthcare system, understand health information, and engage in health-promoting behaviours. However, there is still a significant gap in our understanding of health literacy within migrant communities. This study has a dual aim: to identify health literacy strengths and needs among migrants from Portuguese-speaking African Countries (PALOP) countries in the Lisbon Metropolitan Area and to examine associations between demographic, socioeconomic, migration and health condition characteristics and the health literacy domains. Methods: A cross-sectional survey was conducted. Data were collected from 506 PALOP migrants using the Health Literacy Questionnaire (HLQ). We also collected demographic, socioeconomic, migration, and health condition data. We employed multiple linear regression to understand the relationship between the HLQ nine domains and these characteristics. Results: The HLQ scores revealed distinct patterns of health literacy between the groups. Health literacy needs were particularly evident in the domains related to feeling understood and supported by healthcare providers and navigating the healthcare system. Conversely, higher scores and potential strengths were observed in actively managing one's health and understanding enough health information to make informed decisions. However, in these, the average scores suggest that a high proportion of people recognised difficulties. 'The results also indicated that a higher educational level was associated with increased health literacy. In contrast, low self-perceived health status, living alone, shorter duration of residence in Portugal, and being either undocumented or in the process of obtaining legal status were associated with lower health literacy. Conclusion: Our study highlights the importance of migration-related variables and self-reported health status in understanding health literacy among migrant communities. Factors such as length of stay and low self-perceived health status are associated with potentially disadvantageous levels of health literacy, which could exacerbate health inequalities. Assessing these variables is critical to identify gaps in health literacy and develop tailored interventions to reduce health inequalities.

At the Intersection of Adverse Life Course Pathways: The Effects on Health by Migration Status.

Adverse life events are major causes of declining health and well-being, but the effects vary across subpopulations. We analyze how the intersection of migration status and sex relates to two main adverse life events-job loss and divorce-thereby affecting individual health and well-being trajectories. Using data from the German Socio-Economic Panel (1984-2017), we apply descriptive techniques and individual fixed-effects regressions to analyze how job loss and divorce influence the health of immigrants and nonimmigrants. Our results support the hypothesis that immigrants suffer more from adverse life events than nonimmigrants in both the short and the long run. Relative to nonimmigrants, immigrants have a health advantage at younger ages, which becomes a disadvantage at older ages, and this faster decline at older ages is particularly steep among immigrants who experience adverse life events. These results help explain the vanishing health advantage of immigrants by showing that they are exposed to a double disadvantage over the life course: immigrants are more likely than nonimmigrants to suffer from adverse life events, such as job loss, and these events typically have a larger impact on their health. Our findings are the first to provide evidence regarding the consequences of different adverse life events and how they relate to the intersection of migration status and sex. Moreover, our results highlight the importance of intersectional analyses in research on immigrant health.

Impact of digital infrastructure construction on the migrants' utilization of basic public health services in China.

BACKGROUND: Global digitalization significantly impacts public health by improving healthcare access for marginalized populations. In China, socioeconomic disparities and the Hukou system create significant barriers for the migrant population to access basic public health services (BPHS). This study aimed to assess how digital infrastructure construction (DIC) affects BPHS utilization among China's migrant populations, filling a gap in the literature regarding the relationship between digital advancements and health service accessibility. METHODS: This research used micro-level data from the 2018 China Migrants Dynamic Survey and incorporated variables aligned with the Broadband China policy to employ a comprehensive empirical strategy. It included baseline regressions, robustness checks through propensity score matching and machine learning techniques, and heterogeneity analysis to explore the differential impacts of DIC based on gender, age, education level, and Hukou status. RESULTS: The findings revealed that DIC significantly enhances the likelihood of migrants establishing health records and registering with family doctors, demonstrating quantifiable improvements in health service utilization. Heterogeneity analysis further indicated that the beneficial impacts of DIC were more pronounced among female migrants, those with higher education levels, younger populations, and urban Hukou holders. CONCLUSIONS: DIC plays a crucial role in bridging the accessibility gap to BPHS for migrant populations in China, contributing to narrowing health disparities and advancing social equity. These results emphasize the significance of digital infrastructure in public health strategies and offer valuable insights for policymakers, healthcare providers, and researchers. Future research should prioritize longitudinal studies on the sustained effects of DIC and tailor digital health initiatives to meet the unique needs of migrant populations, promoting inclusive health policy planning and implementation.