Journal Article > ReviewFull Text
J Migr Health. 2020 December 31; Volume 3; 100041.; DOI:10.1016/j.jmh.2021.100041
Hayward SE, Deal A, Cheng C, Crawshaw A, Orcutt M, et al.
J Migr Health. 2020 December 31; Volume 3; 100041.; DOI:10.1016/j.jmh.2021.100041
BACKGROUND
Migrants in high-income countries may be at increased risk of COVID-19 due to their health and social circumstances, yet the extent to which they are affected and their predisposing risk factors are not clearly understood. We did a systematic review to assess clinical outcomes of COVID-19 in migrant populations, indirect health and social impacts, and to determine key risk factors.
METHODS
We did a systematic review following PRISMA guidelines (PROSPERO CRD42020222135). We searched multiple databases to 18/11/2020 for peer-reviewed and grey literature on migrants (foreign-born) and COVID-19 in 82 high-income countries. We used our international networks to source national datasets and grey literature. Data were extracted on primary outcomes (cases, hospitalisations, deaths) and we evaluated secondary outcomes on indirect health and social impacts and risk factors using narrative synthesis.
RESULTS
3016 data sources were screened with 158 from 15 countries included in the analysis (35 data sources for primary outcomes: cases [21], hospitalisations [4]; deaths [15]; 123 for secondary outcomes). We found that migrants are at increased risk of infection and are disproportionately represented among COVID-19 cases. Available datasets suggest a similarly disproportionate representation of migrants in reported COVID-19 deaths, as well as increased all-cause mortality in migrants in some countries in 2020. Undocumented migrants, migrant health and care workers, and migrants housed in camps have been especially affected. Migrants experience risk factors including high-risk occupations, overcrowded accommodation, and barriers to healthcare including inadequate information, language barriers, and reduced entitlement.
CONCLUSIONS
Migrants in high-income countries are at high risk of exposure to, and infection with, COVID-19. These data are of immediate relevance to national public health and policy responses to the pandemic. Robust data on testing uptake and clinical outcomes in migrants, and barriers and facilitators to COVID-19 vaccination, are urgently needed, alongside strengthening engagement with diverse migrant groups.
Migrants in high-income countries may be at increased risk of COVID-19 due to their health and social circumstances, yet the extent to which they are affected and their predisposing risk factors are not clearly understood. We did a systematic review to assess clinical outcomes of COVID-19 in migrant populations, indirect health and social impacts, and to determine key risk factors.
METHODS
We did a systematic review following PRISMA guidelines (PROSPERO CRD42020222135). We searched multiple databases to 18/11/2020 for peer-reviewed and grey literature on migrants (foreign-born) and COVID-19 in 82 high-income countries. We used our international networks to source national datasets and grey literature. Data were extracted on primary outcomes (cases, hospitalisations, deaths) and we evaluated secondary outcomes on indirect health and social impacts and risk factors using narrative synthesis.
RESULTS
3016 data sources were screened with 158 from 15 countries included in the analysis (35 data sources for primary outcomes: cases [21], hospitalisations [4]; deaths [15]; 123 for secondary outcomes). We found that migrants are at increased risk of infection and are disproportionately represented among COVID-19 cases. Available datasets suggest a similarly disproportionate representation of migrants in reported COVID-19 deaths, as well as increased all-cause mortality in migrants in some countries in 2020. Undocumented migrants, migrant health and care workers, and migrants housed in camps have been especially affected. Migrants experience risk factors including high-risk occupations, overcrowded accommodation, and barriers to healthcare including inadequate information, language barriers, and reduced entitlement.
CONCLUSIONS
Migrants in high-income countries are at high risk of exposure to, and infection with, COVID-19. These data are of immediate relevance to national public health and policy responses to the pandemic. Robust data on testing uptake and clinical outcomes in migrants, and barriers and facilitators to COVID-19 vaccination, are urgently needed, alongside strengthening engagement with diverse migrant groups.
Journal Article > EditorialFull Text
BMJ. 2020 March 26; DOI:10.1136/bmj.m1213.
Hargreaves S, Kumar BN, McKee M, Jones LM, Veizis A
BMJ. 2020 March 26; DOI:10.1136/bmj.m1213.
Journal Article > ResearchFull Text
BMC Med. 2018 March 13; Volume 16 (Issue 1); 40.; DOI:10.1186/s12916-018-1028-4
Ben Farhat J, Blanchet K, Juul Bjertrup P, Veizis A, Perrin C, et al.
BMC Med. 2018 March 13; Volume 16 (Issue 1); 40.; DOI:10.1186/s12916-018-1028-4
BACKGROUND
Since 2015, Europe has been facing an unprecedented arrival of refugees and migrants: more than one million people entered via land and sea routes. During their travels, refugees and migrants often face harsh conditions, forced detention, and violence in transit countries. However, there is a lack of epidemiological quantitative evidence on their experiences and the mental health problems they face during their displacement. We aimed to document the types of violence experienced by migrants and refugees during their journey and while settled in Greece, and to measure the prevalence of anxiety disorders and access to legal information and procedures.
METHODS
We conducted a cross-sectional population-based quantitative survey combined with an explanatory qualitative study in eight sites (representing the range of settlements) in Greece during winter 2016/17. The survey consisted of a structured questionnaire on experience of violence and an interviewer-administered anxiety disorder screening tool (Refugee Health Screener). RESULTS: In total, 1293 refugees were included, of whom 728 were Syrians (41.3% females) of median age 18 years (interquartile range 7-30). Depending on the site, between 31% and 77.5% reported having experienced at least one violent event in Syria, 24.8-57.5% during the journey to Greece, and 5-8% in their Greek settlement. Over 75% (up to 92%) of respondents ≥15 years screened positive for anxiety disorder, which warranted referral for mental health evaluation, which was only accepted by 69-82% of participants. Access to legal information and assistance about asylum procedures were considered poor to non-existent for the majority, and the uncertainty of their status exacerbated their anxiety.
CONCLUSIONS
This survey, conducted during a mass refugee crisis in a European Community country, provides important data on experiences in different refugee settings and reports the high levels of violence experienced by Syrian refugees during their journeys, the high prevalence of anxiety disorders, and the shortcomings of the international protective response.
Since 2015, Europe has been facing an unprecedented arrival of refugees and migrants: more than one million people entered via land and sea routes. During their travels, refugees and migrants often face harsh conditions, forced detention, and violence in transit countries. However, there is a lack of epidemiological quantitative evidence on their experiences and the mental health problems they face during their displacement. We aimed to document the types of violence experienced by migrants and refugees during their journey and while settled in Greece, and to measure the prevalence of anxiety disorders and access to legal information and procedures.
METHODS
We conducted a cross-sectional population-based quantitative survey combined with an explanatory qualitative study in eight sites (representing the range of settlements) in Greece during winter 2016/17. The survey consisted of a structured questionnaire on experience of violence and an interviewer-administered anxiety disorder screening tool (Refugee Health Screener). RESULTS: In total, 1293 refugees were included, of whom 728 were Syrians (41.3% females) of median age 18 years (interquartile range 7-30). Depending on the site, between 31% and 77.5% reported having experienced at least one violent event in Syria, 24.8-57.5% during the journey to Greece, and 5-8% in their Greek settlement. Over 75% (up to 92%) of respondents ≥15 years screened positive for anxiety disorder, which warranted referral for mental health evaluation, which was only accepted by 69-82% of participants. Access to legal information and assistance about asylum procedures were considered poor to non-existent for the majority, and the uncertainty of their status exacerbated their anxiety.
CONCLUSIONS
This survey, conducted during a mass refugee crisis in a European Community country, provides important data on experiences in different refugee settings and reports the high levels of violence experienced by Syrian refugees during their journeys, the high prevalence of anxiety disorders, and the shortcomings of the international protective response.
Journal Article > ReviewFull Text
J Travel Med. 2020 November 9; Volume 27 (Issue 7); DOI:10.1093/jtm/taaa113
Greenaway C, Hargreaves S, Barkati S, Coyle CM, Gobbi F, et al.
J Travel Med. 2020 November 9; Volume 27 (Issue 7); DOI:10.1093/jtm/taaa113
Journal Article > EditorialFull Text
BMJ. 2020 March 26; Volume 26 (Issue 368); m1213.; DOI:10.1136/bmj.m1213
Hargreaves S, Kumar BN, McKee M, Jones LM, Veizis A
BMJ. 2020 March 26; Volume 26 (Issue 368); m1213.; DOI:10.1136/bmj.m1213
Journal Article > CommentaryFull Text
The Lancet Regional Health - Europe. 2022 June 1; Volume 17; 100403.; DOI:10.1016/j.lanepe.2022.100403
Kumar BN, James R, Hargreaves S, Bozorgmehr K, Mosca D, et al.
The Lancet Regional Health - Europe. 2022 June 1; Volume 17; 100403.; DOI:10.1016/j.lanepe.2022.100403
The invasion of Ukraine has unleashed a humanitarian crisis and the impact is devastating for millions displaced in Ukraine and for those fleeing the country. Receiving countries in Europe are reeling with shock and disbelief and trying at the same time to grapple with the reality of providing for a large, unplanned, unprecedented number of refugees mainly women and children on the move. Several calls for actions, comments and statements express outrage, the risks, and the impending consequences to life and health. There is a need to constantly assess the situation on the ground, identify priorities for health and provide guidance regarding how these needs could be addressed. Therefore, the Lancet Migration European Regional Hub conducted rapid interviews with key informants to identify these needs, and in collaboration with the World Health Organization Health and Migration Programme, summarized how these could be addressed. This viewpoint provides a summary of the situation in receiving countries and the technical guidance required that could be useful for providing assistance in the current refugee crisis.
Journal Article > LetterFull Text
BMJ. 2020 June 1; Volume 369; m2168.; DOI:10.1136/bmj.m2168
Kondilis E, Puchner K, Veizis A, Papatheodorou C, Benos A
BMJ. 2020 June 1; Volume 369; m2168.; DOI:10.1136/bmj.m2168
Journal Article > CommentaryFull Text
Int Migr. 2020 May 12; Volume 58 (Issue 3); 264-266.; DOI:10.1111/imig.12721
Veizis A
Int Migr. 2020 May 12; Volume 58 (Issue 3); 264-266.; DOI:10.1111/imig.12721
Journal Article > CommentaryFull Text
Lancet. 2020 February 1; Volume 395 (Issue 10225); 668-670.; DOI:10.1016/S0140-6736(19)33175-7
Orcutt M, Mussa R, Hiam L, Veizis A, McCann S, et al.
Lancet. 2020 February 1; Volume 395 (Issue 10225); 668-670.; DOI:10.1016/S0140-6736(19)33175-7
Restrictive migration policies that deny migrants and asylum seekers their right to health—a fundamental right enshrined in universal human rights declarations and treaties since 1948—are increasingly prevalent globally. They are the result of the so-called migration crisis that is a politically made humanitarian crisis. States are criminalising people who are in some of the most vulnerable situations, often also denying their right to seek asylum and right to health. Such policies are particularly apparent in situations of indefinite containment, such as on the Greek Islands (Chios, Kos, Leros, Lesvos, and Samos), where people are contained in EU-supported hotspot facilities in overcrowded, unhealthy, and undignified conditions.