Migration health research in the Nordic countries: Priorities and implications for public health.

The past 50 years have witnessed an increase in immigration to the Nordic countries from and beyond neighbouring countries in Europe. Diversity implies variations and differences in health status and health outcomes both within and across populations. Migrant health research has not been prioritized and health policies and practice, especially long-term national plans, often exclude migrants. In this article, we briefly trace the history, the groups, reasons for migration and the road to migrant health research in Norway, Sweden, Finland and Denmark. We discuss the case for data and research including needs, basis for data collection and the methodological challenges. We provide a brief snapshot of migrant health research, identify current gaps and discuss the implications for research. We recommend a regional Nordic strategy to promote intercountry exchange, sharing and learning. Finally, we reflect on the larger picture, implications for policy and practice that could enable societal conditions to reduce avoidable health inequalities.

Country of birth, time period of resettlement and subsequent treated common mental disorders in young refugees in Sweden.

BACKGROUND: Little is known regarding treatment for common mental disorders (CMDs) in young refugees. We aimed to identify (i) if the risk of treatment for CMDs in young refugees varies by their country of birth, compared with the Swedish-born population and (ii) if time period of resettlement influences these possible associations. METHODS: All Swedish-born individuals and people who were granted refugee status, aged 16-25 years, living in Sweden on 31 December 1999, 2004 or 2009 (around 1 million people with 3-4% refugees in each cohort), were followed for 4 years for treated CMDs by linking register data. To facilitate stratified analyses by refugees' country of birth, the 2009 cohort was followed for 7 years with regard to specialized healthcare and antidepressant prescription due to CMDs. Hazard ratios with 95% confidence intervals were computed in crude and adjusted models. RESULTS: Refugees in the 2009 cohort with 7-year follow-up had a 25% lower risk for treated CMDs, compared with the Swedish-born. Stratified analysis by country of birth showed a similarly lower risk regarding treated CMDs among refugees from all countries but Iran [hazard ratios (95% confidence intervals): 1.15 (1.05-1.26)] than their Swedish-born peers. No substantial effect of time period of resettlement was observed in the risk for treated CMDs in refugees. CONCLUSIONS: Treatment for CMDs is lower in young refugees than in the majority population in Sweden, is stable across time, but varies with country of birth. Strategies to improve access to mental healthcare for young refugees are warranted.

[Hospital staff's different attitudes and experiences with regard to immigrant patients]. / Hospitalspersonale har forskellige holdninger til indvandrerpatienter.

INTRODUCTION: The study investigates hospital staff's different attitudes and experiences with regard to immigrant patients as a basis for educational initiatives. MATERIALS AND METHODS: The study is based on a questionnaire to nurses, doctors and assistant nurses at Bispebjerg Hospital, a major general hospital in Copenhagen in spring 2001. Among the 1,012 persons included, the total response rate was 58%. RESULTS: Doctors had more frequent contact with immigrant patients than nurses and assistant nurses. Doctors used interpreters more often and experienced more often the need for an interpreter when none was available. The professionals regarded it as appropriate that immigrant patients participate in the general preventive programmes, but especially doctors and nurses favoured special programmes to meet the special needs of immigrant patients. In particular, nurses and assistant nurses showed interest in education within the area of migrant health. Attitudes among different health professions towards immigrants, preventive programmes and the need for further education reflect educational background, but also differences in experiences and working conditions regarding patient contact. CONCLUSIONS: There is a need for educational interventions relating to major issues such as communication and culture and to specific issues of immigrants' health and disease patterns in a global perspective. The starting point of interventions should be the specific interests and needs of the different groups of professionals.

Pre- and postgraduate education in international health--secondary publication.

The aim of this article is to provide information about possibilities for medical students and doctors to obtain knowledge about international health. Increasing globalisation requires knowledge about international health in such a way that Danish doctors are able to diagnose and treat patients, regardless of the patient's nationality and ethnic background. Denmark has a global responsibility towards low and middle income countries to increase the standard of health. Increased knowledge and research in these countries are important both at an undergraduate and postgraduate level.

Migrants' access to healthcare.

Migration means that both locally and globally our world is getting more and more multicultural. From 1975 up to the year 2000, the number of migrants in the world doubled to 175 million, which is 3% of the world's population--half of them living in low-income countries [1]. This figure includes labour migrants, permanent migrants, refugees, and asylum seekers, while undocumented migrants and people who migrate from rural to urban areas are not included. The increasing diversity of the population means new challenges for our societies, including our health services. The aim of this article is to outline a general framework for understanding the access that migrants have to healthcare and the factors that can affect that access.

[Access to health care for migrants]. / Adgang til sundhedsydelser for migranter.

Migrants include a broad category of individuals moving from one place to another, either forced or voluntarily. Ethnicity and migration are interacting concepts which may act as determinants for migrants' health and access to health care. This access to health care may be measured by studying utilisation patterns or clinical outcomes like morbidity and mortality. Migrants' access to health care may be affected by several factors relating to formal and informal barriers. Informal barriers include economic and legal restrictions. Formal barriers include language and psychological and sociocultural factors.