The multicultural conceptualisation of well-being : The role of culture and circumstance in operationalising well-being in South Africa: A mixed-methods approach.

BACKGROUND: Exploring and understanding indicators of better life outcomes have remained popular among social and health researchers. However, the subjective approach to measuring well-being has raised questions on the appropriateness of standard measures of well-being in multicultural settings. The current study examines generalised well-being and its dependence on the implicit understanding of individual culture and circumstances. METHODS: A mixed-method approach with a cross-sectional design and focus group discussions was adopted. Fifteen focus group discussions with 66 participants were conducted in four provinces of South Africa. Descriptive statistics, correlations, regression analysis and analysis of variance were computed for quantitative data. The focus group discussions were analysed using a content analysis approach. The recorded focus group discussions were transcribed using the intelligent verbatim technique. Data analysis was done stepwise using open, axial, and selective coding techniques. RESULTS: Quantitative analysis showed a strong and significant association between quality of life and income and a moderate association with educational attainment. The open coding technique for qualitative data confirmed 11 different subconstructs of well-being, mentioned 403 times during the 15 focus group discussions. Furthermore, well-being indicators varied based on participants' racial identity. CONCLUSIONS: The findings confirm personal circumstance and culture as significant for interpreting results from well-being research. Furthermore, it supports Maslow's Hierarchy of Needs, highlighting the movement from deficiency needs to growth needs after deficiency needs are met. Research must adopt a more sociological approach to improve the accuracy and implementibility of findings when using standardised measures of well-being.

Mental health outcomes and quality of life of Ukrainian refugees in Germany.

The war in Ukraine has generated an increase in the number of refugees. As one of the top recipients of refugees, Germany has introduced policies to ease the integration of Ukrainians. The current study explores mental health outcomes and their association with quality of life among a sample of Ukrainian refugees in Germany. Cross-sectional data were collected from a sample of Ukrainian refugees in Germany (n = 304) using standardised instruments. A t-test was used to check for possible significant differences based on gender. Multiple regression analysis was used to analyse potential associations between general health (GHQ-12) and depressive symptoms and anxiety (PHQ-4), and quality of life (EUROHIS-QOL 8 item). Female participants reported significantly higher psychological distress, depressive symptoms and anxiety. The significant model (p < .001) for the males accounts for 33.6% of the variance in quality of life. General psychological distress (ß = - .240) and depressive symptoms and anxiety (ß = - .411) are associated with decreased quality of life. For the female sample (p < .001), the model explains 35.7% of the variance in quality of life. General psychological distress (ß = - .402) and depressive symptoms and anxiety (ß = - .261) are associated with decreased quality of life. The current study provides the first knowledge on the prevalence of mental health problems and their associations with quality of life among Ukrainian refugees. The findings further identify the vulnerability of women refugees to poorer mental health outcomes. The results also confirm that traumatic experiences in the context of war explain a considerable bulk of mental health problems.

Walkability and urban built environments-a systematic review of health impact assessments (HIA).

BACKGROUND: Urban environments are important determinants of human health. The term walkability summarizes features of the urban built environment that promote walking and other types of physical activity. While the beneficial effects of active and public transport have been well established, the health impact of other features of walkability are less well documented. METHODS: We conducted a systematic review of health impact assessments (HIAs) of walkability. Studies were identified through PUBMED and Science Direct, from two German websites related to urban health and reference tracking. Finally, 40 studies were included in the present review. We applied qualitative thematic analysis to summarize the major results from these studies. RESULTS: Most of the HIAs (n = 31) reported the improvement of health or health behaviour resulting from an investigated project or policy. However, three HIAs reported a lack of improvement or even a decrease of health status. In parallel, 13 HIAs reported a gain in economic value, whereas one reported a lack or loss of economic effects. Moreover, three HIAs reported on social effects and six HIAs gave additional recommendations for policies or the implementation of projects or HIAs. CONCLUSIONS: Most HIAs investigate the impact of increasing active or public transport. Other features of walkability are less well studied. With few exceptions, HIAs document beneficial impacts of improving walkability on a variety of health outcomes, including reductions of mortality and non-communicable diseases.

Interpreting Microaggression as a Determinant of Wellbeing.

Despite the increasing interest in exploring microaggression in the humanitarian context, there remains uncertainty on its mechanism for affecting life outcomes. There is a lack of studies on ethnic and racial minorities in non-western countries. The current research explores dimensions and manifestations of microaggression and how they affect wellbeing in a multicultural setting. The study uses a qualitative approach with 15 focus group discussions (FGDs) and 66 participants conducted in 4 provinces of South Africa: Gauteng (k = 6), North-West (k = 3), KwaZulu-Natal (k = 3), and Western Cape (k = 3). The recorded FGDs were transcribed using the intelligent verbatim technique. The transcripts were then analysed using a phenomenological approach. Data analysis was done stepwise using the deductive coding technique. Results show that participants' perception of the dimensions of microaggression varies depending on the manifestation as verbal, behavioural, or systemic. Furthermore, variations in patterns and reactions to dimensions of microaggression were linked with participants' racial identity. It further confirms that experiencing discrimination is associated with poorer wellbeing. Connectedness to the ingroup provides stability and certainty in multi-group societies due to the group rivalry that pervades such societies.

Racial identity as a moderator of the association between socioeconomic status and quality of life.

Research in social and humanitarian science has identified socioeconomic status (SES) as one of the essential determinants of quality of life (QoL). Similarly, racial identity is assumed to predict SES outcomes in multiracial settings. Therefore, understanding how racial identity moderates the association between SES and QoL may provide essential insights into the mechanisms generating socioeconomic inequalities and their implication on life outcomes. The current study employs a cross-sectional study designed to investigate the moderating effect of racial identity on the association between SES and QoL in a sample of 1,049 South Africans. A correlation matrix was computed to explore the bivariate associations between QoL, socioeconomic, and sociodemographic features. ANOVA was used to evaluate racial differences in QoL and SES. A moderator analysis was adopted to determine a possible moderating effect of racial identity on the connection between SES and QoL. Findings show a significant difference in QoL and SES based on race. While racial identity was a significant moderator of the association between QoL and SES for Black Africans, no significant moderating effect was reported for other racial groups. These results highlight the importance of racial identity for life outcomes and emphasis the unique experience associated with Black racial identity and its implications for SES, QoL, and their association in South Africa. This study explains the necessity to improve the QoL of minority groups, such as Black South Africans, and offers detailed explanations of their perceived disadvantage.

Health-related quality of life among migrants and natives in Hamburg, Germany: An observational study.

PURPOSE: The aim of this observational study was firstly, to assess the Health-related Quality of Life (HrQoL) among migrants and German natives in Hamburg, Germany, using the SF-12 mental and physical summary scores and secondly, to evaluate the contribution of selected sociodemographic and socioeconomic variables to explain the variance in mental and physical HrQoL separately for migrants and natives. METHODS: Face-to-face interviews were conducted with n=809 participants between May 2018 and July 2019 in six randomly selected statistical districts of Hamburg grouped into four levels of socioeconomic status (SES). The SF-12 questionnaire was used to measure the HrQoL. Socioeconomic (school education, income) and sociodemographic (age, gender, marital status, children) data was recorded, too. RESULTS: Migrants and natives scored higher in mental (migrants: M=45.77, SD=7.66; natives: M=47.60, SD=6.14) than in physical HrQoL (migrants: M=42.55, SD=5.55; natives: M=42.03, SD=4.71). Natives had a significantly higher (p<0.001) SF-12 mental summary score than migrants. There was a positive association between education and mental HrQoL (ß=0.248, p=2.308) in the migrant but not in the native group. Due to limitations of the study the results of the impact of migration on the HrQoL require interpretation. CONCLUSION: Differences between migrants and German natives in HrQoL were partially confirmed. Future research should differentiate more strongly between migration contexts as well as other determinants of health (e.g. early life, social support, unemployment) and their policy implications according to the WHO.