The Migrant Health and Wellbeing
Survey (Maamu)
Results
Aims of the survey
• to describe health and wellbeing, and the use of services
in migrant populations
• based on the surve...
•

The survey was coordinated by the National Institute for Health
and Welfare, in collaboration with
– The Ministry of So...
Sample and participants
• Random sample from the Population Register
• 3 000 persons, 1 000 persons / ethnic group
• 6 cit...
Why these target groups?
• All among the largest migrant populations in Finland
• Potentially vulnerable groups

• To incl...
Implementation
• Planning and preparation started in 2008
– Including expert groups, focus groups and consultations with
m...
• The study consisted of
– an computer-assisted structured interview (60-90
minutes)
– a health examination (45-60 minutes...
Content of interviews:
• Background information
• Health status and chronic conditions

• Health behavior
• Experiences of...
Content of health examinations:
•

blood pressure and pulse

•

height and weight, waist and hip circumference

•

oral he...
Participation
Russian

Somali

Kurdish

N

%

N

%

N

%

702

70,2

512

51,2

632

63,2

466

46,6

317

31,7

480

48,0...
Socio-demographic factors and
living conditions

The Migrant Health and Wellbeing Survey (Maamu)

11
Migration background
• Average migration age was 24–25 years.
• Those with Somali background had moved to Finland at
young...
Residence permit, by gender (%)
100 %
90 %

Other

80 %
70 %

Remigrant

60 %
50 %
40 %

Work-based immigrant,
his or her ...
Basic education, by gender (%)
100 %
90 %
80 %
70 %
60 %
High school

50 %

Elemanetary school
40 %

No education

30 %
20...
The main activity, by gender (%)
100 %
90 %
Retired or other
80 %

70 %

Unemployed

60 %
50 %

Work at
home/housewife

40...
Experienced financial difficulties, by gender (%)
70%

60%

50%

40%

Men
Women

30%

20%

10%

0%
Russian

Somali

Kurdis...
Self-rated health and long-term
illnesses

The Migrant Health and Wellbeing Survey (Maamu)

17
Self-rated health good or rather good, by gender (%)
100%
90%
80%
70%
60%
Men

50%

Women
40%
30%
20%
10%

0%
Russian

Som...
Prevalence of constant pain and aches, by gender (%)
30%

25%

20%

Men

15%

Women
10%

5%

0%
Russian

Somali

Kurdish

...
Chronic disease risk factors

The Migrant Health and Wellbeing Survey (Maamu)

20
Body Mass Index (BMI), by gender (%)
100 %
90 %
80 %
70 %
60 %
BMI ≥ 30

50 %

BMI 25-29,99
40 %

BMI < 25

30 %
20 %
10 %...
Prevalence of high blood pressure (systolic ≥ 140 or diastolic
≥ 90 mmHg and/or use of medication for high BP), by gender ...
Lipids
• Total cholesterol levels were significantly lower among
those of Somali and Kurdish background compared to
the to...
Prevalence of low levels of vitamin D (< 50 nmol/l), by
gender (%)
100%
90%
80%
70%
60%
Men

50%

Women
40%
30%
20%
10%
0%...
Infectious diseases

The Migrant Health and Wellbeing Survey (Maamu)

25
•

Infectious diseases were rarely screened upon arrival to Finland,
except among those who were refugees or asylum seeker...
Correct answers to all five HIV awareness questions
(UNGASS), by gender (%)
60%

50%

40%

30%
Men
20%

Women

10%

0%
Rus...
Oral health

The Migrant Health and Wellbeing Survey (Maamu)

28
Oral health
• In all migrant groups the perceived oral health status
was worse than in the total population.

• 34-54 % of...
Reproductive health

The Migrant Health and Wellbeing Survey (Maamu)

30
Number of lifetime abortions among women aged 18–
54 years (%)
100 %
90 %
80 %
70 %
60 %
3 or more
50 %

1-2
None

40 %

3...
Prevalence of female circumcisions and problems
related to the circumcision (% of female participants)
90%
80%
70%
60%

Ci...
Mental health

The Migrant Health and Wellbeing Survey (Maamu)

33
Prevalence of severe depression and anxiety
symptoms over the last 7 days, by gender (%)
60%

50%

40%

Men

30%

Women
20...
Prevalence of trauma experiences in the country of
origin, by gender (%).
100%
90%
80%
70%
60%
Men

50%

Women
40%
30%
20%...
Health service use due to mental health problems
over last 12 months, by gender (%).
25%

20%

15%
Men
Women
10%

5%

0%
R...
Lifestyle factors

The Migrant Health and Wellbeing Survey (Maamu)

37
Prevalence of daily smoking, by gender (%)
40%
35%
30%
25%
Men

20%

Women
15%
10%
5%
0%
Russian

Somali

Kurdish

The Mig...
Alcohol and substance use
• Nearly 40 % of those with Russian background aged
18–29 years had used cannabis.
• Compared to...
Eating habits and physical exercise
• Those with Somali background used fresh vegetables,
fruits and berries less often th...
Fitness training for several hours per week, by gender
(%)
45%
40%
35%
30%
25%
Men
20%

Women

15%
10%
5%
0%
Russian

Soma...
Functional and working capacity

The Migrant Health and Wellbeing Survey (Maamu)

42
Having difficulties or being unable to climb up the
stairs (several floors without rest), by gender (%)
45%
40%
35%
30%
25...
Standing balance test performed successfully (for 60
seconds), by gender (%)
100%
90%
80%
70%
60%
Men

50%

Women
40%
30%
...
Understands spoken Finnish or Swedish not at all or
poorly, by gender (%)
40%
35%
30%
25%
Men

20%

Women
15%
10%
5%
0%
Ru...
Unable to use internet, by gender (%)
40%
35%
30%
25%
Men

20%

Women
15%
10%
5%
0%
Russian

Somali

Kurdish

The Migrant ...
Work ability, by gender (%)
100 %
90 %

80 %
70 %

Fully unable to
work

60 %
50 %

To some extent
unable to work

40 %
30...
Social wellbeing

The Migrant Health and Wellbeing Survey (Maamu)

48
Quality of life good or very good, by gender (%)
120%

100%

80%

Men

60%

Women
40%

20%

0%
Russian

Somali

Kurdish

T...
Experiencing own life very or a lot meaningful, by
gender (%)
120%

100%

80%

Men

60%

Women
40%

20%

0%
Russian

Somal...
Having at least one good Finnish friend, by gender (%)
80%
70%
60%
50%
Men

40%

Women
30%
20%
10%
0%
Russian

Somali

The...
Experiences on discrimination
and violence

The Migrant Health and Wellbeing Survey (Maamu)

52
Experiences of discrimination in everyday life in
Finland

unpolite treatment

disrespectful treatment
Russian
Somalian
Ku...
Experienced violence over the last 12 months, by
gender (%)
16%
14%
12%
10%
Men

8%

Women
6%
4%
2%
0%
Russian

Somali

Ku...
Health care services

The Migrant Health and Wellbeing Survey (Maamu)

55
Health check-up or eyesight examination over last 5
years (%).
• Also women had
participated in cancer
screening less ofte...
Outpatient and primary care visits during
the past 12 months
• Compared to the total population
– Those with Somali- and K...
Reported need for dental health services, by gender
(%)
80%
70%
60%
50%
Men

40%

Women
30%
20%
10%
0%
Russian

Somali

Ku...
Reported need for continuous care by a physician and
those not receiving the care they expected (%)
50%
45%
40%
35%
30%
Ne...
Satisfaction with latest physician visit
• Those with Russian background were most critical and those
with Somali backgrou...
Conclusions

The Migrant Health and Wellbeing Survey (Maamu)

61
Achievements and challenges
• New information on health, wellbeing and integration

• Strengths among the migrant groups
•...
Conclusions to developing heath care
• Culture sensitive, participatory approaches to health
promotion are needed, activat...
Health promotion: information and
support in collaboration
• Migrant groups need more information on health and
health ser...
Conclusions about services
• Migrants’ insufficient knowledge about health services
• Professionals’ insufficient knowledg...
Conclusions about mental health
services
• Prevalence of depression and anxiety symptoms vs. use
of mental health care ser...
Development of migrant health care
• Migrant specific services, e.g.
– Consulting team for migrants’ psychiatric care, spe...
Monitoring system
• Interactive database Terveytemme (Our health)
www.terveytemme.fi
• TOIMIA-database www.toimia.fi
– Que...
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The Migrant Health and Wellbeing Survey (Maamu)

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The Migrant Health and Wellbeing Survey (Maamu)

  1. 1. The Migrant Health and Wellbeing Survey (Maamu) Results
  2. 2. Aims of the survey • to describe health and wellbeing, and the use of services in migrant populations • based on the survey, a monitoring system is developed to plan and evaluate actions • to promote integration and employment of migrants • to promote health and wellbeing of migrants and their families The Migrant Health and Wellbeing Survey (Maamu) 2
  3. 3. • The survey was coordinated by the National Institute for Health and Welfare, in collaboration with – The Ministry of Social Affairs and Health – The Finnish Institute of Occupational Health – The Family Federation – Municipalities – Statistics Finland • Funded by – The European Social Fund – The Social Insurance Institution of Finland – The Finnish Work Environment Fund – The National Institute for Health and Welfare – Municipalities The Migrant Health and Wellbeing Survey (Maamu) 3
  4. 4. Sample and participants • Random sample from the Population Register • 3 000 persons, 1 000 persons / ethnic group • 6 cities: Helsinki, Espoo, Vantaa, Turku, Tampere, Vaasa • Selection criteria – Age 18–64-years – country of birth: Somalia, Iraq/Iran, Russia/Soviet Union – mother tongue: Kurdish, Russian/Finnish – minimum one year residence in Finland • Comparable information for the Finnish overall population from the Health 2011 Survey (same age frame and same cities) The Migrant Health and Wellbeing Survey (Maamu) 4
  5. 5. Why these target groups? • All among the largest migrant populations in Finland • Potentially vulnerable groups • To include both refugees and people who have other reasons for migration • To cover different areas of origin (country of birth) The Migrant Health and Wellbeing Survey (Maamu) 5
  6. 6. Implementation • Planning and preparation started in 2008 – Including expert groups, focus groups and consultations with migrant organizations and health care professionals with the selected ethnic origins • Pilot stage August-October 2010 • Data collection between December 2010 and May 2012. • Basic results published in November 2012: Castaneda AE, Rask S, Koponen P, Mulki M, Koskinen S (eds.) Migrant health and wellbeing. A study on persons of Russian, Somali and Kurdish origin in Finland. THL Report 61/2012. The Migrant Health and Wellbeing Survey (Maamu) 6
  7. 7. • The study consisted of – an computer-assisted structured interview (60-90 minutes) – a health examination (45-60 minutes) – a short-interview for those refusing or not able to participate in the longer interview (15-20 minutes) • Conducted by bilingual fieldwork personnel recruited and trained by THL – – – – Fieldwork coordinators for each team (3) Interviewers (13) Nurses (6) Students and other assistants (14) The Migrant Health and Wellbeing Survey (Maamu) 7
  8. 8. Content of interviews: • Background information • Health status and chronic conditions • Health behavior • Experiences of discrimination and violence • Health services • Oral health • Living conditions • Social wellbeing • Work The Migrant Health and Wellbeing Survey (Maamu) 8
  9. 9. Content of health examinations: • blood pressure and pulse • height and weight, waist and hip circumference • oral health • fingertip blood sample to measure haemoglobin (anemia) • functional capacity: self reported and tested (hand grip strength, balance test, chair stand) • Depression and anxiety (HSCL-25) and other symptoms (e.g. pain and allergy) • blood samples (e.g. fasting glucose, blood lipids, liver function tests and inflammatory markers, vitamin D) • Questions on HIV-awareness • HIV, hepatitis and syphilis tests (with specific consent) The Migrant Health and Wellbeing Survey (Maamu) 9
  10. 10. Participation Russian Somali Kurdish N % N % N % 702 70,2 512 51,2 632 63,2 466 46,6 317 31,7 480 48,0 Health examination + short interview 1 0,1 42 4,2 26 2,6 Only interview 79 7,9 34 3,4 28 2,8 Only health examination 1 0,1 19 1,9 14 1,4 155 15,5 101 10,1 81 8,1 Refused / no show / no appointment 201 20,1 299 29,9 226 22,6 Not contacted 84 8,4 144 14,4 134 13,4 Wrong address 22 2,2 38 3,8 54 5,4 Tried home visit 5 times 62 6,2 106 10,6 80 8,0 13 1,3 45 4,5 8 0,8 1000 100 1000 100 1000 100 Participation, at least one part Health examination + full interview Only short interview Moved / abroad Total The Migrant Health and Wellbeing Survey (Maamu) 10
  11. 11. Socio-demographic factors and living conditions The Migrant Health and Wellbeing Survey (Maamu) 11
  12. 12. Migration background • Average migration age was 24–25 years. • Those with Somali background had moved to Finland at younger age than other groups and they had lived longest in Finland. • Mean time lived in Finland was over 10 years in all study groups. The Migrant Health and Wellbeing Survey (Maamu) 12
  13. 13. Residence permit, by gender (%) 100 % 90 % Other 80 % 70 % Remigrant 60 % 50 % 40 % Work-based immigrant, his or her spouse or children 30 % Family-reunification 20 % Aslum seeker or refugee 10 % 0% Russian men Russian women Somali men Somali women Kurdish men The Migrant Health and Wellbeing Survey (Maamu) Kurdish women 13
  14. 14. Basic education, by gender (%) 100 % 90 % 80 % 70 % 60 % High school 50 % Elemanetary school 40 % No education 30 % 20 % 10 % 0% Russian Russian Somali men women men Somali Kurdish Kurdish Finnish Finnish women men women men women The Migrant Health and Wellbeing Survey (Maamu) 14
  15. 15. The main activity, by gender (%) 100 % 90 % Retired or other 80 % 70 % Unemployed 60 % 50 % Work at home/housewife 40 % Student 30 % 20 % Employed 10 % 0% Russian Russian Somalian Somalian Kurdish men women men women men Kurdish women Finnish men The Migrant Health and Wellbeing Survey (Maamu) Finnish women 15
  16. 16. Experienced financial difficulties, by gender (%) 70% 60% 50% 40% Men Women 30% 20% 10% 0% Russian Somali Kurdish The Migrant Health and Wellbeing Survey (Maamu) 16
  17. 17. Self-rated health and long-term illnesses The Migrant Health and Wellbeing Survey (Maamu) 17
  18. 18. Self-rated health good or rather good, by gender (%) 100% 90% 80% 70% 60% Men 50% Women 40% 30% 20% 10% 0% Russian Somali Kurdish The Migrant Health and Wellbeing Survey (Maamu) Finnish 18
  19. 19. Prevalence of constant pain and aches, by gender (%) 30% 25% 20% Men 15% Women 10% 5% 0% Russian Somali Kurdish The Migrant Health and Wellbeing Survey (Maamu) 19
  20. 20. Chronic disease risk factors The Migrant Health and Wellbeing Survey (Maamu) 20
  21. 21. Body Mass Index (BMI), by gender (%) 100 % 90 % 80 % 70 % 60 % BMI ≥ 30 50 % BMI 25-29,99 40 % BMI < 25 30 % 20 % 10 % 0% Russian Russian men women Somali men Somali women Kurdish men Kurdish women Finnish men The Migrant Health and Wellbeing Survey (Maamu) Finnish women 21
  22. 22. Prevalence of high blood pressure (systolic ≥ 140 or diastolic ≥ 90 mmHg and/or use of medication for high BP), by gender (%) 40% 35% 30% 25% Men 20% Women 15% 10% 5% 0% Russian Somali Kurdish The Migrant Health and Wellbeing Survey (Maamu) Finnish 22
  23. 23. Lipids • Total cholesterol levels were significantly lower among those of Somali and Kurdish background compared to the total population. • Lipid levels of those with Russian background were very close to the levels of total population. • HDL cholesterol levels were lower in all groups (except Russian men) than in the total population. The Migrant Health and Wellbeing Survey (Maamu) 23
  24. 24. Prevalence of low levels of vitamin D (< 50 nmol/l), by gender (%) 100% 90% 80% 70% 60% Men 50% Women 40% 30% 20% 10% 0% Russian Somali Kurdish The Migrant Health and Wellbeing Survey (Maamu) 24
  25. 25. Infectious diseases The Migrant Health and Wellbeing Survey (Maamu) 25
  26. 26. • Infectious diseases were rarely screened upon arrival to Finland, except among those who were refugees or asylum seekers. • Over 95 % of those who participated to the health examination agreed to be tested for HIV, hepatitis and syfilis. • Less than half of the participants had contacted health care professionals before visiting their country of origin (e.g. to be vaccinated) • Infectious diseases were relatively uncommon; the most common was hepatitis B, no HIV infections were found • The prevalence of infectious diseases reflected their prevalence in the country of origin. • Awareness of HIV was low especially among those with Somali and Kurdish background. The Migrant Health and Wellbeing Survey (Maamu) 26
  27. 27. Correct answers to all five HIV awareness questions (UNGASS), by gender (%) 60% 50% 40% 30% Men 20% Women 10% 0% Russian Somali Kurdish The Migrant Health and Wellbeing Survey (Maamu) 27
  28. 28. Oral health The Migrant Health and Wellbeing Survey (Maamu) 28
  29. 29. Oral health • In all migrant groups the perceived oral health status was worse than in the total population. • 34-54 % of the participants reported having had tooth pain or other problems in teeth or dentures during the past 12 months, this was most common among women with Somali origin. • Those with Russian and Somali background reported that they were brushing thier teeth at least twice a day as often than those in the total population. A third of those of Kurdish background reported brushing their teeth less often than recommended. The Migrant Health and Wellbeing Survey (Maamu) 29
  30. 30. Reproductive health The Migrant Health and Wellbeing Survey (Maamu) 30
  31. 31. Number of lifetime abortions among women aged 18– 54 years (%) 100 % 90 % 80 % 70 % 60 % 3 or more 50 % 1-2 None 40 % 30 % 20 % 10 % 0% Russian Somali Kurdish The Migrant Health and Wellbeing Survey (Maamu) Finnish 31
  32. 32. Prevalence of female circumcisions and problems related to the circumcision (% of female participants) 90% 80% 70% 60% Circumcision 50% Problems related to circumcision 40% 30% 20% 10% 0% Somali Kurdish The Migrant Health and Wellbeing Survey (Maamu) 32
  33. 33. Mental health The Migrant Health and Wellbeing Survey (Maamu) 33
  34. 34. Prevalence of severe depression and anxiety symptoms over the last 7 days, by gender (%) 60% 50% 40% Men 30% Women 20% 10% 0% Russian Somali Kurdish The Migrant Health and Wellbeing Survey (Maamu) Finnish 34
  35. 35. Prevalence of trauma experiences in the country of origin, by gender (%). 100% 90% 80% 70% 60% Men 50% Women 40% 30% 20% 10% 0% Russian Somali The Migrant Health and Wellbeing Survey (Maamu) Kurdi 35
  36. 36. Health service use due to mental health problems over last 12 months, by gender (%). 25% 20% 15% Men Women 10% 5% 0% Russian Somali Kurdish The Migrant Health and Wellbeing Survey (Maamu) Finnish 36
  37. 37. Lifestyle factors The Migrant Health and Wellbeing Survey (Maamu) 37
  38. 38. Prevalence of daily smoking, by gender (%) 40% 35% 30% 25% Men 20% Women 15% 10% 5% 0% Russian Somali Kurdish The Migrant Health and Wellbeing Survey (Maamu) Finnish 38
  39. 39. Alcohol and substance use • Nearly 40 % of those with Russian background aged 18–29 years had used cannabis. • Compared to other groups there were less of those not using any alcohol at all and more of those using at least six doses of alcohol at one occasion among participants of Russian origin . • Using any alcohol was rare among those with Somali background. The Migrant Health and Wellbeing Survey (Maamu) 39
  40. 40. Eating habits and physical exercise • Those with Somali background used fresh vegetables, fruits and berries less often than other groups. • Men and women with Somali background and women of Kurdish background reported working strenuously less often than those in the total population. The Migrant Health and Wellbeing Survey (Maamu) 40
  41. 41. Fitness training for several hours per week, by gender (%) 45% 40% 35% 30% 25% Men 20% Women 15% 10% 5% 0% Russian Somali Kurdish The Migrant Health and Wellbeing Survey (Maamu) Finnish 41
  42. 42. Functional and working capacity The Migrant Health and Wellbeing Survey (Maamu) 42
  43. 43. Having difficulties or being unable to climb up the stairs (several floors without rest), by gender (%) 45% 40% 35% 30% 25% Men 20% Women 15% 10% 5% 0% Russian Somali Kurdish The Migrant Health and Wellbeing Survey (Maamu) 43
  44. 44. Standing balance test performed successfully (for 60 seconds), by gender (%) 100% 90% 80% 70% 60% Men 50% Women 40% 30% 20% 10% 0% Russian Somali Kurdish The Migrant Health and Wellbeing Survey (Maamu) 44
  45. 45. Understands spoken Finnish or Swedish not at all or poorly, by gender (%) 40% 35% 30% 25% Men 20% Women 15% 10% 5% 0% Russian Somali Kurdish The Migrant Health and Wellbeing Survey (Maamu) 45
  46. 46. Unable to use internet, by gender (%) 40% 35% 30% 25% Men 20% Women 15% 10% 5% 0% Russian Somali Kurdish The Migrant Health and Wellbeing Survey (Maamu) 46
  47. 47. Work ability, by gender (%) 100 % 90 % 80 % 70 % Fully unable to work 60 % 50 % To some extent unable to work 40 % 30 % 20 % Fully able to work 10 % 0% Russian Russian men women Somali men Somali Kurdish Kurdish Finnish Finnish women men women men men The Migrant Health and Wellbeing Survey (Maamu) 47
  48. 48. Social wellbeing The Migrant Health and Wellbeing Survey (Maamu) 48
  49. 49. Quality of life good or very good, by gender (%) 120% 100% 80% Men 60% Women 40% 20% 0% Russian Somali Kurdish The Migrant Health and Wellbeing Survey (Maamu) Finnish 49
  50. 50. Experiencing own life very or a lot meaningful, by gender (%) 120% 100% 80% Men 60% Women 40% 20% 0% Russian Somali The Migrant Health and Wellbeing Survey (Maamu) Kurdish 50
  51. 51. Having at least one good Finnish friend, by gender (%) 80% 70% 60% 50% Men 40% Women 30% 20% 10% 0% Russian Somali The Migrant Health and Wellbeing Survey (Maamu) Kurdish 51
  52. 52. Experiences on discrimination and violence The Migrant Health and Wellbeing Survey (Maamu) 52
  53. 53. Experiences of discrimination in everyday life in Finland unpolite treatment disrespectful treatment Russian Somalian Kurdish name-calling threatening/harassing 0% 5% 10% 15% 20% 25% 30% The Migrant Health and Wellbeing Survey (Maamu) 35% 40% 53
  54. 54. Experienced violence over the last 12 months, by gender (%) 16% 14% 12% 10% Men 8% Women 6% 4% 2% 0% Russian Somali Kurdish The Migrant Health and Wellbeing Survey (Maamu) 54
  55. 55. Health care services The Migrant Health and Wellbeing Survey (Maamu) 55
  56. 56. Health check-up or eyesight examination over last 5 years (%). • Also women had participated in cancer screening less often compared to the total population 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Russian Somali Health check-up Kurdish Finnish Eye examination The Migrant Health and Wellbeing Survey (Maamu) 56
  57. 57. Outpatient and primary care visits during the past 12 months • Compared to the total population – Those with Somali- and Kurdish background reported more visits to municipal health centers – Those with Kurdish background reported more visits to hospital outpatient clinics – All migrant groups reported less visits to occupational health care and private clinics • Women reported more physician consultations than men in all other groups except those with Kurdish background • Visiting physicians outside Finland was common among women with Russian background (22 % of these women reported visits to physicians outside Finland during the past 12 months) The Migrant Health and Wellbeing Survey (Maamu) 57
  58. 58. Reported need for dental health services, by gender (%) 80% 70% 60% 50% Men 40% Women 30% 20% 10% 0% Russian Somali Kurdish The Migrant Health and Wellbeing Survey (Maamu) 58
  59. 59. Reported need for continuous care by a physician and those not receiving the care they expected (%) 50% 45% 40% 35% 30% Need for continuous care 25% Unmet need for care 20% 15% 10% 5% 0% Russian Somali Kurdish Finnish The Migrant Health and Wellbeing Survey (Maamu) 25
  60. 60. Satisfaction with latest physician visit • Those with Russian background were most critical and those with Somali background most satisfied with the care they had received • The participants were least satisfied with getting information on their own health (54-81 % reported getting enough information) and with possibilities to take part in decisions about their care (50-77 % reported being able to take part). • 54-75 % thought that the care they had received had helped them The Migrant Health and Wellbeing Survey (Maamu) 60
  61. 61. Conclusions The Migrant Health and Wellbeing Survey (Maamu) 61
  62. 62. Achievements and challenges • New information on health, wellbeing and integration • Strengths among the migrant groups • Good perceived heath • Good quality of life and trust in the services • Many issues improved by longer stay in Finland • Worries among the migrant groups • • • • • Mental health Experiences of discrimination Restrictions in functional capacity Overweight and obesity with Somali and Kurdish women Low vitamin D levels The Migrant Health and Wellbeing Survey (Maamu) 62
  63. 63. Conclusions to developing heath care • Culture sensitive, participatory approaches to health promotion are needed, activating migrants is essential • Goals need to be set to prevent obesity and to promote physical activity, especially among women with Somali and Kurdish background • Development of family planning and actions to promote reproductive health are needed especially among women with Russian and Somali background • Work against female circumcision is needed also in Kurdish communities, not only the Somali communities. The Migrant Health and Wellbeing Survey (Maamu) 63
  64. 64. Health promotion: information and support in collaboration • Migrant groups need more information on health and health services • Health in all policies: services and organizations (also non governmental) in the fields of e.g. sports and physical activity, education, housing, as well as those who organize activities to support migrant integration need to work together • Support to health promoting choices and integration of migrants at individual, family and community levels by removing obstacles – in cultural, educational, practical and economical factors • Focus on health disparities The Migrant Health and Wellbeing Survey (Maamu) 64
  65. 65. Conclusions about services • Migrants’ insufficient knowledge about health services • Professionals’ insufficient knowledge about migrants; their culture and specific needs • Understanding differences between migrant groups and between individuals (e.g. culture and life experiences) manifesting in differences in seeking health services and in expressing personal problems and needs The Migrant Health and Wellbeing Survey (Maamu) 65
  66. 66. Conclusions about mental health services • Prevalence of depression and anxiety symptoms vs. use of mental health care services – Unmet need for mental health care • Challenges to mental health care: – Stigmatization – Self-refection, giving conceptualizing symptoms – Culture specific characteristics taken into account both in identifying symptoms and in therapy  Training professionals – Complicated care system  Easier access to care – Limited language skills  Challenges to develop interpreting services The Migrant Health and Wellbeing Survey (Maamu) 66
  67. 67. Development of migrant health care • Migrant specific services, e.g. – Consulting team for migrants’ psychiatric care, specific hours for migrant women in sports centers and swimming halls • Universal services, e.g. – Child health care: focus to coping among migrant parents, mental health issues and promoting migrant women’s health (especially mental wellbeing among parents of Kurdish origin, prevention of obesity among women of Somali origin) – Primary health care services: education for staff members to encounters with migrant patients and more use of interpreters when needed The Migrant Health and Wellbeing Survey (Maamu) 67
  68. 68. Monitoring system • Interactive database Terveytemme (Our health) www.terveytemme.fi • TOIMIA-database www.toimia.fi – Questionnaires and methods, and a recommendation on how to measure functional capacity in migrant populations • New survey on work and wellbeing of people of foreign origin www.thl.fi/uth to be repeated in 4-5 year intervals The Migrant Health and Wellbeing Survey (Maamu) 68

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