What is a migrant death? An operational definition for a more accurate enumeration of migrant mortality along the US-Mexico border.

Over the last forty years an indeterminate number of persons, ranging from thousands to tens of thousands, have died along the US-Mexico border during migration, fleeing poverty, armed conflict, situations of violence, and disasters. An accurate accounting of migrant deaths along the southern US border is the first step toward an understanding of the extent and the contributing factors of these deaths. In this article, we describe a key aspect of our collaborative work aimed at developing a more representative account of migrant mortality along the southwestern US border: the determination of criteria for inclusion of specific forensic cases as "migrant." Our intention is not to propose a definition of "what is a migrant death" applicable to all contexts and situations but rather one specific to the US-Mexico border region. Our main impetus is to build and launch a web portal to track and map migrant deaths at the US-Mexico border. The criteria we have identified are based on an examination of death data collected by various agencies in the four border states (California, Arizona, New Mexico, and Texas) and at the federal level by the National Missing and Unidentified Persons System (NamUs). They include a) context of human remains discovery; b) identification media/documentation; c) geographic setting; and d) personal effects. Taken together, these criteria will facilitate our determination, case by case, of the probability that human remains found along the United States side of the border may be from a person in the context of migration.

Adequate housing as a social determinant of the health of international migrants and locals in Chile between 2013 and 2022.

BACKGROUND: Adequate housing is a fundamental right and a social determinant of health. It also represents a historically contentious topic in Latin America. Migratory flows to Chile have become increasingly precarious in the past few years, limiting opportunities for adequate housing, with potential repercussions on the health of international migrants and the general population. This study aims to analyse adequate housing as a social determinant of health among international migrants and locals between 2013 and 2022 in Chile. METHODS: Observational cross-sectional study based on repeated versions of the nationally representative Socioeconomic Characterization Survey in Chile. Adequate housing indicators adapted from the United Nations Housing Rights Programme guidelines were analyzed with relation to individual health, distinguishing between the local and international migrant populations. Logistic regression models were fitted for housing indicators with migration as the main independent variable and for short-term and long-term healthcare needs in locals and immigrants with housing as the main dependent variables. Models were adjusted for sociodemographic variables and considered the complex sample design. RESULTS: Descriptive findings indicated higher availability of services and infrastructure among international migrants, and a disadvantage for habitability, location, and affordability by quintiles compared to locals. Logistic regression models, adjusting for demographic variables, revealed significant associations between migration status and overcrowding (OR 6.14, 2022), poor housing materiality (OR 5.65, 2022) and proximity to healthcare centres (OR 1.4, 2022) compared to locals. Experiencing hazardous situations consistently predicted short-term healthcare needs in both migrants (OR = 1.4, 2022) and locals (OR = 2.8, 2022). Overcrowding predicted both long and short-term healthcare needs among locals across the years and long term needs among migrants in 2013 and 2015. CONCLUSIONS: We found significant inequities in adequate housing between migrant populations and locals in Chile, and some inequities among both populations based on structural socioeconomic deprivation. Experiencing hazardous situations emerged as a social determinant of health among international migrants in 2022, potentially suggesting growing challenges related to social exclusion in urban areas. However, limitations such as exclusion criteria of the survey and sample sizes for data on the migrant population potentially suggest that housing challenges and their impact on health are underestimated.

Insights from the EQUALS4COVID19 study on migrant mental health in Portugal: a cross-sectional mixed-methods approach.

BACKGROUND: The COVID-19 pandemic and related disruptive consequences in the economic, health, and educational sectors have impacted people's lives, contributing to a context of increased economic and social vulnerability. The pandemic has revealed and accentuated social inequalities and discrimination based on racial or ethnic origin. This study aimed to contribute to the promotion of the mental health and well-being of migrant populations living in Portugal via the definition of an analytical framework and recommendations emerging from the EQUALS4COVID19 project. METHODS: To gather information on the impact of the COVID-19 pandemic and resilience determinants among immigrants, a mixed-methods approach was implemented in 2022, combining a cross-sectional survey targeting immigrant adults in Portugal, focus groups with immigrants, focus groups with healthcare professionals, and in-depth individual interviews with stakeholders involved in the implementation of measures related to mental health and well-being during the pandemic. The analysis followed an integrated framework; quantitative data informed the script of qualitative data collection methods, and qualitative analysis informed the reinterpretation of quantitative data. RESULTS: The survey with 604 Brazilian and Cape Verdean immigrants revealed that gender (being a woman) was associated with both psychological distress and depression-related symptomatology and that the perception of discrimination was a major risk factor for psychological suffering, while perceived social support and individuals' resilience characteristics were protective factors. Qualitative data provided deeper insights into these findings, revealing the ways mental health is affected by social structures, such as gender and ethnic hierarchies. Migrants tend to work in precarious jobs requiring physical presence, which, together with dense housing conditions, puts them at higher risk of infection. The deterioration of the economic conditions of the general population has also increased the perception of ethnic-racial discrimination, which was found to be related to the increase in insecurity and anxiety-related symptomatology among the migrant population. Newly arrived migrants, with reduced support networks, experienced a greater sense of insecurity as well as concern and anguish regarding relatives who live far away, in their home country. Migrant women reported greater family-related distress, including work-life balance problems. CONCLUSIONS: Proposals to address mental health inequalities should be considered in the context of the necessary global changes both at the societal level and in the delivery of mental health services. Additionally, they should be considered with the active involvement of migrants, families, and communities in the design and delivery of mental health promotion and care processes.

Climate-health risk (In)visibility in the context of everyday humanitarian practice.

Nongovernmental migrant shelters in Mexico play a key role in documenting the factors that shape forced migration from Central America. Existing intake protocols in shelters are largely oriented to humanitarian legal frameworks that determine eligibility for international protection based on interpersonal violence and political persecution. This qualitative study calls attention to how existing humanitarian logics may obscure climate- and health-related disruptions as drivers of forced migration from Central America in the context of everyday humanitarian practice. In May 2022 we compared migrant's responses (n = 40) to a standardized intake protocol at a nongovernmental humanitarian migrant shelter in Mexico with responses to semi-structured interviews that focused on migrants' perceptions of climate change and health as drivers of forced displacement. We found that slow- and rapid-onset climatic disruptions; illness and disease; and various forms of violence and repression are often interrelated drivers of forced displacement. Comparing intake protocols and in-depth interview responses, we found that climate- and health-related drivers of forced displacement are rarely documented. These findings speak to the importance of critically examining everyday humanitarian practices in the context of ongoing advocacy that calls for climate-related disruptions to be integrated into existing humanitarian protection frameworks.

Using Respondent-Driven Sampling (RDS) to Identify the Healthcare Needs among Women of Reproductive Age Who Migrated from Venezuela to Brazil, 2018-2021.

In 2021, an RDS survey was conducted among Venezuelan migrant women of reproductive age who migrated to two Brazilian cities (Manaus and Boa Vista) from 2018 to 2021. To start the RDS recruitment, we chose seeds non-randomly in both cities. The study variables were age, educational level, self-rated health, pregnancy, migratory status and use of health services. We estimated the prevalence, confidence intervals and homophily effects by variable category. We used a multivariate logistic regression model to identify the main factors associated with healthcare use. A total of 761 women were recruited in Manaus and 1268 in Boa Vista. Manaus showed more irregular migrants than Boa Vista. The main reasons for using health services were as follows: illness, disease prevention and prenatal care. The logistic regression model showed the use of health services was associated with educational level and healthcare needs but not with migratory status. The social inclusion of Venezuelan migrants is extremely relevant, although many challenges must be overcome. The strategy of the Brazilian Federal Government for providing humanitarian assistance to Venezuelan migrants should be expanded to include and facilitate their integration into labor markets, access to healthcare and education, benefiting both migrants and the Brazilian people by reducing social inequality.

An epidemiological analysis of TB trends in native and migrant populations, New Mexico, 1993-2021.

To analyze the epidemiological, demographic, clinical, laboratory, radiographic and treatment outcome trends in non-US-born individuals with TB in New Mexico.We retrospectively analyzed TB data from New Mexico TB surveillance system from (1993-2021), comparing variables between non-US-born and US-born individuals.Of the 1,512 TB cases, 876 (56.5%) were non-US-born and 653 (43.3%) were US-born. The incidence rate among non-US-born patients declined from 15.3/100,000 (1993) to 7.8/100,000 (2021) (54.6% reduction), while among US-born patients it declined from 3.3/100,000 (1993) to 0.5/100,000 (2021) (84.8% reduction). The majority of non-US-born individuals were from Mexico (n = 482, 73.5%). Non-US-born were typically younger adults (median age: 54 vs. 61), predominantly male (64.8% vs. 59.4%), less likely to consume excess alcohol and have extrapulmonary TB. However, they were more likely to exhibit resistance to standard TB drugs (P < 0.01). Non-US-born individuals were less likely to die (7.8% vs. 15.4%), but more likely to be lost to follow-up (P < 0.007). Treatment by providers outside the Department of Health was associated with noncompletion (OR 0.18, 95% CI 0.09-0.35; P < 0.001).These results highlight the need for a detailed understanding of the impact of migration on TB epidemiology and the development of tailored interventions to improve treatment outcomes..

"The Hotel of 10,000 Stars": The Impact of Social-Structural Determinants of Health Among Im/migrant Shrimpers in the Gulf of Mexico.

Objectives. To identify appropriate interventions to prevent injury, we conducted a qualitative study among commercial shrimp fishermen in the Gulf of Mexico. Methods. Using qualitative and participatory research methods, including interviews, photovoice, and workplace observations in southeast Texas and the Rio Grande Valley in Texas, we examined the social‒structural dimensions that contribute to physical and psychological injury. Results. We found that multiple layers of vulnerability and danger exist among shrimpers with interacting themes: (1) recognizing risk, (2) precarious employment, and (3) psychological distress. Conclusions. Our results add to the growing body of knowledge that emphasizes the negative health impacts of underregulated, high-risk, and physically demanding work performed primarily by im/migrants. Public Health Implications. Our findings highlight the larger social‒structural conditions and context of hardships endemic to migrant labor and suggest implications for practice and policy interventions. (Am J Public Health. 2024;114(8):824-832. https://doi.org/10.2105/AJPH.2024.307696).

Comparing Mediators and Moderators of Mental Health Outcomes from the Implementation of Group Problem Management Plus (PM+) among Venezuelan Refugees and Migrants and Colombian Returnees in Northern Colombia.

Colombia hosts the largest number of refugees and migrants fleeing the humanitarian emergency in Venezuela, many of whom experience high levels of displacement-related trauma and adversity. Yet, Colombian mental health services do not meet the needs of this population. Scalable, task-sharing interventions, such as Group Problem Management Plus (Group PM+), have the potential to bridge this gap by utilizing lay workers to provide the intervention. However, the current literature lacks a comprehensive understanding of how and for whom Group PM+ is most effective. This mixed methods study utilized data from a randomized effectiveness-implementation trial to examine the mediators and moderators of Group PM+ on mental health outcomes. One hundred twenty-eight migrant and refugee women in northern Colombia participated in Group PM+ delivered by trained community members. Patterns in moderation effects showed that participants in more stable, less marginalized positions improved the most. Results from linear regression models showed that Group PM+-related skill acquisition was not a significant mediator of the association between session attendance and mental health outcomes. Participants and facilitators reported additional possible mediators and community-level moderators that warrant future research. Further studies are needed to examine mediators and moderators contributing to the effectiveness of task-shared, scalable, psychological interventions in diverse contexts.

The Venezuelan Humanitarian Crisis, Out-Migration, and Household Change Among Venezuelans in Venezuela and Abroad.

International migration is increasingly characterized by the need to evade threats to survival. Nevertheless, demographic understandings of how families-rather than individuals alone-decide to migrate or separate in response to threats remain limited. Focusing on the recent humanitarian crisis in Venezuela, we analyze 2012-2016 data on Venezuelans in Venezuela and 2018-2020 data on UNHCR (United Nations High Commissioner for Refugees)-registered Venezuelans in nine receiving countries to illuminate the evolution of threats Venezuelans sought to evade, how threat evasion transformed households away from previous norms, the selection of migrants into different receiving countries and household structures, and demographic disparities in migrants' odds of reporting changes to their household because of specific migration-related processes (e.g., leaving someone in Venezuela, leaving someone in another country). Results underscore a simultaneous escalation of economic, safety, and political concerns that informed Venezuelans' increasing intentions to out-migrate. Where Venezuelans migrated and who ended up in their households abroad varied by demographic background and migration experiences. Among UNHCR-registered Venezuelans, 43% left family members in Venezuela, and more than 10% left or were left behind by members in another country. Such household separations, however, were unevenly distributed across factors such as age, gender, and country of reception.

International migration, food insecurity, and mental health: A scoping review protocol.

Introduction: Food insecurity is a global priority that has been found to negatively impact mental health, increasing the risk of mental disorders and severe mental illness. International migrants may face food insecurity throughout their migratory cycle due to a range of risk factors, such as poor transit conditions, precarious employment, financial pressure, discrimination, and lack of availability and access to culturally relevant food, among others. Although there are multiple reviews on migration, food insecurity, and health in general, no scoping review has been conducted on food insecurity among international migrants focusing on mental health. Objective: To investigate the available evidence on food insecurity and mental health among international migrants. Methods: A search of scientific literature in English, Spanish, French, Italian, and Portuguese published since 2013 will be performed in the Web of Science, PubMed, Medline, APA PsycArticles, Cinahl, and ASSIA databases, including grey literature available in Google Scholar. Two authors will independently review titles, abstracts, and full texts before extracting data from publications complying with the eligibility criteria. Extracted data will be descriptively mapped according to emerging thematic categories. Expected results: The review will contribute to identifying what is known about international migration, food insecurity, and mental health, gaps in the literature, opportunities for specific research subtopics, and how food insecurity and mental health can be linked in the existing literature.

Introducción: La inseguridad alimentaria es una prioridad mundial que, según se ha constatado, repercute negativamente en la salud mental, aumentando los riesgos de padecer trastornos mentales comunes y enfermedades mentales graves. Los migrantes internacionales pueden enfrentarse a la inseguridad alimentaria a lo largo del ciclo migratorio, debido a una serie de factores de riesgo como las precarias condiciones de tránsito, la precariedad laboral, la presión financiera, la discriminación y la falta de disponibilidad y acceso a alimentos culturalmente relevantes, entre otros. Aunque existen varias revisiones sobre migración, inseguridad alimentaria y salud en general, no se ha realizado ninguna revisión de alcance sobre la inseguridad alimentaria entre los migrantes internacionales con especial atención a la salud mental. Objetivo: Investigar la evidencia sobre inseguridad alimentaria y salud mental entre los migrantes internacionales. Métodos: Se realizará una búsqueda de literatura científica en inglés, español, francés, italiano y portugués publicada desde 2013 en las bases de datos Web of Science, PubMed, Medline, APA PsycArticles, Cinahl, y ASSIA, y de literatura gris en Google Scholar. Dos autores revisarán de forma independiente los títulos, resúmenes y textos completos, antes de extraer los datos de las publicaciones que cumplan los criterios de elegibilidad. Los datos extraídos se mapearán descriptivamente según categorías temáticas generales emergentes. Resultados esperados: La revisión contribuirá a identificar lo que se sabe sobre la migración internacional, la inseguridad alimentaria y la salud mental, las lagunas en la literatura sobre el tema, las oportunidades para subtemas específicos de investigación, y explorar cómo la inseguridad alimentaria y la salud mental pueden estar vinculadas en la literatura existente.

Access to Contraceptives among Venezuelan Migrant Women Residing in Peru: Analysis on a Population-Based Survey.

Introduction: The emigration of Venezuelans has seen a significant increase in recent years. The aim of this study was to identify factors associated with access to contraceptives in migrant women from Venezuela residing in Peru. Methods: An exploratory cross-sectional study was conducted using data from the Second Survey of the Venezuelan Population Residing in Peru. Access to contraceptives (yes/no) was established as the dependent variable. A Poisson regression model was performed for complex samples, and crude (PRc) and adjusted (PRa) prevalence ratios were reported. Results: A total of 3617 migrant women were analyzed, with 50.12% reporting access to contraceptives. Factors associated with greater access to contraceptives included being between 20 to 29 years old, having a university education, the entry period after the declaration of COVID-19 quarantine was associated with lower access to contraceptives. Conclusions: Access to contraceptives for Venezuelan migrants should be provided to all, as it is a free service in Peru. Additionally, education and family planning should be provided from the basic or middle school level to prevent unintended pregnancies in the future. Complete coverage should be provided regardless of the time of entry into Peru.

Interplay of premigration crisis exposure and postmigration cultural stress on depressive symptoms among Venezuelan crisis migrants in Colombia.

OBJECTIVES: A growing body of research points to a relationship between exposure to migration-related cultural stress and mental health problems. However, such research is often conducted with the tacit assumption that postmigration experiences are the primary-if not singular-driver of psychological distress. In the present study, we aim to extend the cultural-stress paradigm by examining the influences of both premigration crisis exposure and postmigration cultural stress on depression in a sample of Venezuelan crisis migrants in Colombia. METHOD: Survey data for the present study were collected from Venezuelan youth (N = 429, ages 12-17, Mage = 14.0 years, 49% female) and adults (N = 566, ages 18+, Mage = 35.1 years, 82% female) in Bogota and Medellin, Colombia between April and June 2023. RESULTS: Both crisis exposure and discrimination were independently related to depressive symptoms. However, when examined in a multivariate model along with discrimination, crisis exposure was not a significant predictor of depressive symptoms among youth, and its influence weakened considerably among adults. Among both youth and adults, a Crisis Exposure × Discrimination interaction term significantly predicted depressive symptoms, indicating that discrimination was a more robust predictor of depressive symptoms among those endorsing lower levels of crisis exposure than among those reporting high levels of crisis exposure. CONCLUSION: Our research provides new insights into the experiences of Venezuelan migrant youth and adults in Colombia. It provides further support for the importance of drawing from a crisis-informed cultural-stress framework when working with crisis migrant populations. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Obstetrical Complications in Venezuelan Refugee and Migrant Women: Analysis of Ecuadorian National Hospital Discharge Data, 2018-2021.

An estimated 7.7 million Venezuelans have fled a severe humanitarian crisis in their country, most (70%) to other middle-income host countries in the same Andean region. Migration-related exposures during periconception and other critical gestational periods can adversely impact maternal-perinatal outcomes. Emerging evidence suggests that Venezuelan refugee and migrant women (VRMW) who migrate to Andean host countries are at-risk for delivering preterm and low birthweight infants and for Cesarean-sections. However, relatively few studies have examined obstetrical complications that could contribute to these or other short- and longer-term health outcomes of VRMW and/or their offspring. Our exploratory study analyzed four recent years of national hospital discharge data (2018-2021) from Ecuador to compare the primary discharge diagnoses of VRMW (n = 29,005) and Ecuadorian nationals (n = 1,136,796) for ICD-10 O code obstetrical complications related to or aggravated by pregnancy, childbirth, or the puerperium. Our findings indicated that VRMW were hospitalized for 0.5 days longer than Ecuadorian reference group women and they had higher adjusted odds (aOR) for a primary discharge diagnosis for obstetrical complications including preeclampsia (aOR:1.62, 95% CI:1.55,1.69), preterm labor (aOR:1.20, 95% CI:1.11,1.31), premature rupture of membranes (aOR: 1.72, 95% CI:1.63,1.83), oligohydraminos (aOR:1.24, 95% CI:1.12,1.36), obstructed labor (aOR: 1.39, 95% CI:1.31,1.47), perineal lacerations/other obstetric trauma (aOR:1.76, 95% CI:1.63, 1.91), STIs (aOR:2.59, 95% CI:1.29,2.92), anemia (aOR:1.33, 95% CI:1.24,1.42), and ectopic pregnancy (aOR:1.16 95% CI:1.04,1.28). They had similar aOR for diagnosed gestational diabetes and spontaneous abortion (SAB) compared to the reference group but a reduced aOR for genitourinary infections (aOR:0.79, 95% CI:0.74,0.84) and early pregnancy hemorrhage not ending in SAB (aOR:0.43, 95% CI:0.36,0.51). Our findings underscore the vulnerability of VRMW for a number of potentially serious obstetrical complications with the potential to adversely impact the short- and longer-term health of mothers and their offspring. Future studies should collect more detailed information on the migration status, experiences, and exposures of MRMW that influence their risk for obstetrical complications. These are needed to expand our findings to better understand why they have excess risk for these and to inform social and public health policies, programs and targeted interventions aimed at reducing the risk of this vulnerable refugee and migrant group.

International migration, food insecurity, and mental health: a scoping review protocol / Migración internacional, inseguridad alimentaria y salud mental: protocolo de una revisión de alcance

INTRODUCCIÓN: La inseguridad alimentaria es una prioridad mundial que, según se ha constatado, repercute negativamente en la salud mental, aumentando los riesgos de padecer trastornos mentales comunes y enfermedades mentales graves. Los migrantes internacionales pueden enfrentarse a la inseguridad alimentaria a lo largo del ciclo migratorio, debido a una serie de factores de riesgo como las precarias condiciones de tránsito, la precariedad laboral, la presión financiera, la discriminación y la falta de disponibilidad y acceso a alimentos culturalmente relevantes, entre otros. Aunque existen varias revisiones sobre migración, inseguridad alimentaria y salud en general, no se ha realizado ninguna revisión de alcance sobre la inseguridad alimentaria entre los migrantes internacionales con especial atención a la salud mental. OBJETIVO: Investigar la evidencia sobre inseguridad alimentaria y salud mental entre los migrantes internacionales. MÉTODOS: Se realizará una búsqueda de literatura científica en inglés, español, francés, italiano y portugués publicada desde 2013 en las bases de datos Web of Science, PubMed, Medline, APA PsycArticles, Cinahl, y ASSIA, y de literatura gris en Google Scholar. Dos autores revisarán de forma independiente los títulos, resúmenes y textos completos, antes de extraer los datos de las publicaciones que cumplan los criterios de elegibilidad. Los datos extraídos se mapearán descriptivamente según categorías temáticas generales emergentes. RESULTADOS: esperados La revisión contribuirá a identificar lo que se sabe sobre la migración internacional, la inseguridad alimentaria y la salud mental, las lagunas en la literatura sobre el tema, las oportunidades para subtemas específicos de investigación, y explorar cómo la inseguridad alimentaria y la salud mental pueden estar vinculadas en la literatura existente.

INTRODUCTION: Food insecurity is a global priority that has been found to negatively impact mental health, increasing the risk of mental disorders and severe mental illness. International migrants may face food insecurity throughout their migratory cycle due to a range of risk factors, such as poor transit conditions, precarious employment, financial pressure, discrimination, and lack of availability and access to culturally relevant food, among others. Although there are multiple reviews on migration, food insecurity, and health in general, no scoping review has been conducted on food insecurity among international migrants focusing on mental health. OBJECTIVE: To investigate the available evidence on food insecurity and mental health among international migrants. METHODS: A search of scientific literature in English, Spanish, French, Italian, and Portuguese published since 2013 will be performed in the Web of Science, PubMed, Medline, APA PsycArticles, Cinahl, and ASSIA databases, including grey literature available in Google Scholar. Two authors will independently review titles, abstracts, and full texts before extracting data from publications complying with the eligibility criteria. Extracted data will be descriptively mapped according to emerging thematic categories. EXPECTED RESULTS: The review will contribute to identifying what is known about international migration, food insecurity, and mental health, gaps in the literature, opportunities for specific research subtopics, and how food insecurity and mental health can be linked in the existing literature.

Hearing Difficulties Among Farmworkers in the México-US Southwest Border Region.

Migrant and seasonal farmworkers are a vulnerable population with a potentially high risk for hearing loss due to farm-related noise exposures. Occupational noise-induced hearing loss (NIHL) is permanent, and it is associated with an increased risk for injuries on the job, as well as communication difficulties, isolation, and depression. The México/US border region is one of the most productive agricultural regions in the country, however, no known studies have explored hearing loss among farmworkers in this area. This pilot study was a first step toward measuring and addressing hearing loss and noise exposure among this region's farmworkers. We conducted a cross-sectional survey to estimate the prevalence of subjective hearing difficulties among Yuma County, Arizona farmworkers. Survey interviews took place during a late-night farmworker health fair from 2 am to 6 am to accommodate local farms' labor schedules. Multivariable regression adjusted for demographic and work covariates estimated subjective hearing loss prevalence ratios. Among 132 farmworker participants, 36% reported they have or might have hearing loss, and 62% reported no hearing loss. Subjective hearing loss prevalence was lower in farmworkers who report not working in noise compared to prevalence in farmworkers who work in noise [prevalence ratio, 0.44 (95% CI 0.23-0.82)]. This report contributes to understanding the perception of hearing-related health and occupational exposures among farmworkers in the México-US Southwest border region. The information from this line of research will inform appropriate safety measures known to lower the risk of experiencing occupational NIHL.

Accessibility and Perceived Impact of a Group Psychosocial Intervention for Women in Ecuador: A Comparative Analysis by Migration Status.

There is increasing guidance promoting the provision of mental health and psychosocial support programs to both migrant and host community members in humanitarian settings. However, there is a lack of information on the respective experiences and benefits for migrant and host community members who are participating in mental health and psychosocial support programming. We evaluated a community-based psychosocial program for migrant and host community women, Entre Nosotras, which was implemented with an international non-governmental organization in Ecuador in 2021. Data on participant characteristics and psychosocial wellbeing were collected via pre/post surveys with 143 participants, and qualitative interviews were conducted with a subset (n = 61) of participants. All quantitative analyses were conducted in STATA, and qualitative analysis was done in NVivo. Attendance was higher for host community members. Specifically, 71.4% of host community members attended 4-5 sessions, whereas only 37.4% of migrants attended 4-5 sessions (p = 0.004). Qualitative analysis shows that the intervention was less accessible for migrants due to a variety of structural barriers. However, this analysis also demonstrated that both groups of women felt a greater sense of social connectedness after participating in the program and expressed gratitude for the bonds they formed with other women. Some migrant women described negative experiences with the host community because they felt as though they could not confide in host community women and speak freely in front of them. These results underscore how the migratory context influences the implementation of mental health and psychosocial support (MHPSS) programs. As humanitarian guidelines continue to emphasize the integration of host community members and displaced persons, it is critical to account for how the same intervention may impact these populations differently.

Improving Retention in Mental Health and Psychosocial Support Interventions: An Analysis of Completion Rates across a Multi-Site Trial with Refugee, Migrant, and Host Communities in Latin America.

Research on mental health and psychosocial support (MHPSS) interventions within refugee and migrant communities has increasingly focused on evaluating implementation, including identifying strategies to promote retention in services. This study examines the relationship between participant characteristics, study setting, and reasons for intervention noncompletion using data from the Entre Nosotras feasibility trial, a community-based MHPSS intervention targeting refugee, migrant, and host community women in Ecuador and Panama that aimed to promote psychosocial wellbeing. Among 225 enrolled women, approximately half completed the intervention, with varying completion rates and reasons for nonattendance across study sites. Participants who were older, had migrated for family reasons, had spent more time in the study community, and were living in Panamá (vs. Ecuador) were more likely to complete the intervention. The findings suggest the need to adapt MHPSS interventions to consider the duration of access to the target population and explore different delivery modalities including the role of technology and cellular devices as reliable or unreliable source for engaging with participants. Engaging younger, newly arrived women is crucial, as they showed lower completion rates. Strategies such as consulting scheduling preferences, providing on-site childcare, and integrating MHPSS interventions with other programs could enhance intervention attendance.

Plano Estadual de Atenção Integral à saúde da população migrante, refugiada, apátrida e retornados / State Plan for Comprehensive Health Care for the migrant, refugee, stateless and returnee population

Propõe o desenvolvimento de diretrizes, linhas de ação e fomento de condições para formulação e implantação da Política Estadual de Saúde para Migrantes no Estado de Goiás, numa perspectiva equitativa e de inclusão intercultural das necessidades de saúde da população migrantes na Rede de Atenção à Saúde. Sendo assim, a Atenção Primária em Saúde (APS) terá maior ênfase como eixo estruturante da assistência aos migrantes e refugiados, contemplando a promoção, prevenção e recuperação dos agravos de saúde, visando a efetivação do direito à saúde e enfrentamento de situações de xenofobia

It proposes the development of guidelines, lines of action and promotion of conditions for the formulation and implementation of the State Health Policy for Migrants in the State of Goiás, from an equitable perspective and intercultural inclusion of the health needs of the migrant population in the Health Care Network. Therefore, Primary Health Care (PHC) will have greater emphasis as a structuring axis of assistance to migrants and refugees, including the promotion, prevention and recovery of health problems, aiming to realize the right to health and confront situations of xenophobia

Persistence of Emotional Distress in Unaccompanied Migrant Children and Adolescents Primarily From the Northern Triangle of Central America.

Importance: In the US, unaccompanied migrant children and adolescents (hereinafter referred to as children) are predominantly from Central America's Northern Triangle. While unaccompanied migrant children are at high risk for psychiatric sequelae due to complex traumatic exposures, longitudinal investigations of psychiatric distress after resettlement are lacking. Objective: To identify factors associated with emotional distress and longitudinal changes in emotional distress among unaccompanied migrant children in the US. Design, Setting, and Participants: For this retrospective cohort study, the 15-item Refugee Health Screener (RHS-15) was administered between January 1, 2015, and December 31, 2019, to unaccompanied migrant children as part of their medical care to detect emotional distress. Follow-up RHS-15 results were included if they were completed before February 29, 2020. Median follow-up interval was 203 days (IQR, 113-375 days). The study was conducted in a federally qualified health center that provides medical, mental health, and legal services. Unaccompanied migrant children who completed the initial RHS-15 were eligible for analysis. Data were analyzed from April 18, 2022, to April 23, 2023. Exposures: Traumatic events before migration, during migration, during detention, and after resettlement in the US. Main Outcomes and Measures: Emotional distress, including symptoms of posttraumatic stress disorder, anxiety, and depressive symptoms, as indicated by the RHS-15 (ie, score ≥12 on items 1-14 or ≥5 on item 15). Results: In total, 176 unaccompanied migrant children completed an initial RHS-15. They were primarily from Central America's Northern Triangle (153 [86.9%]), were mostly male (126 [71.6%]), and had a mean (SD) age of 16.9 (2.1) years. Of the 176 unaccompanied migrant children, 101 (57.4%) had screen results above the positive cutoff. Girls were more likely to have positive screen results than boys (odds ratio, 2.48 [95% CI, 1.15-5.34]; P = .02). Follow-up scores were available for 68 unaccompanied migrant children (38.6%). On the follow-up RHS-15, most scored above the positive cutoff (44 [64.7%]). Three-quarters of unaccompanied migrant children who scored above the positive cutoff initially continued to have positive scores at follow-up (30 of 40), and half of those with negative screen scores initially had positive scores at follow-up (14 of 28). Female vs male unaccompanied migrant children (unstandardized ß = 5.14 [95% CI, 0.23-10.06]; P = .04) and initial total score (unstandardized ß = 0.41 [95% CI, 0.18-0.64]; P = .001) were independently associated with increased follow-up RHS-15 total score. Conclusions and Relevance: The findings suggest that unaccompanied migrant children are at high risk for emotional distress, including symptoms of depression, anxiety, and posttraumatic stress. The persistence of emotional distress suggests that unaccompanied migrant children would benefit from ongoing psychosocial and material support after resettlement.

The use of medicinal plants by Paraguayan migrants in the Atlantic Forest of Misiones, Argentina, is based on Guaraní tradition, colonial and current plant knowledge.

ETHNOPHARMACOLOGICAL RELEVANCE: Information on the use of medicinal plants in the daily life by Paraguayan people is scarce in mainstream scientific literature. The study on the Paraguayan diaspora in the Provincia de Misiones, Argentina, gives an insight into Guaraní traditions, colonial legacy and current search for new medicinal plants to address new health challenges. AIM OF THE STUDY: To document the use of medicinal plants by Paraguayan mestizo migrants who moved into a new country, yet within the same ecological region. The present and past uses of medicinal plants were compared to understand the continuity and change in the Paraguayan herbal pharmacopoeia. MATERIALS AND METHODS: Fieldwork based on ethnographic and ethnobotanical techniques was carried out in the Provincia de Misiones, Argentina, in 2014, 2015, and 2019. Eighty-five Paraguayan migrants and their descendants from eastern Paraguay took part in the study. The list of recorded plants was compared with the information in historical sources from Paraguay, to examine the continuity and changes in Paraguayan herbal medicine, and with the present-day ethnobotanical studies from Paraguay. Ethnopharmacological and phytochemical studies on the medicinal plants with the highest consensus of uses were reviewed. RESULTS: Altogether, 204 medicinal plant species were recorded. The most frequently mentioned species represented a combination of plants native to the New and Old World. Nearly 40% of the present-day Paraguayan pharmacopoeia shows continuity from colonial and post-colonial periods. Plants were used for 19 medical categories, of which digestive, circulatory and those belonging to humoral medicine were the most prevalent. The ongoing search of plants to treat new health problems is illustrated by reports of 40 species used for hypertension, 26 for diabetes and 18 to lower cholesterol. There is still little evidence for the effectiveness of these plants in the pharmacological literature. Paraguayan migrants were able to continue their traditional plant medicine in Misiones, Argentina, in a substantial way. CONCLUSION: This study was carried out in a geographic area with a long-standing tradition of Guaraní medicine. Paraguayan migrants in Misiones integrate pre-Hispanic Guaraní names and uses of plants and old humoral concepts with current adaptation of plants to meet new health challenges. Several of the uses described in early colonial times are still practiced, giving a solid background for in-depth studies of the local pharmacopoeia.