Cardiovascular health care and health literacy among immigrants in Europe: a review of challenges and opportunities during the COVID-19 pandemic

Abstract

Objectives Europe is a destination for many migrants, a group whose proportion of the overall population will increase over the next decades. The cardiovascular (CV) risk distribution and outcomes, as well as health literacy, are likely to differ from the host population. Challenges related to migrant health status, cardiovascular risk distribution and health literacy are compounded by the ongoing coronavirus disease 2019 (COVID-2019) crisis. Methods We performed a narrative review of available evidence on migrant CV and health literacy in Europe. Results Health literacy is lower in migrants but can be improved through targeted interventions. In some subgroups of migrants, rates of cardiovascular disease (CVD) risk factors, most importantly hypertension and diabetes, are higher. On the other hand, there is strong evidence for a so-called healthy migrant effect, describing lower rates of CV risk distribution and mortality in a different subset of migrants. During the COVID-19 pandemic, CV risk factors, as well as health literacy, are key elements in optimally managing public health responses in the ongoing pandemic. Conclusions Migrants are both an opportunity and a challenge for public health in Europe. Research aimed at better understanding the healthy migrant effect is necessary. Implementing the beneficial behaviors of migrants could improve outcomes in the whole population. Specific interventions to screen for risk factors, manage chronic disease and increase health literacy could improve health care for migrants. This pandemic is a challenge for the whole population, but active inclusion of immigrants in established health care systems could help improve the long-term health outcomes of migrants in Europe.

Health Literacy among Older Adults during COVID-19 Pandemic: A Cross-Sectional Study in an Urban Community in Thailand

“…33 Therefore, their lifestyles may differ. 31 Moreover, our study indicated that social support was a reinforcing factor for HL among older adults, similar to other studies. Social support from neighbors is important to older adults, particularly those in Asian countries.…”

“…The sample population’s residence in urban or semiurban settings may have resulted in a better quality of life related to education level, living conditions, and access to information. 31 ) Although older adults in rural communities receive more support, many areas were locked down and activities canceled. 32 ) However, women were one of the most vulnerable populations during the pandemic and often had less access to information compared to men.…”

Clinical outcomes and risk factors for COVID-19 among migrant populations in high-income countries: A systematic review

“…With routine services closed due to the pandemic, concerns have been raised that migrants have struggled to navigate the new systems ( Doctors of the World 2020 , Valeriani et al, 2020 , Esegbona-Adeigbe, 2020 , Nobody Left Outside 2020 ) and it has exacerbated migrants’ exclusion from health services ( Desai and Samari, 2020 , Santos et al, 2020 , Aragona et al, 2020 , Clarke et al, 2020 , Devillanova et al, 2020 ). Migrants may experience challenges in accessing healthcare remotely ( Doctors of the World 2020 , Brickhill-Atkinson and Hauck, 2020 , Page et al, 2020 , Langellier, 2020 , Wernly et al, 2020 ); however, telemedicine may also offer opportunities that need to be further explored in these populations ( Warner et al, 2020 , Green et al, 2020 ).…”

Clinical outcomes and risk factors for COVID-19 among migrant populations in high-income countries: a systematic review

“…With routine services closed due to the pandemic, concerns have been raised that migrants have struggled to navigate the new systems (50, 113–115) and it has exacerbated migrants’ exclusion from health services (116–120). Migrants may experience challenges in accessing healthcare remotely (50, 63, 101, 106, 121); however, telemedicine may also offer opportunities that need to be further explored in these populations (122, 123).…”