Editorial: Refugees and migrants health: expanding the findings of the WHO Global Evidence Review on Health and Migration (GEHM) and beyond

A study by Marchetti et al. aimed to understand the health needs and perceptions of healthcare from migrants, asylum seekers, and refugees within an Italian health care context. Findings highlighted the complex health needs of these population groups spanning mental, sexual, reproductive, and nutritional health, alongside a desire for better health system knowledge and inclusion. Recommendations for policy makers include reorganization of health services to meet migrants, asylum seekers, and refugees' needs, cultural mediation, peer education, and healthcare workers training to improve accessibility, equity, and effectiveness.Three papers investigated on refugees and migrants' health in the context of the COVID-19 pandemic. The scoping review by Adel et al tried to collect the available evidence on the impact of COVID-19 on the physical and mental well-being. The results showed that vulnerabilities of these population groups were further exacerbated by COVID-19, particularly because of lack of resources, support and adequate information. Misinformation and lack of trust in healthcare workforce and healthcare systems also contributed to limited access to care or prevention programs, including vaccinations. Moreover, the transition to digital tools has presented new challenges, not just related to language difficulties or a lack of technical expertise, but also due to systemic issues, like the need for a bank ID, which frequently remains out of reach for these communities. This element was also examined by Wu at al. In their study, they explored how the pandemic impacted the access to services by asylum seekers and how community-based programs in Canada responded to the challenges arising from the public health directives put in place. Their qualitative analysis showed that, on the one hand, the transition from in-person to online services created new challenges related to technological, linguistic and material barriers, lack of trust related to protection of privacy and security; on the other hand, organizations adapted to public health regulations by building new partnerships and collaborations to ensure provision of services. Brandt et al. reported the results of a cross-sectional study in adult asylum seekers arriving in Berlin to explore the flight-associated risk factors of contracting COVID-19. The authors highlighted a higher likelihood for seropositivity in women but reduced by frequent hygiene behaviors. Accommodation in a refugee shelter and poor hygiene behaviors resulted to be associated with an elevated risk of infection. Other associated factors were lower educational level, travelling with children or by foot, and COVID-19 information seeking.Migrants face significant health challenges, including a high prevalence of noncommunicable diseases, particularly in low-and middle-income countries. The study by Rada et al. reviewed scientific literature on hypertension prevention and control among migrants in Latin America, examining the impact of migration and health policies on access to healthcare. It identified barriers like insurance coverage, language differences, and financial constraints. The findings emphasize the need for culturally sensitive healthcare interventions that consider migrants' unique vulnerabilities, lifestyles, and gender-specific needs.Three among these manuscripts proposed study protocols and methods. The study by Adel et al. proposed a study protocol for a mixed-methods study involving qualitative interviews with asylum seekers and Ukrainian refugees. The objective was to establish guidance for enhancing access to healthcare services, encompassing both the prevention and management of chronic and acute conditions, via primary and secondary healthcare provision, with the aim of diminishing worse health outcomes in these population groups. Furthermore, the results tried to offer a perspective on their integration within the community, including their job and educational opportunities.The manuscript by Martinez-Donate et al. described the protocol of the "Migrante" project, a 14-years long project which is trying to address the health needs of Mexican migrants traveling across the Mexico-United States border region. The relevance of this study is clearly related to the population-level health data for this group, which is particularly hard to obtain. The findings will also lay the groundwork for a future longterm expansion of this migrant health observatory to shed lights on the effects of migration policies on the health of migrants.Finally, the paper by Banaschak et al. proposed a multimodal information campaign intended to increase the use of medical rehabilitation by migrant children and adolescents and ultimately to reduce disparities in health care. The campaign adopts a participatory approach, training individuals from migrant communities in Berlin and Hamburg as transcultural health mediators. These mediators educate other families about chronic illnesses and medical rehabilitation in their native languages and assist them in applying for rehabilitation services.Research on the healthy migrant effect often finds migrants in better health than their native counterparts, but this does not consistently apply to cognitive functioning in aging populations. In their article, Abuladze at al. compare cognitive performance among middle-aged and older foreign-origin population in Estonia to host and origin populations. It finds that Russian migrants in Estonia show higher odds of cognitive impairment in immediate recall than Estonians, but not in verbal fluency, and these differences align with those in Russia when adjusting for age at migration. The findings challenge the healthy migrant effect, suggesting that migration impacts certain cognitive abilities differently and that age at migration plays a significant role in cognitive health outcomes.Another study by Chen et al. focus on mental health disorders, particularly their association with poor labor market outcome. This study found that common mental disorders and multimorbidity increased the likelihood of receiving disability pension and unemployment benefits, with variations between refugees and Swedish-born individuals. Particularly, refugees faced a higher risk of unemployment when multimorbidity was present. Schizophrenia and behavioral syndromes were identified as having a notably high risk for labor market marginalization. The findings suggest that interventions should consider the specific needs of young adults, accounting for their mental health status and refugee background.Another study addressing the social determinants of health, focused the attention on Chinese migrant workers. The research by Yang et al. aimed to examine the link between social support and the quality of life among Chinese migrant workers, investigating how a healthy lifestyle mediates this relationship. Findings indicated that migrant workers scored higher on social support and quality of life than urban workers. Social support was positively related to quality of life for both groups, with healthy lifestyle habits mediating this relationship among migrant workers. The study underscores the importance of enhancing social support and promoting healthy lifestyles to boost migrant workers' quality of life.Despite not covering all topics, this collection of papers demonstrates that impactful and insightful research, which contributes to policy, practice, and the global knowledge in the field of health and migration, is being conducted globally and can guide policy and programmatic efforts to enhance the health of refugees and migrants in their origin, transit, and destination communities..

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