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\"Hyoungah Park interviews fifty-eight North Korean migrants in China and analyzes their stories, exploring why they decided to escape North Korea despite the risks, how they escaped, and their experiences being victimized by human trafficking\"-- Provided by publisher.

Despite being newcomers, immigrants often exhibit better health relative to native-born populations in industrialized societies. We extend prior efforts to identify whether self-selection and/or protection explain this advantage. We examine migrant height and smoking levels just prior to immigration to test for self-selection; and we analyze smoking behavior since immigration, controlling for self-selection, to assess protection. We study individuals aged 20-49 from five major national origins: India, China, the Philippines, Mexico, and the Dominican Republic. To assess self-selection, we compare migrants, interviewed in the National Health and Interview Surveys (NHIS), with nonmigrant peers in sending nations, interviewed in the World Health Surveys. To test for protection, we contrast migrants' changes in smoking since immigration with two counterfactuals: (1) rates that immigrants would have exhibited had they adopted the behavior of U.S.-born non-Hispanic whites in the NHIS (full \"assimilation\"); and (2) rates that migrants would have had if they had adopted the rates of nonmigrants in sending countries (no-migration scenario). We find statistically significant and substantial self-selection, particularly among men from both higher-skilled (Indians and Filipinos in height, Chinese in smoking) and lower-skilled (Mexican) undocumented pools. We also find significant and substantial protection in smoking among immigrant groups with stronger relative social capital (Mexicans and Dominicans).

Background Forced displacement is a significant issue globally, and it affected 112 million people in 2022. Many of these people have found refuge in low- and middle-income countries. Migrants and refugees face complex and specialized health challenges, particularly in the area of mental health. This study aims to provide an in-depth qualitative assessment of the multi-level barriers that migrants face in accessing mental health services in Germany, Macao (Special Administrative Region of China), the Netherlands, Romania, and South Africa. The ultimate objective is to inform tailored health policy and management practices for this vulnerable population. Methods Adhering to a qualitative research paradigm, the study centers on stakeholders’ perspectives spanning microsystems, mesosystems, and macrosystems of healthcare. Utilizing a purposive sampling methodology, key informants from the aforementioned geographical locations were engaged in semi-structured interviews. Data underwent thematic content analysis guided by a deductive-inductive approach. Results The study unveiled three pivotal thematic barriers: language and communication obstacles, cultural impediments, and systemic constraints. The unavailability of professional interpreters universally exacerbated language barriers across all countries. Cultural barriers, stigmatization, and discrimination, specifically within the mental health sector, were found to limit access to healthcare further. Systemic barriers encompassed bureaucratic intricacies and a conspicuous lack of resources, including a failure to recognize the urgency of mental healthcare needs for migrants. Conclusions This research elucidates the multifaceted, systemic challenges hindering equitable mental healthcare provision for migrants. It posits that sweeping policy reforms are imperative, advocating for the implementation of strategies, such as increasing the availability of language services, enhancing healthcare providers’ capacity, and legal framework and policy change to be more inclusive. The findings substantially contribute to scholarly discourse by providing an interdisciplinary and international lens on the barriers to mental healthcare access for displaced populations.

Background The prevalence of exclusive breastfeeding for at least 4 months was previously found to be very low among Chinese immigrants in Ireland, at 5.8% (Zhou et al., Front Public Health 6:351, 2018). This study investigates the successful experiences of Chinese mothers living in Ireland who exclusively breastfeed for between four and 6 months. Methods Participants were recruited from the sample of the Ireland Chinese Mother Survey. Qualitative in-depth interviews were conducted with fourteen participants in their homes or public places. Results A content analysis revealed that various factors contributed to a successful experience of exclusive breastfeeding among the group of Chinese immigrant mothers, including strong self-determination; appropriate physical conditions; awareness of the benefits of exclusive breastfeeding; a lack of time constraints; and family, professional and policy support. The barriers that the mothers faced included the difficulty of balancing breastfeeding and employment, infant health issues, language barriers, an inability to consume the traditional Chinese postpartum diet and a lack of public breastfeeding facilities. Measures taken to overcome these barriers included seeking family support, resting during the lactation period, and pumping breast milk to feed from a bottle when outside the home. Conclusions This study highlights unique factors affecting exclusive breastfeeding among Chinese mothers in Ireland, which may be useful to health care professionals working with Chinese immigrant women internationally.

OBJECTIVE:To understand information-gathering and decision-making processes of immigrant mothers for scheduled childhood vaccines, vaccination during pregnancy, seasonal flu and pandemic vaccination. METHODS:We conducted 23 qualitative semi-structured interviews with immigrated mothers from Bhutanese refugee, South Asian and Chinese communities. Participants lived in Edmonton, Alberta and had at least one child under eight years old. Using NVivo™ qualitative software, we generated an inductive coding scheme through content analysis of interview transcripts. RESULTS:Our three main findings on information gathering and use in vaccination decisions were: 1) participants in all three communities passively received immunization information. Most mothers learned about vaccine practices exclusively from health care practitioners during scheduled visits. Social networks were primary sources of information in origin countries but were lost during immigration to Canada; 2) participants demonstrated universal trust in vaccines (i.e., no anti-vaccination sentiment). They were comfortable in receiving vaccines for themselves and their children, regardless of past adverse reactions; 3) participants' recollection of the H1N1 vaccination campaign was almost nil, demonstrating the lack of reach of public health vaccination campaigns to designated priority groups (pregnant women and children) in Alberta. CONCLUSION:Our results highlight the limitations of Alberta's current vaccination communication strategies in reaching immigrant women. When immigrant mothers receive vaccination information, our results indicate they will likely follow recommendations. However, our study shows that current communication strategies are not making this information accessible to immigrant women, which limits their ability to make informed vaccination decisions for themselves and their children.

Chinese women raising children in Japan tend to experience high parenting stress and poor mental well-being. However, their specific parenting and mental health promotion needs remain unknown. This study aimed to explore the parenting and mental health promotion needs of Chinese women living in Japan and provide recommendations to guide interventions. Semi-structured in-depth interviews were conducted. Participants included 15 women aged 28–39 years who were pregnant or rearing a child younger than six years old. Thematic analysis was performed for data analysis. More than half of the participants experienced mental health problems, such as depressive symptoms and child-rearing stress. Four themes relating to their needs were identified: concrete support, information provision, caring and understanding, and social network building. Information provision and social network building should be emphasized as practical social support mechanisms to improve these women’s mental health. Furthermore, a mental health promotion intervention should be developed to address this vulnerable population’s needs. Healthcare providers and public health workers should help improve the social support systems of Chinese women in Japan to prevent mental health problems. Potential transcultural education can, arguably, help healthcare providers better understand transcultural care.

Background This mixed methods study identified needed refinements to a telehealth-delivered cultural and linguistic adaptation of Meaning-Centered Psychotherapy for Chinese patients with advanced cancer (MCP-Ch) to enhance acceptability, comprehensibility, and implementation of the intervention in usual care settings, guided by the Ecological Validity Model (EVM) and the Practical, Robust Implementation and Sustainability Model (PRISM). Methods Fifteen purposively sampled mental health professionals who work with Chinese cancer patients completed surveys providing Likert-scale ratings on acceptability and comprehensibility of MCP-Ch content (guided by the EVM) and pre-implementation factors (guided by PRISM), followed by semi-structured interviews. Survey data were descriptively summarized and linked to qualitative interview data. Three analysts independently coded the transcripts according to EVM and PRISM domains; discrepancies were resolved through discussion and consensus. Results Quantitative findings showed high appropriateness and relevance of MCP-Ch across five EVM domains of Language, Metaphors/Stories, Goals, Content, and Concepts. Qualitative analysis yielded 23 inductive codes under the seven EVM domains: (1) Language (3 subcodes), (2) Persons (2 subcodes), (3) Metaphors/Stories (2 subcodes), (4) Methods (8 subcodes), (5) Content (2 subcodes), (6) Goals (4 subcodes), and (7) Concepts (2 subcodes). Themes based on PRISM included (1) Intervention characteristics (organizational perspective, 7 subcodes; and patient perspective, 6 subcodes) (2) External environment (2 subcodes), (3) Implementation and sustainability infrastructure (4 subcodes), and (4) Recipients (organizational characteristics, 5 subcodes; and patient characteristics, 4 subcodes). Conclusion Recommendations for next steps include increasing the MCP-Ch protocol’s flexibility and adaptability to allow interventionists to flexibly tailor MCP-Ch material to meet patients’ individual needs, simplifying content to improve comprehension and acceptability, providing additional training to Chinese-serving providers to increase adoption and sustainability, and considering interpreter-assisted delivery to increase access. Findings yielded important information to maximize cultural relevance as well as the implementation and sustainability potential of MCP-Ch in real-world settings.

Type 2 Diabetes (T2D) among older Asian American immigrants (AA) is a growing concern. Asian Americans represent 9% of diagnosed diabetes. Very little is known on how older Asian American immigrants with T2D navigate diabetes management, in particular the role of family support. This qualitative study examines Chinese and Filipino Americans, the two largest Asian subgroups in the US (4.2 million, and 3.6 million, respectively), and family support dynamics among adult children and their parents diagnosed with T2D. Ten dyads (n = 20) made up of adult children and aging parents participated in in-depth and dyadic interviews. Results indicate that family support occurs in a trajectory of stages. The following thematic patterns emerged in these dyads around support: independence, transitions, partnership, and stepping in. The findings point to various supportive stages that Asian American adult children and aging parents with T2D experience and the importance of developing supportive interventions for both adult children and aging parents at these various stages.

Why is China's household registration system so resilient, and why are migrant workers consistently excluded from equal urban welfare? By disaggregating the hukou and land components of the rural–urban dualist regime, this article argues that dualist land ownership, formalized in China's 1982 Constitution, perpetuates the hukou system and unequal welfare rights. On the one hand, dualist land ownership results in an abundance of low-cost, informal housing in urban villages. This reduces the cost of short-term labour reproduction and diminishes migrants’ demands for state-defined urban rights. On the other hand, dualist land ownership enables local governments to amass significant revenues from land sales. The prominence of land-based revenues prompts local governments to link urban welfare rights with formal property ownership and residency, obstructing substantive reforms to the hukou system. For comparison, this article highlights Vietnam, a communist country with a unitary land ownership system, which has made greater strides in reforming its household registration system.

Background Ecological migration serves as an important measure for poverty eradication as well as for the protection, inheritance, and utilization of traditional ecological knowledge. This study investigated and cataloged the traditional forage plant resources and recorded the associated traditional knowledge of immigrant villages in Hongsibu District of Ningxia, China. The diversity of traditional forage plant resources and the changes in associated traditional ecological knowledge were compared among ecological immigrant villages from different emigration areas, with a hope of providing a reference for forage development, the conservation of wild forage plant resources, and the development of regional animal husbandry. Methods From March 2018 to May 2019, a field investigation was conducted in six villages in Ningxia. Through the snowball technique, a total of 315 immigrants were interviewed using various methods, including semistructured interviews and key person interviews, which included opportunities for free listing. The changes in the utilization of traditional forage plants were compared between the ecological migrants and the original inhabitants, and the causes underlying the changes were analyzed. In addition, the major forage plant species in the research area were investigated and evaluated. Results (1) The six investigated villages reported 224 traditional forage plant species that belong to 42 families and 150 genera. Compared with their original living areas, the number of traditional forage plant species used in the immigrant villages decreased with the increase in the relocation distance. (2) The utilization of traditional forage plants varied among the immigrants who moved to Hongsibu District from forest areas, loess hilly areas, and semiarid desertified areas. The smaller the difference was in ecological environment between the immigration and emigration areas, the more the traditional forage plant knowledge had been retained. (3) The diversity and associated knowledge of traditional forage plants retained by ecological migrants are closely correlated to gender, age, education level, and occupation. Conclusion This study revealed that the diversity of traditional forage plants and associated knowledge retained after migration vary among ecological immigrants from different areas; generally, the immigrants that relocated from a closer place retained more ecological knowledge. In the immigrant villages with significantly different natural resources and a long distance from the migrants’ original locations, the diversity of traditional forage plants decreased, and the traditional knowledge about forage plants showed signs of being forgotten and abandoned by the younger generation. Therefore, measures are urgently needed to document and protect the forage plant resources and preserve the traditional knowledge of ecological immigrants.