Mental Health and Migration: Depression, Alcohol Abuse, and Access to Health Care Among Migrants in Central Asia

Abstract

Background One fifth of Kazakhstan’s population is labor migrants working in poor conditions with limited legal rights. This paper examines self-rated health, mental health and access to health care among migrant workers. Methods Using geo-mapping, a random sample of internal and external migrant market workers was selected in Almaty (N=450). We used survey logistic regression adjusted for clustering of workers within stalls. Results Almost half of participants described their health as fair or poor and reported not seeing a doctor when needed, 6.2% had clinical depression and 8.7% met criteria for alcohol abuse. Female external migrants were at higher risk for poor health and underutilization of health services. High mobility was associated with depression among internal migrants and with alcohol abuse among female migrant workers. Conclusions This study demonstrates the urgent need to address health and mental health needs and improve access to health care among labor migrants in Central Asia.

Factors associated with self-rated health among migrant workers: results from a population-based cross-sectional study in Almaty, Kazakhstan

“…We previously reported that high mobility was associated with poor utilization of health care services in this population (Ismayilova et al 2014). Internal migrants may be as much at risk as external migrants because in Kazakhstan health care access is linked to the specific location of legal residency.…”

Depression Among People Who Inject Drugs and Their Intimate Partners in Kazakhstan

“…In the fSU and Kazakhstan, depression has also been found to be associated with mobility (Ismayilova et al, 2014) and social isolation (Goryakin et al, 2013; Roberts et al, 2010). Research has also identified associations between depression and food insecurity (Vogenthaler et al, 2011; Weiser et al, 2011) and poor access to health care (Bhatia, Hartman, Kallen, Graham, & Giordano, 2011)…”

The Association Between Social Resources and Depressive Symptoms Among Chinese Migrants and Non-Migrants Living in Guangzhou, China

“…Furthermore, in a meta-analytic review, it was shown that the prevalence of depressive symptoms in China was 2.3% for 12-months and 3.3% for lifetime respectively (Gu et al, 2013). In comparison, Chinese migrants were more vulnerable to depression, with a prevalence between 12.8% to 21.4% (Mou et al, 2011;Qiu et al, 2011;Wong, He, Leung, Lau, & Chang, 2008).Migrant communities are exposed to social and environmental factors that may lead to poor mental health (Ismayilova et al, 2014;Li et al, 2009;Lu, Hu, & Treiman, 2012;Mou et al, 2011;Qiu et al, 2011). Among the multiple factors affecting mental health, migrant status appears to be associated to depression substantially and uniquely in China due to the household registration system, or 'hukou' system.…”

“…The system divides people into two kinds of citizenship: 'agricultural' and 'non-agricultural' (Wu & Treiman, 2004). Although people from rural areas are able to move to urban areas for economic advantages, jobs, and increased chances for social mobility, they might be exposed to risk factors such as interpersonal violence and perceived discrimination that lead to poorer mental health (Teng, Hall, & Li, 2014;Lin et al, 2011).Several studies conducted in China and elsewhere suggest that when people migrate to other cities or countries they are at increased risk for poor mental health (Ismayilova et al, 2014;Li et al, 2009;Lu et al, 2012;Mou et al, 2011;Qiu et al, 2011). Aside from individual-level risk factors such as gender, marital status, age, education level, and employment status (Li, Stanton, Fang, & Lin, 2006;Li et al, 2009), the lack of adequate social network supports are implicated in poor mental health following numerous life adversities, including migration (Záleská, Brabcová, & Vacková, 2014).…”

“…Megacities such as Guangzhou have undergone rapid economic development and changes in population composition, and an increasing number of migrants may experience a mental health burden. For the general population, studies showed the 12-month prevalence for depression was 1.1% to 3.3% (Chen, Cheng, Huang, Liu, & Luo, 2012;Lee et al, 2007;Lu et al, 2008;Ma et al, 2009;Zhang et al, 2008), while the lifetime prevalence was between 0.5% and 6.1% in China (Lee et al, 2007;Lee et al, (Ismayilova et al, 2014;Li et al, 2009;Lu, Hu, & Treiman, 2012;Mou et al, 2011;Qiu et al, 2011). Among the multiple factors affecting mental health, migrant status appears to be associated to depression substantially and uniquely in China due to the household registration system, or 'hukou' system.…”