Health Status of Temporary Migrants in Urban Areas in Vietnam1

The rapid economic growth after economic reform, known in Viet Nam as “Doi Moi”, and the growing scope of urban migration raise specific questions for social policy, including migration and health policies. This paper compares issues of health status and its determinants as they affect temporary urban migrants versus permanent urban migrants and non‐migrants. The analyses utilize multivariate logistic regression and data from the 1997 Vietnam Migration and Health Survey. The results show that temporary migrants staying in guest houses are most vulnerable to health problems. Though most of them are initially healthier, their reported health deteriorates faster than other groups of urban residents. The findings also present important implications for the current migration and health policies in Vietnam: 1) A special attention should be given to temporary migrants in guest houses; 2) Different priorities in health policy should be applied to different groups of migrants and non‐migrants; 3) The current population management policy by registration system needs to be reviewed; 4) Providing clean water is one of the most important ways to improve health of temporary migrants; 5) Targeting educational investments and reducing unemployment would likely to improve overall health; 6) A higher priority on health policies targeting women would likely pay dividends, and; 7) Improving management and collaboration between government offices and interested partners is important to improving health status and reducing inequity.     

Improving water service to the urban poor through delegated management: Lessons from the city of Kisumu,Kenya

Partnerships like the delegated management model (DMM), in which a utility delegates management of infrastructure and service delivery to slum residents, are being promoted to improve services to the urban slums in sub‐Saharan Africa. However, there is little empirical evidence of the benefits that DMM offers beneficiaries and its potential limitations. This study, conducted in 2013, compared water service in two slums in the city of Kisumu in Kenya where DMM has been implemented with another where it has not been implemented. Results showed that DMM had lowered the cost of water compared to water kiosks in neighbourhoods in which DMM had not been implemented. The study findings contribute toward an evidence base for stakeholders and regulators who see an opportunity in the integration of DMM into local drinking water provision solutions in urban slums.     

Foster youth emancipating from care: caseworkers' reports on needs and services

This article presents findings from a survey mailed to caseworkers, who answered questions about special needs, independent living skills, educational attainment, and services for 416 randomly selected foster youth in Illinois. A third of the adolescents had a mental health disorder, developmental disability, or other special need that their caseworkers believed would interfere with their ability to live independently. Additionally, urban youth were underserved relative to other youth. Youth with more behavior problems and educational and job skill deficits were less likely than other youth to continue to receive child welfare services past age 18, suggesting that services must be provided throughout adolescence to meet the needs of the most vulnerable clients.     

Asian migrants in Australia: A socio‐economic study

This paper presents a socio‐economic profile of Asian migrants in Australia, using data from the 1981 Census of Population. It shows that Asian migrants are highly educated (large proportions are university graduates and are in professional occupations), English‐speaking (many are bi‐lingual) and mostly Christian. The paper then goes on to estimate the economic benefits Asian migrants bring when they migrate to Australia, as well as the costs they might impose on the economy. Benefits were estimated by measuring the costs of education and training that Australia avoided by allowing skilled migrants to enter the country. In addition, migrants brought in financial capital when they came to Australia. They also contributed to the supply of goods and services by participating in productive employment. The costs that migrants might impose on the economy relate to the possibility of taking jobs and other resources (such as education, health and other public services) which might otherwise have gone to other Australians. Careful estimates of these factors indicate that, far from imposing a burden, Asian migrants make a substantial net contribution to the economy. In addition, the findings do not lend support to the view that they may be a cause of societal dissention, or a threat to Australian democratic institutions. On the contrary, the social attributes they possess indicate that they are well placed to settle successfully, and to make a substantial contribution to the development of Australian society.     

Meeting immigrant health challenges: An integrated model in New York City

New York City has traditionally been the portal to America for millions of foreign‐born immigrants. Current immigration echoes this past. Each year, tens of thousands of immigrants and migrants enter New York City. These individuals and families come from diverse cultures and health care systems which continue to impact on their health care needs. How can New York's health care system provide culturally sensitive and epidemiologically informed health services to these immigrants? In 1990, with a grant from the Aaron Diamond Foundation, an interdisciplinary group of professionals established the New York Task Force on Immigrant Health. This paper will describe the work of this unique multi‐disciplinary organisation as it seeks to address issues of health status and service delivery to immigrant populations. The paper will discuss specific issues and strategies with respect to a) the development of data bases, b) ethnographic investigations, c) cross‐cultural and structural barriers to care, d) the creation and analysis of models to integrate traditional and Western bio‐technical health care, and e) the informing and transforming of public policy and programs to result in more linguistically appropriate, culturally sensitive and effective health and social services. The successes of the New York Task Force on Immigrant Health, in a relatively brief period of time, provide both a model and a stimulus for other localities and nation‐states interested in preventing illness and improving the health status of their diverse populations.     

Social Capital and Livelihoods in Johannesburg: Differential Advantages and Unexpected Outcomes among Foreign‐Born Migrants,Internal Migrants,and Long‐Term South African Residents

Foreign‐born migrants – a group rarely compared with both internal migrants and long‐term residents – are often positioned as the most disadvantaged South African urban population. We use data from a 2008 cross‐sectional household survey conducted in Johannesburg to compare a contextually relevant measure of social capital and livelihood advantages between foreign‐born migrants, internal migrants, and long‐term South African residents. Our findings are counterintuitive and emphasize the need to explore the heterogeneity of urban migrant populations, and the mechanisms in which they better their lives, by showing that (1) foreign‐born migrants have better urban livelihood outcomes, and (2) indicators of social capital are not necessarily associated with improved livelihood outcomes.     

Social Stigma, Social Capital Reconstruction and Rural Migrants in Urban China: A Population Health Perspective

In this study, we examine migrant stigma and its effect on social capital reconstruction among rural migrants who possess legal rural residence but live and work in urban China. After a review of the concepts of stigma and social capital, we report data collected through in-depth interviews with 40 rural migrant workers and 38 urban residents recruited from Beijing, China. Findings from this study indicate that social stigma against rural migrants is common in urban China and is reinforced through media, social institutions and their representatives, and day-to-day interactions. As an important part of discrimination, stigma against migrant workers creates inequality, undermines trust, and reduces opportunities for interpersonal interactions between migrants and urban residents. Through these social processes, social stigma interferes with the reconstruction of social capital (including bonding, bridging and linking social capital) for individual rural migrants as well as for their communities. The interaction between stigma and social capital reconstruction may present as a mechanism by which migration leads to negative health consequences. Results from this study underscore the need for taking measures against migrant stigma and alternatively work toward social capital reconstruction for health promotion and disease prevention among this population.     

Access to Water in the Slums of Sub‐Saharan Africa

This article reviews the changing perspectives for improving access to water in the slums of developing countries, especially in sub‐Saharan Africa. While much of the literature continues to maintain an aversion to state‐led urban development policies, there is now increasing emphasis on the importance of informal, small‐scale providers and communitarian initiatives, following the many failures of privatisation. The article argues that market‐oriented solutions are inappropriate for sub‐Saharan African countries where over two‐thirds of the urban population live in squatter settlements with multidimensional challenges.     

Child welfare caseworkers' perspectives on the challenges of addressing mental health problems in early childhood

Although nearly half of child maltreatment victims are under the age of five and at high risk for developing serious emotional or behavioral problems, few young children involved in the child welfare system receive treatment. As the first point of service contact, child welfare caseworkers can play a key role in quickly identifying children with mental health problems and linking them to services. This study examines caseworkers' perspectives on the challenges of addressing mental health problems in early childhood. Based on five focus groups conducted with 50 caseworkers from an urban, public child welfare agency, results suggest that although workers acknowledge the importance of early intervention, difficulty identifying mental health needs in early childhood and workplace barriers impede linkage to services. Given the lasting impacts of early experiences on children's development, it is imperative that these challenges be addressed. Implications for systematic mental health screening and caseworker training are discussed.     

A capital theory approach to migrants' views and engagement with climate adaptation in the region of origin: A qualitative study in Belgium

Combining insights from migration and climate adaptation studies, this study examines how migrants living in Belgium contribute to climate adaptation in their region of origin, based on 29 qualitative interviews with migrants in Belgium. The findings varied considerably, depending on the region of origin, the main driver of migration and the possibility of returning. The results show that both the knowledge and capacity to contribute to climate adaptation in the region of origin depends on the forms and degrees of capital individuals have, both in the immigrant country and region of origin. Migrants with more cultural capital in the region of origin had more transnational bonding and bridging ties, resulting in more opportunities to contribute to the development of the region. However, as many of the interviewees originated from urban areas, their actions were oriented more towards waste, pollution and life domains other than climate adaptation. This contrasts with migrants with less formal cultural capital. Due to specific living conditions, they were more familiar with local climate impacts. Their transnational bonding social ties increased this knowledge and familiarity with the need for climate adaptation. Nevertheless, the high costs of integration into the immigrant society and a lack of cultural and economic capital limits this group's capacity to contribute to climate adaptation initiatives in the region of origin. Bringing the concept of ‘migrant capital’ into the study of climate adaptation fills a gap in the literature on environmental migration, and especially engages with discourses that frame migration as an adaptation strategy.     

Access to Mental Health Services: The Struggle of Poverty Affected Urban Children of Color

It is estimated that, in the United States, one in ten children and adolescents suffer from illness severe enough to cause some level of psychosocial dysfunction. Urban children, and in particular low-income children of color, are at greater risk of developing mental health problems, and are less likely to receive effective child mental health services. Prompt and effective access to mental health services by urban children of color is a critical direct practice and social policy concern. This article provides an overview of significant barriers to mental health care experienced by poverty affected urban children of color and their families. It also addresses a broad range of practice and policy issues that need to be raised in order to ensure competent delivery of mental health services for children living in urban environments. The role of social work in assisting poor urban children of color to access and benefit from mental health services is stressed. Manny John González, D.S.W., is an Assistant Professor of Social Work at Fordham University Graduate School of Social Service.     

Victim service and justice system representative responses about partner stalking: what do professionals recommend?

Research suggests that partner stalking is associated with reassault and lethality as well as increased psychological distress for victims. However, there is a significant gap in information about stalking interventions and the responses of health, mental health, law enforcement, social services, and criminal justice professionals to women experiencing partner stalking. The purpose of this study is to examine the ideas about appropriate and effective responses to stalking victims from professionals in victim services and the justice system. The study also examined differences among rural and urban representatives because prior studies have shown significant differences between rural and urban areas on experiences and responses to partner violence. A total of 152 key informants (38 urban and 114 rural) were interviewed. Study results suggest a need for more training for victim services and justice system professionals on stalking and service needs of women who experience stalking in the context of partner violence.     

Healthcare Use in the Heartland: How Health Care Selection Varies Between Rural,Retirement‐Age Migrants and Long‐Term Residents

One increasingly important problem affecting rural health care selection is the tendency of older residents to bypass local health care providers. This research investigates how the effects of community characteristics and attachment on health care bypass behavior vary between rural retirement‐age migrants and retirement‐age long‐term residents. Non‐health‐related behaviors, such as purchasing goods and services outside one's community during a health care trip, that is, “outshopping,” could influence bypass if individuals combine trips for their medical care with other consumer needs. Basing our work on the outshopping theory, we argue that bypass behavior is one facet of consumer consumption patterns for both rural retirement‐age migrants and long‐term residents. In addition, dissatisfaction with local health care and services like shopping can “push” rural residents to bypass local health care and travel greater distances for primary health care. We further contend that strong community attachment has an opposite “pull” effect that can help to negate the push of outshopping and reduce the likelihood of bypass. Our results reveal retirement‐age migrants are significantly more likely to bypass local primary health care providers than retirement‐age long‐term residents. Furthermore, our analysis bridges the rural health care and retirement community development literature to suggest that outshopping theory can now be applied to rural primary health care bypass behavior.     

Diaspora and Health? Traditional Medicine and Culture in a Mexican Migrant Community

As members of the Mexican diaspora acculturate/assimilate to life in the United States they gain skills that help them improve their socioeconomic status and overcome barriers to the mainstream American healthcare system. Thus, we might expect better health among more acculturated Mexicans. However, most of the research conducted during the past 20 years shows that the health of Mexicans living in the United States deteriorates as acculturation increases. This suggests that certain health promoting aspects of Mexican culture are lost as migrants adapt to and adopt American ways of life. This paper is the first step in testing the hypothesis that declining health among acculturated people of Mexican descent is related to a loss of traditional medical knowledge. During an ethnographic study of women’s medical knowledge in an unacculturated Mexican migrant community in Athens, Georgia, I observed many ways low‐income, undocumented migrants maintain good health. Migrant women encourage health‐promoting behaviors and treat sick family members with a variety of home remedies that appear to be effective according to chemical and pharmacological analyses. Additionally, migrant women in Athens learn how to navigate the American medical and social service systems and overcome barriers to professional healthcare services using information provided through social networks. Nevertheless, migrant women often prefer to treat sick family at home and indicated a preference for Mexican folk medicines over professional medical care in most situations. This case study suggests that migration and diaspora need not always lead to disease. The maintenance of a Mexican culture that is distinct from the rest of American society helps ensure that traditional medical knowledge is not lost, while the social networks that link Mexicans to each other and to their homeland help minimize threats to health, which are usually associated with migration. Thus, increased access to professional medical care may not improve the health of migrants if it comes with the loss of traditional medical knowledge.     

“A lot of work needs to be done”—Service provider perspectives of mental health services available to Croatia- and Bosnia-born migrants

Research suggests that migrants have higher rates of mental health disorders but are less likely to access mental health services, which highlights both their vulnerability to mental illness and inequity in service provision. Despite being large and established culturally similar migrant cohorts in Australia, Croatians and Bosnians are invisible in mental health research. This qualitative study collected practice-based evidence from eight mental health service providers who have had direct professional contact with these communities, in order to understand how they engage with services, barriers to uptake and provide suggestions for service improvements. Thematic analysis was used to identify themes across interviews, which were then compared against Yang and Hwang's Migrant Mental Health Service Utilisation Model. The study identified unique factors specific to Croatia- and Bosnia-born migrants that impact how they engage with services, including mandated/prescribed services, religious resources, knowledge resources, referral pathways and procedures, and service provider competencies. This study will promote a better understanding of the limitations of the current mental health service offerings for Croatia- and Bosnia-born migrants, making it significant to practitioners, mental health organizations, policymakers and the general public.     

Provision of basic services in slums: A review of the evidence on top‐down and bottom‐up approaches

This article synthesizes the evidence on the effectiveness of top‐down and bottom‐up approaches in providing basic services in slums in developing countries. The findings indicate that: (1) government‐led top‐down approaches focus predominantly on connectivity, but approaches led by community‐based organizations (CBOs) and non‐government organizations (NGOs) improve many additional dimensions of access; (2) legal recognition of slums improves access to services in both approaches; and (3) NGO and CBO involvement results in the right balance between the technical, social and financial resources required for effective service delivery.     

Telling their story of homelessness: voices of Victoria’s Tent City

In a climate of reduced access to affordable and appropriate housing, tent cities have emerged as a unique solution to homelessness. Conducted with a semi-structured interview schedule, this qualitative study presents the findings of research conducted at Tent City, Victoria in 2016. Using snowball sampling, 12 residents of Tent City participated in research that revealed four themes for analysis: (1) push and pull motivations to join the encampment; (2) the role of services in resident’s lives; (3) residents’ experiences with the outside community; and (4) Tent City as a home community. Push factors included substance abuse, mental health problems, unemployment, family problems while pull factors included lack of affordable and appropriate housing, loss of housing, and personal issues. Residents’ experiences with services were generally negative with social/health services being considered inadequate, housing options overly restrictive and controlling. The outside community was considered hostile and uninformed as the workings of Tent City and the benefits it provided. Importantly, Tent City provided both a psychological and functional sense of community for residents. While the directions for future research are many, further examination of the broader sociopolitical context in which tent cities emerge could be examined. As well, the themes identified here could be explored further in terms of how existing services could be restructured to better respond to the needs of homeless persons.     

Barriers and facilitators to delivering effective mental health practice strategies for youth and families served by the child welfare system

While the gap between need for and access to mental health services is well documented among children of color in foster care, little is known about why they are sustained. To illuminate barriers of service delivery, thirty-six caseworkers participated in one of five focus group meetings in a large urban Mid-Atlantic City. Ground Theory Methods revealed that there are barriers and facilitators at the macro, meso, and micro practice orientations. At the macro-level, development of effective practice strategies and proximity to effective services are likely to influence dissemination of effective practices. Secondly, at the meso-level, job support is needed to facilitate awareness, but for case managers to feel supported, they need effective training and opportunities to facilitate interagency collaboration. Finally, at the micro-level, cultural competence largely impacts implementation of effective practices. However, increased awareness around the social ills of stigma and the salience of “insider work” are needed to increase cultural competence. A “downstream” effect in which there are numerous barriers identified at the macro level has a direct negative impact on organizational capacity and readiness to deliver and engage youth and families in mental health services served by the child welfare system. Findings underscore the need for child welfare agencies to build supports at the macro, meso, and micro practice levels to ameliorate mental health service disparities.     

Mindfulness,Emotion and Behaviour: An Intervention Study with Chinese Migrant Children

Migrant children in China who move from rural to urban areas face significantly greater emotional and behavioural challenges than their urban peers. In recent decades, western countries have used mindfulness to enhance child psychosocial and behavioural outcomes. This approach has not yet been applied to rural‐to‐urban migrant children in China. This study utilised one‐group pretest‐posttest design to examine the effects of a 4‐week school‐based mindfulness intervention on Chinese migrant children's emotions and behaviours. The results show that mindfulness training significantly improved participants’ mindfulness. The training was particularly effective for those with lower mindfulness at baseline. There was significant decrease in students’ internalising and externalising problems after mindfulness training, particularly internalising problems.     

Context matters: The state of racial disparities in mental health services among youth reported to child welfare in 1999 and 2009

Upwards of 50% of youth reported to the child welfare system (CWS) do not receive mental health services, despite need. While children of color are less likely to receive services than Caucasians, the mechanisms through which disparities are sustained remain largely unknown. Data come from two nationally representative cohorts of youth who were referred to the CWS in 1999 and 2009. Results showed that while need for mental health services decreased, significant differences in the number of children who received services was not detected between cohorts. African American youth were less likely to receive services compared to their Caucasian counterparts, even after controlling for age, gender, type of maltreatment, and placement instability. However, after taking into account urbanicity, poverty, and the organizational-social context, the disparity between African American and Caucasian youth dissipated. Service disparities between Latino and Caucasian youth were not detected. The odds of service receipt were lower among youth nested within stressful organizational climates and urban (versus rural) counties, and the organizational-social context did not moderate the relationship between race and service receipt. Findings underscore the need to develop and implement strategies to increase access to services in urban counties and to promote an organizational climate conducive to reducing racial disparities.