Determinants of self-rated health among highly educated Ukrainian women refugees in Czechia: analysis based on cross-sectional study in 2022
Jazyk angličtina Země Velká Británie, Anglie Médium electronic
Typ dokumentu časopisecké články
Grantová podpora
LX22NPO5101
European Union, Next Generation EU
LX22NPO5101
European Union, Next Generation EU
LX22NPO5101
European Union, Next Generation EU
101061104
Horizon 2020
PubMed
38561703
PubMed Central
PMC10985999
DOI
10.1186/s12905-024-03053-8
PII: 10.1186/s12905-024-03053-8
Knihovny.cz E-zdroje
- Klíčová slova
- Czechia, Economic determinants, Social capital, Subjective health, Systemic risks, Ukraine, War refugees,
- MeSH
- charakteristiky rodiny MeSH
- dítě MeSH
- lidé MeSH
- průřezové studie MeSH
- socioekonomické faktory MeSH
- uprchlíci * MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
BACKGROUND: Russia's military aggression against Ukraine set in motion a large number of refugees. Considerable amount of them came and stayed in Czechia. Refugees represent special vulnerable individuals often affected by war physically and psychologically. Due to the national regulations not allowing most of Ukrainian men aged 18-60 to leave the country, nowadays Ukrainian forced migration is relatively young and strongly gendered. Evidence suggests the higher probability for searching the safe refuge abroad among Ukrainian women with small children as well as those with relatively higher economic and cultural capital. The aim of this study is to identify the structural features of systemic risks associated with war migration by examining determinants of self-rated health among forcibly displaced highly educated Ukrainian women of productive age residing in Czechia. METHODS: Data from one wave of the panel survey among Ukrainian refugees in Czechia conducted in September 2022 was used. Determinants of self-rated health including self-reported diseases and healthcare factors, lifestyle, human and social capital, economic factors, and migration characteristics were analysed using binary logistic regression. RESULTS: About 45% highly educated Ukrainian women refugees in Czechia assessed their health as poor. The poor self-rated health was mostly associated with the number of diseases and depressive symptoms, and by social capital and economic factors. Having four and more diseases (OR = 13.26; 95%-CI: 5.61-31.35), showing some severe depressive symptoms (OR = 7.20; 95%-CI: 3.95-13.13), experiencing difficulties to seek help from others (OR = 2.25; 95%-CI: 1.20-4.23), living alone in a household (OR = 2.67; 95%-CI: 1.37-5.27), having severe material deprivation (OR = 2.70; 95%-CI: 1.35-5.41) and coming originally from the eastern part of Ukraine (OR = 2.96; 95%-CI: 1.34-6.55) increased the chance of these refugees to assess their health as poor. CONCLUSION: Social and economic determinants such as lack of social contacts for seeking help and material deprivation were found to be crucial for self-rated health and should be tackled via migration policies. Further, qualitative research is needed to better understand the mechanisms behind the factors affecting subjectively assessed health.
Czech Social Science Data Archive Institute of Sociology Czech Academy of Sciences Prague Czechia
Department of Demography and Geodemography Faculty of Science Charles University Prague Czechia
Zobrazit více v PubMed
Statista. Estimated number of refugees from Ukraine recorded in Europe and Asia since February 2022 as of May 9, 2023, by selected country. https://www.statista.com/statistics/1312584/ukrainian-refugees-by-country/. Accessed 5 Jun 2023.
Leontiyeva Y. Ukraininans in the Czech Republic: on the pathway from Temporary Foreign workers to oNe of the Largest Minority Group. In: Fedyuk O, Kindler M, editors. Ukrainian Migration to the European Union. Cham: Springer; 2016. pp. 133–49.
Drbohlav D, Dzúrová D. Where are they going? Immigrant inclusion in the Czech Republic (A Case Study on ukrainians, Vietnamese, and armenians in Prague) Int Migr. 2007;45:69–95. doi: 10.1111/j.1468-2435.2007.00404.x. DOI
Drbohlav D, Janská E, Šelepová P. Ukrajinská Komunita v České Republice. [Ukrainian community in the Czech Republic] In: Šišková T, editor. Menšiny a migranti v České republice: my a Oni v multikulturní společnosti 21. století. Praha: Portál; 2001. pp. 89–97.
Klimešová M, Šatava J, Ondruška M. Situace uprchlíků z Ukrajiny. [The situation of refugees from Ukraine]. Praha; 2022. https://www.mpsv.cz/documents/20142/1248138/Situace_uprchliku_MPSV_13072022.pdf.
Ministry of the Interior of the Czech Republic. Statistika v souvislosti s válkou na Ukrajině - archiv [Statistics in connection with the war in Ukraine - archive]. https://www.mvcr.cz/clanek/statistika-v-souvislosti-s-valkou-na-ukrajine-archiv.aspx?q=Y2hudW09MQ%3D%3D. Accessed 14 Jul 2023.
Mendola D, Pera A. Vulnerability of refugees: some reflections on definitions and measurement practices. Int Migr. 2022;60:108–21. doi: 10.1111/imig.12942. DOI
Zwysen W. Different patterns of Labor Market Integration by Migration Motivation in Europe: the role of host Country Human Capital. Int Migr Rev. 2019;53:59–89. doi: 10.1177/0197918318767929. DOI
Drbohlav D, Novotný J. Dotazníkové šetření mezi válečnými uprchlíky z Ukrajiny v Česku se zaměřením na jejich ekonomickou aktivitu, znalost českého jazyka a možný návrat. Výzkumná zpráva projektu Informační setkání pro uprchlíky z Ukrajiny. [Survey among war refugees from Ukraine in Czechia with focus on their economic activity, Czech language knowledge and possible return]. Prague; 2023.
Drbohlav D. International migration in the Czech Republic and Slovakia and the outlook for East Central Europe. Czech Sociol Rev. 1994;2:89–106. doi: 10.13060/00380288.1994.30.11.17. PubMed DOI
Dzúrová D, Drbohlav D. Gender inequalities in the Health of immigrants and Workplace discrimination in Czechia. Biomed Res Int. 2014;2014:1–9. doi: 10.1155/2014/480425. PubMed DOI PMC
Spörlein C, Kristen C. Why we should care about Regional origins: Educational Selectivity among refugees and Labor Migrants in Western Europe. Front Sociol. 2019;4:39. doi: 10.3389/fsoc.2019.00039. PubMed DOI PMC
Mykhailyshyna D, Samoyliuk M, Tomilina M, Vyshlinsky G. Біженці з України: хто вони, скільки та як їх повернути? Проміжний звіт. [Refugees from Ukraine: who are they, how many of them and how to return them? Interim report.]. Kyjiv; 2023.
Scoglio AAJ, Salhi C. Violence exposure and Mental Health among resettled refugees: a systematic review. Trauma Violence Abus. 2021;22:1192–208. doi: 10.1177/1524838020915584. PubMed DOI
Bogic M, Njoku A, Priebe S. Long-term mental health of war-refugees: a systematic literature review. BMC Int Health Hum Rights. 2015;15:29. doi: 10.1186/s12914-015-0064-9. PubMed DOI PMC
Buchcik J, Kovach V, Adedeji A. Mental health outcomes and quality of life of Ukrainian refugees in Germany. Health Qual Life Outcomes. 2023;21:23. doi: 10.1186/s12955-023-02101-5. PubMed DOI PMC
Mazhak I, Paludo AC, Sudyn D. Self-reported health and coping strategies of Ukrainian female refugees in the Czech Republic. Eur Soc. 2023:1–27.
Gilmore AB, McKee M, Rose R. Determinants of and inequalities in self-perceived health in Ukraine. Soc Sci Med. 2002;55:2177–88. doi: 10.1016/S0277-9536(01)00361-6. PubMed DOI
Bobak M, Pikhart H, Rose R, Hertzman C, Marmot M. Socioeconomic factors, material inequalities, and perceived control in self-rated health: cross-sectional data from seven post-communist countries. Soc Sci Med. 2000;51:1343–50. doi: 10.1016/S0277-9536(00)00096-4. PubMed DOI
Pikhart H, Drbohlav D, Dzurova D. The self-reported health of legal and illegal/irregular immigrants in the Czech Republic. Int J Public Health. 2010;55:401–11. doi: 10.1007/s00038-010-0156-1. PubMed DOI
Refle J-E, Fakhoury J, Burton-Jeangros C, Consoli L, Jackson Y. Impact of legal status regularization on undocumented migrants’ self-reported and mental health in Switzerland. SSM - Popul Heal. 2023;22:101398. doi: 10.1016/j.ssmph.2023.101398. PubMed DOI PMC
Ambrosetti E, Dietrich H, Kosyakova Y, Patzina A. The impact of pre- and Postarrival Mechanisms on Self-Rated Health and life satisfaction among refugees in Germany. Front Sociol. 2021;6. PubMed PMC
Chiswick BR, Lee YL, Miller PW. Immigrant selection systems and immigrant health. Contemp Econ Policy. 2008;26:555–78. doi: 10.1111/j.1465-7287.2008.00099.x. DOI
La Parra-Casado D, Stornes P, Solheim EF. Self-rated health and wellbeing among the working-age immigrant population in Western Europe: findings from the European social survey (2014) special module on the social determinants of health. Eur J Public Health. 2017;27(suppl1):40–6. doi: 10.1093/eurpub/ckw221. PubMed DOI
Spoel E, Accoe K, Heymans S, Verbeeren P, de Béthune X. Migrants’ social determinants of health: living conditions, violence exposure, access to healthcare. Eur J Public Health. 2019;29:Supplement4. doi: 10.1093/eurpub/ckz186.034. DOI
Spallek J, Zeeb H, Razum O. What do we have to know from migrants’ past exposures to understand their health status? A life course approach. Emerg Themes Epidemiol. 2011;8:6. doi: 10.1186/1742-7622-8-6. PubMed DOI PMC
Anikeeva O, Bi P, Hiller JE, Ryan P, Roder D, Han G-S. The Health Status of migrants in Australia: a review. Asia Pac J Public Heal. 2010;22:159–93. doi: 10.1177/1010539509358193. PubMed DOI
Lu Y. Test of the ‘healthy migrant hypothesis’: a longitudinal analysis of health selectivity of internal migration in Indonesia. Soc Sci Med. 2008;67:1331–9. doi: 10.1016/j.socscimed.2008.06.017. PubMed DOI
Helgesson M, Johansson B, Nordquist T, Vingård E, Svartengren M. Healthy migrant effect in the Swedish context: a register-based, longitudinal cohort study. BMJ Open. 2019;9:e026972. doi: 10.1136/bmjopen-2018-026972. PubMed DOI PMC
Razum O, Migrant Mortality . Encyclopedia of Public Health. Dordrecht: Springer Netherlands; 2008. Healthy migrant effect; pp. 932–5.
Kennedy S, Kidd MP, McDonald JT, Biddle N. The healthy immigrant effect: patterns and evidence from four countries. J Int Migr Integr. 2015;16:317–32.
Fennelly K. The healthy migrant effect. Minn Med. 2007;90:51–3. PubMed
Aksoy CG, Poutvaara P. Refugees’ and irregular migrants’ self-selection into Europe. J Dev Econ. 2021;152:102681. doi: 10.1016/j.jdeveco.2021.102681. DOI
Dahlgren G, Whitehead M. Policies and strategies to promote social equity in health. Background document to WHO - strategy paper for Europe. Sweden: Stockholm; 1991.
Marmot M, Wilkinson RG. Social determinants of health. Second edi. Oxforc: Oxford University Press; 2005.
Kroenke K, Strine TW, Spitzer RL, Williams JBW, Berry JT, Mokdad AH. The PHQ-8 as a measure of current depression in the general population. J Affect Disord. 2009;114:163–73. doi: 10.1016/j.jad.2008.06.026. PubMed DOI
Guerrero Z, Melicharová H, Kavanová M, Prokop D, Škvrňák M, Kunc M, et al. Mental health conditions and help-seeking among Ukrainian war refugees in Czechia: a cross-sectional study. Psychiatry Res. 2023;329:115552. doi: 10.1016/j.psychres.2023.115552. PubMed DOI
European Union. Measuring material deprivation in the EU. Indicators for the whole population and child-specific indicators. Luxembourg; 2012.
Hnilicová H, Dobiášová K. Migrants’ Health and Access to Healthcare in the Czech Republic. Cent Eur J Public Health. 2011;19:134–8. doi: 10.21101/cejph.a3657. PubMed DOI
Brell C, Dustmann C, Preston I. The Labor Market Integration of Refugee Migrants in High-Income Countries. J Econ Perspect. 2020;34:94–121. doi: 10.1257/jep.34.1.94. DOI
Cortes KE. Are refugees different from Economic immigrants? Some empirical evidence on the heterogeneity of immigrant groups in the United States. Rev Econ Stat. 2004;86:465–80. doi: 10.1162/003465304323031058. DOI
Adda J, Dustmann C, Görlach J-S. The dynamics of Return Migration, Human Capital Accumulation, and wage assimilation. Rev Econ Stud. 2022;89:2841–71. doi: 10.1093/restud/rdac003. DOI
Becker SO, Ferrara A. Consequences of forced migration: a survey of recent findings. Labour Econ. 2019;59:1–16. doi: 10.1016/j.labeco.2019.02.007. DOI
Yang H, Deng Q, Geng Q, Tang Y, Ma J, Ye W, et al. Association of self-rated health with chronic disease, mental health symptom and social relationship in older people. Sci Rep. 2021;11:14653. doi: 10.1038/s41598-021-94318-x. PubMed DOI PMC
Tamayo-Fonseca N, Quesada JA, Nolasco A, Melchor I, Moncho J, Pereyra-Zamora P, et al. Self-rated health and mortality: a follow-up study of a Spanish population. Public Health. 2013;127:1097–104. doi: 10.1016/j.puhe.2013.09.003. PubMed DOI
Sheridan PE, Mair CA, Quiñones AR. Associations between prevalent multimorbidity combinations and prospective disability and self-rated health among older adults in Europe. BMC Geriatr. 2019;19:198. doi: 10.1186/s12877-019-1214-z. PubMed DOI PMC
Darviri C, Artemiadis AK, Tigani X, Alexopoulos EC. Lifestyle and self-rated health: a cross-sectional study of 3,601 citizens of Athens, Greece. BMC Public Health. 2011;11:619. doi: 10.1186/1471-2458-11-619. PubMed DOI PMC
Pärna K, Siida S. Smoking and self-rated health among physicians and total population in 2002 and 2014 in Estonia. Eur J Public Health. 2018;28:suppl4. doi: 10.1093/eurpub/cky212.538. PubMed DOI PMC
Okosun IS, Choi S, Matamoros T, Dever GEA. Obesity is Associated with reduced self-rated General Health Status: evidence from a Representative Sample of White, Black, and hispanic americans. Prev Med (Baltim) 2001;32:429–36. doi: 10.1006/pmed.2001.0840. PubMed DOI
Prosper M-H. Obesity as a predictor of self-rated health. Am J Health Behav. 2009;33. PubMed
Henning-Smith C, Gonzales G. The relationship between living alone and self-rated Health varies by Age: evidence from the National Health interview survey. J Appl Gerontol. 2020;39:971–80. doi: 10.1177/0733464819835113. PubMed DOI
Mota P, Saez M, Selby K, Bodenmann P. Longitudinal panel data study of self-rated health among migrants in french-speaking Switzerland, 2003–2017. BMJ Open. 2020;10:e035812. doi: 10.1136/bmjopen-2019-035812. PubMed DOI PMC
Jang H, Tang F. Loneliness, age at immigration, family relationships, and depression among older immigrants: a moderated relationship. J Soc Pers Relat. 2022;39:1602–22. doi: 10.1177/02654075211061279. PubMed DOI PMC
Omariba DWR, Ng E, Immigration Generation and self-rated health in Canada: on the role of health literacy. Can J Public Heal. 2011;102:281–5. doi: 10.1007/BF03404049. PubMed DOI PMC
Pottie K, Ng E, Spitzer D, Mohammed A, Glazier R. Language proficiency, gender and self-reported health. Can J Public Heal. 2008;99:505–10. doi: 10.1007/BF03403786. PubMed DOI PMC
van Tubergen F, Kogan I, Kosyakova Y, Pötzschke S. Self-selection of Ukrainian refugees and displaced persons in Europe. J Refug Stud. 2023:1–19.
Tanggaard Andersen P, Holst Algren M, Fromsejer Heiberg R, Joshi R, Kronborg Bak C. Social network resources and self-rated health in a deprived Danish neighborhood. Health Promot Int. 2018;33:999–1009. doi: 10.1093/heapro/dax051. PubMed DOI
Zunzunegui M, Koné A, Johri M, Béland F, Wolfson C, Bergman H. Social networks and self-rated health in two french-speaking Canadian community dwelling populations over 65. Soc Sci Med. 2004;58:2069–81. doi: 10.1016/j.socscimed.2003.08.005. PubMed DOI
White AM, Philogene GS, Fine L, Sinha S. Social support and self-reported Health Status of older adults in the United States. Am J Public Health. 2009;99:1872–8. doi: 10.2105/AJPH.2008.146894. PubMed DOI PMC
Stansfeld S, Candy B. Psychosocial work environment and mental health—a meta-analytic review. Scand J Work Environ Health. 2006;32:443–62. doi: 10.5271/sjweh.1050. PubMed DOI
Cohen S, Wills TA. Stress, social support, and the buffering hypothesis. Psychol Bull. 1985;98:310–57. doi: 10.1037/0033-2909.98.2.310. PubMed DOI
van Bergen APL, Wolf JRLM, Badou M, de Wilde-Schutten K, IJzelenberg W, Schreurs H, et al. The association between social exclusion or inclusion and health in EU and OECD countries: a systematic review. Eur J Public Health. 2019;29:575–82. doi: 10.1093/eurpub/cky143. PubMed DOI PMC
Brydsten A, Rostila M, Dunlavy A. Social integration and mental health - a decomposition approach to mental health inequalities between the foreign-born and native-born in Sweden. Int J Equity Health. 2019;18:48. doi: 10.1186/s12939-019-0950-1. PubMed DOI PMC
Lebano A, Hamed S, Bradby H, Gil-Salmerón A, Durá-Ferrandis E, Garcés-Ferrer J, et al. Migrants’ and refugees’ health status and healthcare in Europe: a scoping literature review. BMC Public Health. 2020;20:1039. doi: 10.1186/s12889-020-08749-8. PubMed DOI PMC
Lin Y, Zhang Q, Chen W, Shi J, Han S, Song X, et al. Association between Social Integration and Health among Internal migrants in ZhongShan, China. PLoS ONE. 2016;11:e0148397. doi: 10.1371/journal.pone.0148397. PubMed DOI PMC
Granovetter MS. The strength of weak ties. Am J Sociol. 1973;78:1360–80. doi: 10.1086/225469. DOI
Granovetter M. The strength of weak ties: A Network Theory Revisited. Sociol Theory. 1983;1:201. doi: 10.2307/202051. DOI
Drbohlav D, Dzúrová D. Social remittances and interpersonal communication: moldovans in Prague and Turin. Geografie. 2023;128:25–48. doi: 10.37040/geografie.2023.002. DOI
Verhaeghe P-P, Pattyn E, Bracke P, Verhaeghe M, Van De Putte B. The association between network social capital and self-rated health: pouring old wine in new bottles? Health Place. 2012;18:358–65. doi: 10.1016/j.healthplace.2011.11.005. PubMed DOI
Lubbers M, Gijsberts M. Changes in self-rated Health Right after Immigration: a panel study of Economic, Social, Cultural, and emotional explanations of self-rated Health among immigrants in the Netherlands. Front Sociol. 2019;4. PubMed PMC
Giordano GN, Lindstrom M. The impact of changes in different aspects of social capital and material conditions on self-rated health over time: a longitudinal cohort study. Soc Sci Med. 2010;70:700–10. doi: 10.1016/j.socscimed.2009.10.044. PubMed DOI
Blázquez M, Cottini E, Herrarte A. The socioeconomic gradient in health: how important is material deprivation? J Econ Inequal. 2014;12:239–64. doi: 10.1007/s10888-013-9248-5. DOI
Leontiyeva Y. The education-employment mismatch among Ukrainian migrants in the Czech Republic. Cent East Eur Migr Rev. 2014;3:63–84.
Smith P, Frank J. When aspirations and achievements don’t meet. A longitudinal examination of the differential effect of education and occupational attainment on declines in self-rated health among Canadian labour force participants. Int J Epidemiol. 2005;34:827–34. doi: 10.1093/ije/dyi047. PubMed DOI
Dunlavy AC, Garcy AM, Rostila M. Educational mismatch and health status among foreign-born workers in Sweden. Soc Sci Med. 2016;154:36–44. doi: 10.1016/j.socscimed.2016.02.018. PubMed DOI
Chen C, Smith P, Mustard C. The prevalence of over-qualification and its association with health status among occupationally active new immigrants to Canada. Ethn Health. 2010;15:601–19. doi: 10.1080/13557858.2010.502591. PubMed DOI
Agudelo-Suárez AA, Ronda-Pérez E, Gil-González D, Vives-Cases C, García AM, Ruiz-Frutos C, et al. The effect of perceived discrimination on the health of immigrant workers in Spain. BMC Public Health. 2011;11:652. doi: 10.1186/1471-2458-11-652. PubMed DOI PMC
Murthy RS, Lakshminarayana R. Mental health consequences of war: a brief review of research findings. World Psychiatry. 2006;5:25–30. PubMed PMC
Andrews J, Isański J, Nowak M, Sereda V, Vacroux A, Vakhitova H. Feminized forced migration: Ukrainian war refugees. Womens Stud Int Forum. 2023;99:102756. doi: 10.1016/j.wsif.2023.102756. DOI