Completed projects

 

 

 

The purpose of the project was to provide knowledge about health and health-seeking behavior among pregnant undocumented migrants and their children in Denmark. There is, at present, very little research on this topic and how the group is affected by having limited access to health care, as well as by their living conditions in general.

The study was based on data from the Red Cross Health Clinic for Undocumented Migrants, interviews with pregnant women and mothers as well as journal data from Danish maternity wards.

A deeper knowledge of the health of the pregnant women and children, their health-seeking behavior and motives must be used to optimize the health of this extremely vulnerable group, who at present do not seem to participate adequately in the health-promoting services available.

Results

One fourth of the study population, which consisted of 679 pregnant women from 78 different countries, visited the health clinic to terminate the pregnancy. The pregnant undocumented migrants had few medical conditions and attended the clinic primarily for antenatal care. Almost half of the study population had a late first visit to antenatal care, and the majority did not have the recommended number of antenatal care visits. These results call for consideration as to whether health care for pregnant undocumented migrants should be formally available and free of charge.

Articles

“No papers. No doctor”: undocumented immigrant women’s access to maternity care services in Denmark

 “No Papers. No Doctor”: A Qualitative Study of Access to Maternity Care Services for Undocumented Immigrant Women in Denmark

Demographic characteristics, medical needs and utilisation of antenatal care among pregnant undocumented migrants living in Denmark between 2011 and 2017

Who was participating in the project?

The project was carried out by midwife Julia Kadin Funge and research assistant Mathilde Boye and project manager Marie Nørredam. The project took place in collaboration with the Danish Red Cross, Research Centers for Migration, Ethnicity and Health (MESU), and the Copenhagen University College.

 
Who has funded the project?

The project was funded by Oak Foundation Denmark and the Rockwool Foundation.

Expected start and end date:

The project started January 2018 and ended March 2020.

Contact person

Mathilde C. Boye, mcb@sund.ku.dk

 

 

In a collaboration between MESU and Section of Immigration Medicine at Hvidovre Hospital vulnerability among children and adolescents of refugees suffering from PTSD was investigated. According to existing literature, mainly focusing on veterans, parent’s symptoms of PTSD can have adverse effect on offspring behavior and physical and mental health. However, the negative consequences of parental PTSD among refugees are not well understood. Therefore, this project aimed to investigate parental PTSD and offspring mental health. This knowledge contributes to documenting a possible vulnerability among children of mentally ill refugees.

Based on register data this project aimed to investigate possible mental and social vulnerability among children of refugees suffering from PTSD in a cohort of refugees in Denmark. The study included children and adolescents of refugees with PTSD who had obtained residence permit in Denmark on the basis of asylum or family-reunification between 1993 and 2015. 

What was the main results?

Increased risk of offspring psychiatric contact was found both among descendants born in Denmark and among children who were also refugees themselves, independently of sociodemographic characteristics. When investigating children of refugees, we need to consider that the refugee children born before arrival in Denmark might have been exposed to the same conflict-related and migration-related traumas as their parent who has PTSD. The present study found an increased risk of psychiatric contact for refugee children and descendants of refugees with PTSD, although the association seemed to be stronger for refugee children.

Public health interventions should, therefore, focus on the mental health of children of traumatised refugees, not only in the recipient country but also in places processing refugees, by use of appropriate assessment tools to identify children in need and by ensuring the consequent availability of relevant mental health services.

Article can be found here.

Who participated in the project?

The project was executed by Public Health student Maj Back Nielsen, associate professor at MESU Marie Nørredam, consultant and head of research at Competence Center for Transcultural Psychiatry Jessica Carlsson Lohman and associate professor at Section of Biostatistics, Department of Public Health, Jørgen Holm Petersen.  

Who funded the project?

Section for Immigrant Medicine, Department of Infectious Diseases, Copenhagen University Hospital Hvidovre.

When did the project take place (start and end date)

The project ended in 2019.

Contact person

Marie Nørredam, mano@sund.ku.dk

 

 

The study aimed to better understand the public health social impact of COVID-19 pandemic and the measures taken to prevent it on refugees and migrants around the world, with a particular attention for asylum applicants, undocumented migrants and recently arrived newcomers.

It was done through a survey containing 32 items to allow for a speedy completion by participants. Simple and accessible language translated in 37 languages allowed for participants from different backgrounds to fill out the questionnaires using their phones or other handheld devices or laptops. The questions related to Socio demographics, COVID-19 and the measures, Daily stressors, Psychological well-being, Social well-being and stigmatization and coping. Qualitative interviews were also conducted. Recruitment of participants was done through organisations and institutions working with migrants and refugees, and an online campaign using different social media channels.

For more information: www.aparttogetherstudy.org

Results

The survey resulted in a report that can be found here

Most refugees and migrants took precautions to avoid COVID-19 infections. 50 % of respondents across the world indicated that COVID-19 increased feelings of depression, anxiety and loneliness as well as worries. 1 out of 5 had also increased their drug- and alcohol use. Migrants and refugees living on the street, in insecure accommodation or in asylum centres were in higher risk of experiencing mental health problems in the aftermath of the COVID-19 pandemic. Migrants and refugees reported that a significant impact of COVID-19 was on their access to work, safety and financial means.

Who participated in the project?

ApartTogether is a collaboration between World Health Organization, across its regional offices, the UN System, and a collaboration of research centres led by Ghent University and the University of Copenhagen (Denmark).

Who has funded the project?

European Union’s Horizon 2020 Research and Innovation Programme

Expected start and end date:

The project started 1st April 2020 and was completed 1st April 2021.

Contact person

Nina Langer Primdahl, nina.primdahl@sund.ku.dk

 

 

The MEM-TP project concerns the development of educational packages for health professionals in order to improve the access to and the quality of health services for migrants and ethnic minorities including Roma people.

The project consisted of six work packages and had nine partners. MESU was responsible for WP1 whose main objective was to conduct a review of the situation of immigrants and ethnic minorities in Europe, focusing on particularly relevant questions for the education of health professionals within this area. The aim of the review was to identify common challenges as well as best practice, which formed the basis of and was incorporated into the educational packages of the project. Aspects related to adequate access to and the quality of health services, as well as potential problems related to access to health services for ethnic minorities, migrants and undocumented immigrants was also included.      

The review from WP1 will, alongside WP2 whose objective it was to review already existing educational material within the area, formed the basis of the development of educational material and a course for health professionals. In the spring of 2015 MESU tested the course which was held over a period of three days and had 30 participants. The project was conducted in the period of January 1st 2014 to December 31st 2015. Are you interested in learning more about the project, please click here. 

 

 

The project explored some of the long-term consequences of resettled refugees’ length of waiting for an asylum decision on their mental health and labour market association. Furthermore, the project studied the association between refugee fathers’ length of waiting for family reunification and their risk of being diagnosed with a psychiatric disorder.

Results

Long asylum-decision waiting periods (more than 1 year) were associated with increased risk of psychiatric disorders. Fathers waiting for their wives and children have an increased risk of mental disorders. The risk increased with longer family separation. Countries receiving refugees should be aware that long waiting times for an asylum-decision as well as family reunification can lead to adverse mental health effects.

Articles

Waiting for family reunification and the risk of mental disorders among refugee fathers: a 24-year longitudinal cohort study from Denmark

Prolonged periods of waiting for an asylum decision and the risk of psychiatric diagnoses: a 22-year longitudinal cohort study from Denmark

Who participated in the project?

The project constituted the core of Camilla Hvidtfeldt’s PhD. Her supervisors were Professor Marie Nørredam (Section of Health Services Research, UCPH), Associate Professor, Jørgen Holm Petersen (Section of Biostatistics, UCPH), and Research Leader Eskil Heinesen, the ROCKWOOL Foundation Research Unit.

Who funded the project?

The project was funded by the ROCKWOOL Foundation Research Unit.

Expected start and end date:

The project started in August 2017 and ended in December 2020.

Contact person

Camilla Hvidtfeldt, ch@rff.dk

 

 

In 2016 MESU participated in a European collaboration project called SH-CAPAC (Supporting health coordination, assessments, planning, access to health care and capacity building in EU member states under particular migratory pressure). The aim of the project was to support capacity building in healthcare for asylum seekers and refugees within the European countries. The project aimed at developing frameworks for a coordinated effort targeting the different phases of refugees’ trajectory: first arrival, transit, and settlement. Furthermore, it was a central aim of the project to support the healthcare for particular vulnerable groups, hereunder unaccompanied minor, pregnant women, elders and refugees with disabilities.

The project specifically worked with capacity building within coordination of health efforts, compilation of needs assessments, insurance of access to healthcare, and development of specific competencies of the healthcare professionals in the health reception of the asylum seekers and refugees.

What was the main results?

The main results were:

  • Implemented a coordinated approach to organise the multi‐stakeholder health sector response to the refugee influx in their territory.
  • Conducted comprehensive public health and health systems assessments of the impact of the migratory pressures and the response needed by the national health systems.
  • Develop action plans for addressing the health needs of refugees, asylum seekers and other migrants.
  • Taken the necessary measures to improve access to health care and public health interventions for the refugees, asylum seekers and other migrants in their territories and health systems.
  • Developed institutional capacity and workforce competence to provide migrant sensitive health services.

For more information, please look at the SH-CAPAC website

Who participated in the project?

The project was conducted in a collaboration between six European universities. Furthermore, the project consortium engaged in close collaboration with national (health) authorities, national and international organizations (such as WHO; IOM, Red Cross, UNHCR, UNICEF). 

Allan Krasnik was the leader of SH-CAPAC for MESU, and a number of MESU researchers and employees were involved.

Who had funded the project?

The project was supported by the European Commission, under the EU Health Program.

When did the project take place (start and end date)

The project started at January 1st, 2016 and ended on December 31st, 2016.

Contact person

Allan Krasnik, alk@sund.ku.dk

 

 

The MAMAACT intervention is a complex intervention aimed at reducing ethnic and social inequality in reproductive health. The project focused on improving the communication between pregnant women and midwives about the body's signs of pregnancy complications, in order to ensure an optimal response to complications on the part of both the woman and the system. The effort consisted of a continuing education course for midwives in intercultural communication as well as a pictogram-based information folder and app in six languages. Folder and app explain the most serious danger signals during pregnancy and how women should respond to these. It was our expectation that these measures together promote both the communication between the women and the midwives as well as the women's ability to navigate the health care system and express help. This should lead to timely handling of complications. In addition, it will lead to better health among newborns at birth and in the long run fewer stillbirths and reduced infant mortality.

The project was implemented and evaluated in a lottery experiment, where 10 maternity wards received the intervention and 9 maternity wards were included as a control group. The project was implemented at departmental level, where the effort was provided for all pregnant women regardless of ethnic origin, as the project can have beneficial effects among all. The project's primary success criterion was that non-western immigrant women's health competence to actively collaborate with health professionals would rise to the level among ethnic Danish women at the start of the project. Another important focus in our evaluation was how the midwives and non-Western pregnant women function when working with MAMAACT and what barriers there were; both the organizational framework in the maternity wards, but also in the everyday lives of women.

What were the results?

19 out of 20 maternity wards in the country participated in MAMAACT, 350 midwives participated in the continuing education course and the project is estimated to reach 25,000 pregnant women.

The qualitative implementation analysis showed that midwives generally were positive towards MAMAACT’s courses in cultural competence and intercultural communication as well as the subsequent dialogue meetings. The midwives had become more aware of how the women had very different levels of health competence and insecurity in regards to navigating in the healthcare system. Overall, they experienced that in daily practice, they had become more reflexive in the meeting with ethnic minority women.

The pregnant women generally found MAMAACT’s folder and app relevant. They used the material to increase their knowledge about complications and distinction between normal and unusual symptom during pregnancy. They also used the material to contact the emergency room. In consultations with the midwives, the women spoke primarily about their symptoms if they were asked by the midwife. The women found it positive that the material was available on many of their mother tongues. Some of the women used the app as a reference work and switched the language setting between Danish and their mother tongue, enabling them to explain their symptoms in Danish.

More information about the project can be found here: https://mamaact.ku.dk/english/

Who was participating in the project?

The project was a partnership between the Research Center for Migration, Ethnicity and Health (MESU) and the Department of Public Health at the University of Copenhagen, the country's maternity wards, Immigrant Medicine clinics at Hvidovre Hospital and Odense University Hospital, the Committee for Health Information, the Midwifery Education at Copenhagen University College.

These partnerships helped to ensure that the project's activities were of the highest level and had relevance to the country's maternity wards. In addition, the partnerships are important in relation to the future education of midwives in intercultural communication and also in connection with the project's app and leaflets being eventually integrated into others' existing materials.

MAMAACTS information materials were developed in collaboration with United.

Who has funded the project?

Trygfonden, Danske Regioner, Østifterne, Jordemoderforeningen, Københavns Professionshøjskole and Institut for Folkesundhedsvidenskab

Expected start and end date:

The project started in May 2017 and is expected to be completed in June 2022.

Contact person

Sarah Fredsted Villadsen, sfv@sund.ku.dk

 

 

The aim of the project is to investigate the mental health impact of being a left-behind child to parental labour migration (internally and internationally) in Sub-Saharan Africa. The project is a first stage proposal to a larger funding application in the summer of 2021.

In this first stage, we investigate the relevance and feasibility of the project. In Ghana and Kenya interviews are conducted with children left behind to parental labour migration, as well as professionals with experience with the target group. In the Netherlands and Denmark interviews are conducted with parental labour migrants with children living in the home country as well as with community leaders from i.e. churches and civil society organisations.

Who participated in the project?

Marie Nørredam (project manager), Morten Skovdal and Mathilde C. Boye. The project and application is made in collaboration with Academic Medical Centre at University of Amsterdam, African Population and Health Centre in Kenya, Regional Institute for Population Studies at University of Ghana and Section for Global Health at Department of Public Health, University of Copenhagen.

Who has funded the project?

The first stage proposal is funded by the Novo Nordisk Foundation.

Expected start and end date:

The project started February 2021 and the first stage will be completed in the summer of 2021.

Contact person

Marie Louise Nørredam, mano@sund.ku.dk

 

 

The Center for Healthy Aging (CESA) is conducting an intervention project targeting older adults residents in two social diverse housing areas - the so-called vulnerable residential areas - in the municipality of Høje-Taastrup. Based on a recent change in legislation, the preventive home visits are targeted and the offer is rooted in a broad collaboration with actors in the two residential areas. The focus is primarily on the growing group of older adults with ethnic minority backgrounds, but older adults with ethnic Danish background are also included. This integrates the preventive home visits into a forward-looking social housing initiative.

The project aims to shed light on the perspectives older adults in these residential areas have on health, aging and municipal health promotion efforts. Furthermore the aim is to document and evaluate new methods for delivering health promotion through close collaboration between research and practice. Both qualitative and quantitative data are collected.

The project is carried out by research student Abirami Srivarathan under the supervision of lecturer and research group leader Maria Kristiansen. The project is funded by Helsefonden and runs from September 2016 to July 2017.

 

 

In collaboration with KABS VIDEN, initiated by KABS in the municipality of Glostrup, MESU is conducting a study of substance abuse among ethnic minorities, focusing on refugees and asylum seekers. The background for the project is that limited knowledge exists, about the spread of abuse, possible abuse patterns and problems specific for specific groups of migrants. This knowledge is relevant for a successful outreach to these groups and planning of special efforts in relation to treatment.

Through three sub studies the project will explore the extent of abuse, types of substances, experience and possibilities related to rehabilitation. First we will conduct a literature review on existing knowledge in the field, and later the conditions in asylum centers and rehabilitation centers run by the municipalities will be explored, by including both qualitative and quantitative data.

What were the main results?

In Copenhagen 60 % of users in the visible drug community are migrants. Data from asylum centers showed that 5.6 % of those older than 18 and 3.8 % of those younger than 18 had a substance abuse. Migrants did not differ from ethnic Danes in regards to which drugs they used and the most common substances were alcohol, hash, cocaine and morfika. The legal framework for treatment are unclear as well as the division of responsibility between the involved authorities.

The respondents and actors called for more cross-disciplinary cooperation between substance abuse centers, asylum centers, rehabilitation clinics and drop-in centers. It was recommended to gather treatment in the substance abuse centers instead of having psychologists and psychiatrists in the asylum system and medical treatment in the substance abuse centers.

Who participated in the project?

The project will be executed by research assistant Liv Stubbe Østergaard, under supervision of associate professor Marie Louise Nørredam A support group consisting of Thomas Fuglsang, Centre leader and Doctor at KABS, Marie Nørredam, Associate Professor at MESU and Chief Physician Ebbe Munk Andersen from Danish Red Cross will be responsible for quality assurance, development and approval of the strategic direction and activities within the project.

Who had funded the project?

KABS.

When did the project take place (start and end date)

The project started in January 2017 and was completed in May 2017.

Contact person

Marie Nørredam, mano@sund.ku.dk

 

 

The overall purpose of the study was to create evidence regarding the incidence of torture, trauma and PTSD among immigrant patients in general practice born in non-western countries as well as uncover how often GPs inquire into these issues. The project showed that there was a relatively high incidence of torture, trauma and PTSD among the study population and that part of the study population is not detected in general practice.

Who was participating in the project?

The project took place in collaboration between MESU and Amnesty International's Medical Group and DIGNITY. Project manager from MESU was Marie Nørredam and the study was carried out by project coordinator and research employee Liv Stubbe Østergaard and Janne Sørensen was part of the project's steering group.

Results

Our results suggest that torture and trauma are widespread among immigrants presenting to GPs. In our study, the GPs had managed to detect half of the torture survivors. A more systematic approach to detection in General Practice is advisable, and more knowledge on how and when to ask is needed.

Article: Prevalence of torture and trauma history among immigrants in primary care in Denmark: do general practitioners ask?

Who has funded the project?

The project was funded by the Amnesty International Medical Group.

Expected start and end date:

The project started in June 2017 and was completed in March 2019.

Contact person

Marie Louise Nørredam, mano@sund.ku.dk

Janne Sørensen, jans@sund.ku.dk

 

 

Europe is becoming more socially and culturally diverse as a result of the increasing migration, but the physicians are largely unprepared. Culturally competent curricula and teachers are needed to ensure cultural competence (CC) among health professionals and to tackle inequalities in health between different ethnic groups. The purpose of the C2ME project was to develop guidelines and tools to assist medical schools and educators with the implementation of CC in the education of medical teachers and the pedagogical leaders as well as to incorporate CC in the curriculum.

The project conducted a Delphi study to devise a framework of competencies for diversity teaching and a survey that explored the concrete needs of medical teachers to teach ethnic and cultural diversity. Subsequently, an online course was developed to meet these needs. A questionnaire to assess possible gaps and flaws in the curriculum of Medical programmes in regards to CC was also developed, and distributed to 12 medical programmes. Based on data from the questionnaire practical guidelines for heads of departments were developed and published.

What were the main results?

The study revealed that in general there is room for improvement regarding CC in the European medical programmes. For example, most medical programmes do not offer CC training for teachers within the programme and resources spent on initiatives related to CC are few. Furthermore, most of the medical programmes acknowledge that the training the students receive in relation to CC is not adequate for future jobs in the health care service in their respective country. Additionally, the survey among the teachers found that 60% assess that they are prepared for teaching CC and approximately 70% are interested in receiving training in different CC elements. Moreover, approximately 75% of the teachers in the survey think it is important to include CC in curriculum. You can find two of the articles here.

Who participated in the project?

There were 13 partners from 12 countries (12 EU + 1 US) involved in the project and the Academic Medical Centre, University of Amsterdam was the coordinating partner. From MESU, Janne Sørensen, Allan Krasnik and Marie Nørredam participated.     

Who had funded the project?

The project were fund by the EACEA Erasmus Lifelong Learning Program.

When did the project take place (start and end date)

The project was conducted in the period of October 1st 2013 to September 30th 2015.

Contact person

Janne Sørensen, jans@sund.ku.dk

 

 

What was the purpose?

The project set out to investigate the following three questions:

What is the effect of ethnic background and migrant status on incidence of bacteremia, including variations in causal infectious agents?

What is the effect of ethnic background and migrant status on the incidence of multi-drug resistant organisms among patients with bacteremia?

What is the effect of ethnic origin and migrant status on all-cause mortality after bacteremia?

We wished to obtain a better understanding of disparities in bacteremia related to ethnicity and migrant status. We expected to identify high risk groups and thereby help direct future prevention and treatment of migrants and finally help reduce inequalities in the incidence of and mortality from bacteremia among migrants compared to Danish-born.

What was the main results?

Vulnerability towards BSI differs according to migrant status. Refugees had a higher risk of BSI overall. Both refugees and family-reunified migrants had a higher incidence of Gram-negative BSI than non-migrants. Similarly, migrants from Southeast Asia and the Pacific had a higher risk of BSI than non-migrants.

Article can be found here

Who participated in the project?

The study was carried out by MD Rikke Thoft Nielsen under supervision of Marie Nørredam, Danish Research Center for Migration, Ethnicity and Health, University of Copenhagen; Christian Østergaard Andersen, Department of Clinical Microbiology, Hvidovre Hospital; Henrik Schønheyder, Department of Clinical Microbiology, Aalborg University Hospital.

Who funded the project?

Hvidovre Hospital and University of Copenhagen.

When did the project take place (start and end date)

The project began March 2017 and ended June 2022

Contact person

Marie Nørredam, mano@sund.ku.dk

 

 

According to prior research, participation in heart rehabilitation reduces mortality, decreases the risk of re-admissions, and improves quality of life among patients with ischemic heart disease.

However, studies among the general population have shown that participation in heart rehabilitation is inexpediently low, and especially among women, elderly, and people who are unemployed or living alone. We have little knowledge about participation among migrants in Denmark, but in general, we know that there can be numerous barriers for some migrants’ use of the healthcare system. Barriers, which can be associated with language and knowledge about the Danish healthcare system, but also general socio-economic barriers such as education, economy and social support.

The aim of the project was to gain knowledge of, how and why ischemic heart disease patients with migrant background partakes in cardiac rehabilitation. This knowledge was achieved partly through register studies, which researched the participation patterns of migrants compared to Danish born, and associations between heart rehabilitation and health related and socio-economic factors. The patient perspective of heart rehabilitation was examined in a qualitative interview study.

What were the main results?

The results from the project are presented in two articles:

Frederiksen HW, Zwisler AD, Johnsen SP, Öztürk B, Lindhardt T, Norredam M. Differences in initiation and discontinuation of preventive medications and use of non-pharmacological interventions after acute coronary syndrome among migrants and Danish-born. Eur Heart J. 2018;39(25):2356-2364. doi:10.1093/eurheartj/ehy227

Frederiksen HW, Zwisler AD, Johnsen SP, Öztürk B, Lindhardt T, Norredam M. Education of Migrant and Nonmigrant Patients Is Associated With Initiation and Discontinuation of Preventive Medications for Acute Coronary Syndrome. J Am Heart Assoc. 2019;8(11):e009528. doi:10.1161/JAHA.118.009528

Who participated in the project?

The project were carried out by nurse and PhD student Hanne Winther Frederiksen and was a collaboration between MESU, University of Copenhagen, Herlev and Gentofte Hospital, University College UCC, The Danish Knowledge Center for Rehabilitation and Palliation (REHPA) at University of Southern Denmark, and Department for Clinical Epidemiology at Aarhus University.

The supervisor group consisted of main supervisor Marie Nørredam (MESU, UCPH), senior researcher Tove Lindhardt (Herlev and Gentofte Hospital) and Professor Ann-Dorte Zwisler (REHPA, SDU).

Who had funded the project?

The project were financed by The Capital Region of Denmark, University College UCC and The Danish Heart Foundation.

When did the project take place (start and end date)

The project were completed in March 2018.

Contact person

Marie Nørredam, mano@sund.ku.dk.

 

 

The aim of this project is to ensure meeting health-related challenges in a more diverse Europe, which will improve the ability of healthcare professionals to provide diversity-sensitive healthcare services to all patients and help to address health inequalities between different ethnic groups. In order to achieve this, a number of concrete parallel efforts will be initiated focusing on both pre-graduate and post-graduate education of physicians. Two of the efforts will focus on optimizing the competencies of 1) pre-trained doctors will be offered an educational programme consisting of a course and follow-up sessions, and 2) the teachers of the medical school will be offered a course of face-to-face lectures as well as supplemental online modules. Additionally, a number of interviews are conducted with focus groups, which will provide input on how diversity competencies can be implemented in the pre-graduate medical programs. The post-graduate course activities will be evaluated by questionnaires which participants will complete before and after the courses. Subsequently, a number of participants will be interviewed for a follow-up.

Results

The results are and will be published in four articles. Find the first article here, where the Delphi panel arranged core competencies for health professionals when delivering diversity-sensitive health care. The competences can also be used to qualify courses for health professionals. Some of the highest prioritised competencies are empathy, respect, knowledge about determinants for health, attention, listening and observation as well as being able to work professionally with interpreters.

Who was participating in the project?

The project is being implemented in collaboration with Ghent University, University Hospital Heidelberg and The Department of Immigrant Medicine, Hvidovre Hospital and the University of Copenhagen. Janne Sørensen (project manager) is responsible for the implementation of the project together with Marie Nørredam and Allan Krasnik.

Who has funded the project?

The project is funded by EIT Health

Expected start and end date:

The project started January 2020 and was completed December, 2020

Contact person

Janne Sørensen, jans@sund.ku.dk

 

 

Previous research shows that migrants in Denmark more often are diagnosed with HIV at a late stage of the disease than persons born in Denmark. Early detection of HIV is important to ensure early initiation of antiretroviral medicine and thereby prevent severe weakening of the immune system with risk of complications. That indicates a need for improving accessibility of early detection and HIV testing for everyone.

The aim of this project was to investigate how to improve early detection of HIV-cases and promote a successful start of treatment for migrants living with HIV in Denmark. We have done this though individual, in-depth interviews with migrants that are diagnosed with HIV after arriving to Denmark. We focused broadly on migrants from Eastern Europe, Latin America, Africa and Asia.

Who were participating in the project?

Mathilde C. Boye implements the project together with Marie Nørredam, who is project manager. The project was carried out in collaboration with departments of infectious diseases at Hvidovre Hospital, and Aarhus University Hospital.

Results

The study found that risk perception and stigma were important factors with regards to seeking test. From the study emerged three pathways to diagnosis:

  1. feeling ill and seeking healthcare
  2. fertility- or pregnancy-related screening
  3. routine HIV-testing.

The study showed that an increased need for provider-initiated testing, conducted in a non-stigmatizing way, to promote early diagnosis of HIV among migrants in Denmark.

Who has funded the project?

The project was funded by the AIDS Foundation.

Start and end date

The project started February 2021 and was completed by the end of 2021.

Contact person

Mathilde C. Boye, mcb@sund.ku.dk

 

 

Amendments to the Danish Health Act were introduced in 2018, that stated immigrant patients who have resided in Denmark for more than 3 years have to pay user fees for interpretation in health care.

The aim of the project was to investigate experiences and consequences the amendments to the Danish Health Act for both patients, doctors and the health care system.

The project explored how the law is implemented and carried out in practice in various sectors of the health care system and explores how the use of interpreters are affected by the introduction of the user fee.

The project is a mixed-method study using both qualitative and quantitative data, including interviews with patients, doctors and administrative staff in the regions.

Who participated in the project?

The project is carried out in collaboration with The Danish Research Centre for Migration, Ethnicity and Health (MESU), Research Unit for General Practice, and Department of Language Psychology at University of Copenhagen.

Results

Results showed a considerable decrease in interpretation services following the introduction of the fee. It is likely to assume that the reduced utilization of interpretation services is highly related to the fee. Further research is needed about the consequences of underutilization of interpretation services.
Read the project’s articles here:

https://static-curis.ku.dk/portal/files/305917351/General.pdf

https://static-curis.ku.dk/portal/files/319139070/ckaa254.pdf

Who has funded the project?

The project is funded by Læge Sofus Carl Emil Friis og Hustru Olga Doris Friis' Legat

Start and end date:

The project started in 2019 and wascompleted in 2021

Contact person

Camilla Michaëlis, cch@sund.ku.dk

 

 

The project was about optimizing stroke care for all individuals in Denmark by increasing awareness, reducing time to diagnosis, and improving access to acute revascularization treatment among ethnic minorities. We will provide new knowledge about the incidence of stroke and outcomes hereof as well as access to acute care and rehabilitation amongst patients with ethnic minority background and Danish-born patients and use this information to develop and evaluate a community-based awareness intervention for ethnic minorities. The project took a longitudinal disease perspective on acute stroke using Danish registers. Reflecting the literature, we hypothesized a low stroke awareness among immigrants or ethnic minorities and a higher incidence of stroke and worse mortality outcomes as well as more impaired access to revascularization treatment and subacute care and rehabilitation compared to Danish-born. Our research aims were 1) To investigate disparities in incidence of stroke, transient ischemic attack, and short- and long-term mortality from acute stroke among immigrants or ethnic minorities compared to Danish-born. 2) To determine the proportion of revascularized patients with acute ischemic stroke and differences in time delay - including patient and system delay - among immigrants or ethnic minorities compared to Danish-born patients. 3) To investigate differences in access to subacute care and rehabilitation including preventive medications among immigrants or ethnic minorities compared to Danish-born patients.

Who participated in the project?

The project has been implemented in collaboration with Danish Center for Health Services Research at Aalborg University, and Danish Research Center for Migration, Ethnicity and Health at the University of Copenhagen. Marie L. Nørredam (University of Copenhagen) and Søren P. Johnsen (Aalborg University) are responsible for the implementation of the project together with George F. Mkoma, a PhD student at University Copenhagen. Other collaborators are Helle K. Iversen (Stroke Centre, Rigshospitalet, University of Copenhagen) and Grethe Andersen (Aarhus University).

Results

Read the project’s articles here:

Immigration status and utilization of secondary preventive treatment after ischemic stroke

Incidence of stroke, transient ischaemic attack and determinants of poststroke mortality among immigrants in Denmark, 2004-2018 - A population-based cohort study

Processes of care and associated factors in patients with stroke by immigration status

Who has funded the project?

The project was funded by TrygFonden

Start and end date

The project started December 31, 2019 and was completed on December 30, 2022

Contact person

George Frederick Mkoma, george.mkoma@sund.ku.dk

 

 

RefugeesWellSchool aims to further the evidence-base on the role of preventive school-based interventions in promoting refugee and migrant adolescents’ mental well-being, and on how they can be implemented in diverse educational contexts. We specifically looked at interventions furthering social support and social cohesion, since these factors are known to be highly beneficial for newcomers’ wellbeing. Five interventions –school-mediation intervention, classroom drama therapy, social support groups in refugee classes, support networks on school level, and teachers’ training– will be implemented in six European countries. We have assessed the interventions’ long-term impact on newcomers’ well-being (n=3,000), particularly their impact on mental health problems, resilience, academic achievements, school drop-out and social support. A mixed-methods longitudinal approach have combined questionnaires completed by adolescents, parents and teachers, focus groups with these groups, data on adolescents’ academic achievements, and an economic assessment of the costs related to the implementation. Additionally, focus groups and national committees with other stakeholders will evaluate the impact of contextual factors (e.g., educational system) in order to design models to implement the effective interventions in other contexts. As such, this study will lead to a solid evidence-base on the impact of preventive school-based interventions on young newcomers’ mental wellbeing and the possibilities to implementing these interventions in differing contexts.

Results

Read the project’s articles via this link: https://refugeeswellschool.org/news-and-publications/?categories=6

Who has participated in the project?

The project was led by the University of Gent, Belgium in collaboration with Catholic University of Leuven, Belgium; University of Sussex, United Kingdom; University of Copenhagen, Denmark, Norwegian Centre for Violence and Traumatic Stress Studies, Norway; Uppsala University, Sweden; and Tampere University, Finland.

From the University of Copenhagen, the following persons were involved: Morten Skovdal (Danish PI), Nina Langer Primdahl (coordinator), Anne Sofie Børsch (PhD student), Signe Smith Jervelund (Danish deputy PI), Nicoline Siemsen (student assistant).

Who has funded the project?

The project is funded by Horizon 2020, EU.

Start and end date:

The project started March 1, 2018 and was completed on April 31, 2022.

Contact person

Morten Skovdal, morten.skovdal@sund.ku.dk

Signe Smith Jervelund, ssj@sund.ku.dk

Nina Langer Primdahl, nina.primdahl@sund.ku.dk

 

 

Background and amis

During the past decades, refugee immigration has changed the societal weave of the Nordic welfare states. The life prospects of these new Nordic citizens is a broad societal concern. The CAGE project aimed at investigating inequalities in education, labour market participation, and health during the formative years in young refugees, and how they relate to national policies and other contextual factors. The project was divided into three studies with focus on education, labour market participation and health.

  1. Comparative analysis of welfare politics in the Nordic countries
  2. Comparative register studies of national cohorts with young refugees
  3. Qualitative studies of education and labour market participation

The project started July 2015 and ended December 2020

The results of the CAGE register studies demonstrated inequalities among young refugees relative to native-born majority populations with regard to education, labour market participation, and health in all four Nordic countries.

Education

With regard to education policies, Finland, Norway, and Sweden have provided equal rights to education for all children, while asylum-seekers in Denmark have been excluded from entitlements to upper secondary education.

In terms of educational outcomes, refugee children in all four countries overall had lower educational achievements than the native-born majority population, but with great heterogeneity within the refugee population. In the cross-country comparison, refugee children in Denmark and Finland had the lowest educational achievements, while those in Sweden tended to have the highest, but with the largest differences by age of arrival.Schools and teachers had varying, and sometimes insufficient, knowledge and competence of how to relate appropriately to the diverse group of refugee students and their multifaceted educational and psychosocial needs.

Labour Market

The Nordic countries have, in their labour market policy, taken slightly different approaches in targeted active labour market measures to integrate refugees and other immigrants into the labour market, yet all four countries connect immigration and asylum policies to labour market integration. In terms of labour market participation, young refugees had a more disadvantaged labour market position at ages 25 and 30 relative to their native-born majority peers. Between countries, refugees in Denmark had the greatest relative disadvantage in labour market participation in comparison with the native-born majority population.

Health

National policies for health reception of asylum-seekers and refugees exist in all four countries. Denmark has the largest focus on refugee mental health upon arrival, but at the same time, Denmark is the only Nordic country that does not have national policy legislation, which explicitly states that asylum-seeking children are entitled to healthcare services on an equal footing with Danish children.

Regarding health indicators, young male refugees in all four countries generally had a worse health status compared to the majority population, while big differences were not observed between female refugees and the majority women. Especially male refugees stood out with a consistent pattern of higher risks for external cause mortality, disability/illness pension, outpatient psychiatric care, substance abuse, and psychotropic drug use compared with female refugees and the male native-born majority in Denmark.

A qualitative study demonstrated the unique positive role of child health nurses as actors in the Danish asylum system, as they have managed to reach families through tailored, coherent, and empowering relationships. On the other hand, the study described the everyday struggles of asylum-seeking families to maintain the positive parenting practices encouraged by the nurses in a context with limited material resources and crowded housing with little space for family intimacy.

Unaccompanied Refugee Minors

A register study of unaccompanied refugee minors in Norway and Sweden showed a consistently disadvantaged pattern of their life trajectories compared with accompanied refugee minors. This pattern was seen for indicators of severe mental health problems, educational outcomes, and being in NEET (not in education, employment or training) at age 30.

Publications

Find the final CAGE report here

Find the list of all CAGE’s publications here

Coming of Age in Exile (CAGE) was a multidisciplinary research project, led by the Danish Research Centre for Migration, Ethnicity and Health (MESU) at the Department of Public Health at the University of Copenhagen and carried out in collaboration with partners from Norway, Sweden and Finland.

The steering committee consisted of PI, Allan Krasnik, the project administratorJanne Sørensenand the team leaders, namely:

Denmark:

Centre for Migration, Ethnicity og Health (MESU), University of Copenhagen

Teamleader: Signe Smith Jervelund

Finland:

Migration Institute of Finland

Teamleader: Elli Heikkilä

 

Norway:

Norwegian Centre for Violence and Traumatic Stress Studies

Teamleader: Lutine de WalPastoor

 

University College of Southeast Norway

Teamleader: KetilEide

 

Sweden

Centre for Health Equity Studies (CHESS), Stockholm Universitet

Teamleder: Anders Hjern 

Who has funded the project?

CAGE was funded by the Nordic Research Council (NordForsk).

 Expected start and end date:

The project started July 2015 and was completedDecember 2020.

 

Contact persons

Allan Krasnik, alk@sund.ku.dk

Signe Smith Jervelund, ssj@sund.ku.dk

Janne Sørensen, jans@sund.ku.dk