Migration, acculturation and environment: determinants of obesity among Iranian migrants in Australia

While migration from low- to high-income countries is typically associated with weight gain, the obesity risks of migration from middle-income countries are less certain. In addition to changes in behaviours and cultural orientation upon migration, analyses of changes in environments are needed to explain post-migration risks for obesity. The present study examines the interaction between obesity-related environmental factors and the pattern of migrant acculturation in a sample of 152 Iranian immigrants in Victoria, Australia. Weight measurements, demographics, physical activity levels and diet habits were also surveyed. The pattern of acculturation (relative integration, assimilation, separation or marginalization) was not related to body mass index, diet, or physical activity behaviours. Three relevant aspects of participants' perception of the Australian environment (physically active environments, social pressure to be fit, unhealthy food environments) varied considerably by demographic characteristics, but only one (physically active environments) was related to a pattern of acculturation (assimilation). Overall, this research highlighted a number of key relationships between acculturation and obesity-related environments and behaviours for our study sample. Theoretical models on migration, culture and obesity need to include environmental factors.

Migration and the right to social security: perceptions of off-farm migrants' rights to social insurance in China's Jiangsu Province

In 2001 China ratified the International Covenant on Economic, Social and Cultural Rights. By so doing the national government became legally bound, "to the maximum of its available resources", to achieve "progressively" full realization of the rights specified in the Covenant. Included amongst these entitlements is the "right of everyone to social security, including social insurance". This paper uses data from Jiangsu to examine the extent to which urbanites agree that previously disenfranchised migrants have the same right to social insurance as the urban population. Many urbanites fear that their existing entitlements to social protection will be diluted if social insurance coverage is extended to include new populations. Accordingly, state agencies and the media have sought to promote acceptance of a more positive view of migrant workers than has traditionally prevailed within towns and cities. We find that younger urban residents, urban residents who already have social insurance and urban residents working in the state-owned sector are more likely to agree that migrants have the same right to social insurance as the urban population. © 2007 Institute of World Economics and Politics, Chinese Academy of Social Sciences.

Risk factors for coronary heart disease among Asian Indians living in Australia

The aim of this study was to assess the coronary heart disease risk factors in the Asian Indian community living in a large city in Australia. A cross-sectional survey was conducted at the Australia India Friendship Fair in 2010. All people of Asian Indian descent who attended the Fair and visited the health promotion stall were eligible to participate in the study if they self-identified as of Asian Indian origin, were aged between 18 and 80 years, and were able to speak English. Blood pressure, blood glucose, waist circumference, height, and weight were measured by a health professional. Smoking, cholesterol levels, and physical activity status were obtained through self-reports. Data were analyzed for 169 participants. More than a third of the participants under the age of 65 years had high blood pressure. Prevalence of diabetes (16%) and obesity (61%) was significantly higher compared with the national average. Ten women identified themselves as smokers. Physical activity patterns were similar to that of the wider Australian population. The study has provided a platform for raising awareness among nurses and promoting advocacy on the cardiovascular risk among Asian Indians. Strategies involving Asian Indian nurses and other Asian Indian health professionals as well as support from the private and public sectors can assist in the reduction of the coronary heart disease risk factors among this extremely susceptible population.

Cardiovascular prevention model from Kenyan slums to migrants in the Netherlands

Cardiovascular diseases (CVD) are the main cause of morbidity and mortality worldwide. As prevention and treatment of CVD often requires active screening and lifelong follow up it is a challenge for health systems both in high-income and low and middle-income countries to deliver adequate care to those in need, with efficient use of resources.We developed a health service model for primary prevention of CVD suitable for implementation in the Nairobi slums, based on best practices from public health and the private sectors. The model consists of four key intervention elements focusing on increasing awareness, incentives for promoting access to screening and treatment, and improvement of long-term adherence to prescribed medications. More than 5,000 slum dwellers aged ≥35 years and above have been screened in the study resulting in more than 1000 diagnosed with hypertension and referred to the clinic.Some marginalized groups in high-income countries like African migrants in the Netherlands also have low rates of awareness, treatment and control of hypertension as the slum population in Nairobi. The parallel between both groups is that they have a combination of risky lifestyle, are prone to chronic diseases such as hypertension, have limited knowledge about hypertension and its complications, and a tendency to stay away from clinics partly due to cultural beliefs in alternative forms of treatment, and lack of trust in health providers. Based on these similarities it was suggested by several policymakers that the model from Nairobi can be applied to other vulnerable populations such as African migrants in high-income countries. The model can be contextualized to the local situation by adapting the key steps of the model to the local settings.The involvement and support of African communities' infrastructures and health care staff is crucial, and the most important enabler for successful implementation of the model in migrant communities in high-income countries. Once these stakeholders have expressed their interest, the impact of the adapted intervention can be measured through an implementation research approach including collection of costs from health care providers' perspective and health effects in the target population, similar to the study design for Nairobi.

Promoting appreciation of cultural diversity and inclusion with the Stephanie Alexander Kitchen garden program

Purpose – The purpose of this paper is to present emergent findings from an evaluation of the Stephanie Alexander Kitchen Garden (SAKG) Program showing that the program promoted appreciation of cultural diversity and inclusion of culturally diverse groups. Design/methodology/approach – The findings reported here are from the qualitative component of a mixed-method, nonrandomized, pre- and post-comparison evaluation study. Focus groups and interviews were held with school principals, teachers, program specialist staff, parents, volunteers and children at the program schools. Findings – In a culturally diverse school, the program enhanced the school’s capacity to engage and include children and families from migrant backgrounds. In less diverse settings, the program provided opportunities for schools to teach children about cultural diversity. Research limitations/implications – Assessing the program’s impact on multicultural education was not a specific objective of this study, rather these findings emerged as an unanticipated outcome during interviews and focus groups that explored participants’ views on important changes to schools associated with the program. Thus, the quantitative component of the evaluation did not assess the extent of this program impact and further research is recommended. Practical implications – The program may have particular value in culturally diverse schools, providing benefits in terms of engagement of children and families and potentially, in the longer term, associated improvements in learning outcomes. Social implications – These findings suggest that the program can help to promote social equity and inclusion for culturally diverse groups. Originality/value – This paper highlights critical equity implications associated with school-based programs’ capacity to include culturally and linguistically diverse groups.

Socio-cultural disparities in GDM burden differ by maternal age at first delivery

Aims : Several socio-cultural and biomedical risk factors for gestational diabetes mellitus (GDM) are modifiable. However, few studies globally have examined socio-cultural associations. To eliminate confounding of increased risk of diabetes in subsequent pregnancies, elucidating socio-cultural associations requires examination only of first pregnancies.

Methods : Data for all women who delivered their first child in Victoria, Australia between 1999 and 2008 were extracted from the Victorian Perinatal Data Collection. Crude and adjusted GDM rates were calculated. Multivariate logistic regression was used to examine odds of GDM within and between socio-cultural groups.

Results : From 1999 to 2008, 269,682 women delivered their first child in Victoria. GDM complicated 11,763 (4.4%) pregnancies and burden increased with maternal age, from 2.1% among women aged below 25 years at delivery to 7.0% among those aged 35 years or more. Among younger women, GDM rates were relatively stable across socioeconomic levels. Amongst older women GDM rates were highest in those living in most deprived areas, with a strong social gradient. Asian-born mothers had highest GDM rates. All migrant groups except women born in North-West Europe had higher odds of GDM than Australian-born non-Indigenous women. In all ethnic groups, these differences were not pronounced among younger mothers, but became increasingly apparent amongst older women.

Conclusions : Socio-cultural disparities in GDM burden differ by maternal age at first delivery. Socio-cultural gradients were not evident among younger women. Health and social programs should seek to reduce the risk amongst all older women to that of the least deprived older mothers.

Itinerant foreign harvest workers in Australia: the impact of precarious employment on occupational safety and health

Horticulture work in many high-income economies is increasingly performed by temporary migrant workers from low-wage economies. In Australia, such work is now performed predominantly by international backpackers – young well-educated workers with mostly sound English language skills. These workers are drawn to harvesting work by a government scheme which provides an incentive for completing a specified number of days work in horticulture. This article examines the health and safety experience of these workers, through focus groups, interviews and an online survey. Notwithstanding their distinctive backgrounds, the harvesting experience of these temporary migrant workers is similar to that of low-skilled migrants working in other high-income countries. Health and safety risks associated with work organisation and payment systems, and a lack of compliance with OHS legal requirements, are commonplace but potentially compounded by a sense of invincibility amongst these young travellers. Furthermore, a growing pool of undocumented workers is placing downward pressures on their employment conditions. The vulnerability associated with work and earnings uncertainty, and the harsh environment in which harvesting work occurs, remains a constant notwithstanding the background of these workers.

Does mortality vary between Asian subgroups in New Zealand: an application of hierarchical Bayesian modelling

The aim of this paper was to see whether all-cause and cause-specific mortality rates vary between Asian ethnic subgroups, and whether overseas born Asian subgroup mortality rate ratios varied by nativity and duration of residence. We used hierarchical Bayesian methods to allow for sparse data in the analysis of linked census-mortality data for 25-75 year old New Zealanders. We found directly standardised posterior all-cause and cardiovascular mortality rates were highest for the Indian ethnic group, significantly so when compared with those of Chinese ethnicity. In contrast, cancer mortality rates were lowest for ethnic Indians. Asian overseas born subgroups have about 70% of the mortality rate of their New Zealand born Asian counterparts, a result that showed little variation by Asian subgroup or cause of death. Within the overseas born population, all-cause mortality rates for migrants living 0-9 years in New Zealand were about 60% of the mortality rate of those living more than 25 years in New Zealand regardless of ethnicity. The corresponding figure for cardiovascular mortality rates was 50%. However, while Chinese cancer mortality rates increased with duration of residence, Indian and Other Asian cancer mortality rates did not. Future research on the mechanisms of worsening of health with increased time spent in the host country is required to improve the understanding of the process, and would assist the policy-makers and health planners.

Belonging and the uses of difference: young people in Australian urban multiculture

This paper examines how young people of migrant background in Australia make meaning of cultural, ethnic and racial difference to work out belonging in times of super-diversity. It asks what functions difference still has for a generation growing up within conditions of proliferating diversity that demand and accommodate competing constructions of cultural identities. It suggests that young people's narratives about difference depend on the space of belonging, and explores how young people use difference differently depending on whether they are articulating membership in the local community, the nation or youth culture.

Muslim citizenship in everyday Australian civic spaces

Questions about Muslims, multiculturalism and citizenship continue to shape the political discourse of many nations, including Australia, a nation often foregrounded as a beacon of multiculturalism in practice. The key assumption underlying these questions is that Islam constrains the full possibilities of citizenship in multicultural secular societies and that Muslims must be actively steered towards participation in civic life. By contrast, this article, based on research with 80 young Australian Muslims from migrant backgrounds reveals how Australian Muslims are enacting everyday citizenship through active, self-driven participation in multicultural civic spaces. This is a process overlooked by contemporary government approaches to the management of Muslim communities and alike. This article argues that is it access to these spaces of everyday interaction rather than an emphasis upon securitisation and civic literacy that fosters the development of citizenship and civic engagement central to the success of Australian multiculturalism. The article provides important considerations for those concerned with the future viability of multicultural policies.

Chinese immigrant youth identities and belonging in Prato, Italy: exploring the intersections between migration and youth studies

This article explores the experiences of young people of Chinese background in Prato (Italy). Despite significant social exclusion, young Chinese develop a sense of belonging to Prato by creating local, translocal and transnational affiliations and interconnections. These relationships contribute to making an often overtly hostile local reality, liveable and meaningful. A central aim of this article is to examine the intersection between migration studies and youth studies. The former tend to focus on the processes of identity formation featuring ethnic background, hence the label ‘second generation’. In contrast, the latter tend to foreground age- and generation-specific practices of belonging that may extend beyond ethnic identification, hence the focus on ‘youth’. We argue that bringing migration and youth studies together by complicating notions of home and host, migrant and local identity and belonging helps us to better understand how young people are managing multiplicity and mobility (and situatedness and stasis/fixity).

Migratory implications for coronary heart disease risk prevention in Asian Indians: Evidence from the leading health indicators.

OBJECTIVEctives of this descriptive comparative study were to (1) review data obtained from the World Health Organisation Statistical Information System (WHOSIS) database relating to the prevalence of risk factors for coronary heart disease (CHD) among Indians and Australians and (2) compare these data with published epidemiological studies of CHD riskfactors in adult migrant Asian Indians to provide a comprehensive and comparable assessment of risk factors relating to CHD and the mortality attributable to these risk factors. Design: ThDESIGNdy was undertaken using a database search and integrative review methodology. Data were obtained for comparison of CHD risk factors between Indians and Australians using the WHOSIS database. For the integrative review the MEDLINE, CINAHL, EMBASE, and Cochrane databases were searched using the keywords 'Migrants', 'Asian Indian', 'India', 'Migration', 'Immigration', 'Risk factors', and coronary heart disease. Two reviewers independently assessed the eligibility of the studies for inclusion in the review, the methodological quality and extracted details of eligible studies. Results from the integrative review on CHD risk factors in Asian Indians are presented in a narrative format, along with results from the WHOSIS database. Results: TRESULTSadjusted mortality for CHD was four times higher in migrant Asian Indians when compared to both the native population of the host country and migrants from other countries. Similarly when compared to migrants from other countries migrant Asian Indians had the highest prevalence of overweight individuals. Prevalence rates for hypercholesterolemia were up to 18.5 % among mgrant Asian Indians and migrant Asian Indian women had a higher prevalence of hypertriglyceridaemia compared to Caucasian females. Migrant Asian Indians also had a higher incidence of hypertension and upto 71 % of migrnt Asian Indian men did not meet current guidelines for participation in physical activity. Ethnic-specific prevalence of diabetes ranged from 6-7% among the normal weight to 19-33% among the obese migrant Asian Indians compared with non-Hispanic whites. ConclusionCONCLUSIONAsian Indians have an increased risk of CHD. Culturally sensitive strategies that recognise the effects of migration and extend beyond the health sector should be developed to target lifestyle changes in this high risk population.

Layered vulnerability: Temporary migrants in Australian horticulture

Australian horticulture (fruit and vegetable production) relies upon a seasonal harvest workforce, much of which now consists of temporary migrant workers. This article argues that the composition of this workforce and the character of the work lead towards layered vulnerability, some groups being more exposed to low pay and substandard working conditions than others. Formally at least, employment conditions are generally protected by the federal Horticulture Award (2010). But are decent employment standards consistently observed? The article explores this question, examining three issues. First, does analysis of workforce composition reveal different tiers in the workforce, some more vulnerable than others? Second, do the casual nature of harvest work and the job search processes used by temporary migrant workers create disadvantaged groups? Third, does evidence about pay, working hours and work intensity reveal some workers to be more vulnerable than others? The article concludes with an examination of those factors that appear to be associated with layered vulnerability in the harvest workforce, and considers some policy implications.

Cultural respect encompassing simulation training: being heard about health through broadband

BACKGROUND: Cultural Respect Encompassing Simulation Training (CREST) is a learning program that uses simulation to provide health professional students and practitioners with strategies to communicate sensitively with culturally and linguistically diverse (CALD) patients. It consists of training modules with a cultural competency evaluation framework and CALD simulated patients to interact with trainees in immersive simulation scenarios. The aim of this study was to test the feasibility of expanding the delivery of CREST to rural Australia using live video streaming; and to investigate the fidelity of cultural sensitivity - defined within the process of cultural competency which includes awareness, knowledge, skills, encounters and desire - of the streamed simulations. DESIGN AND METHODS: In this mixed-methods evaluative study, health professional trainees were recruited at three rural academic campuses and one rural hospital to pilot CREST sessions via live video streaming and simulation from the city campus in 2014. Cultural competency, teaching and learning evaluations were conducted. RESULTS: Forty-five participants rated 26 reliable items before and after each session and reported statistically significant improvement in 4 of 5 cultural competency domains, particularly in cultural skills (P<0.05). Qualitative data indicated an overall acknowledgement amongst participants of the importance of communication training and the quality of the simulation training provided remotely by CREST. CONCLUSIONS: Cultural sensitivity education using live video-streaming and simulation can contribute to health professionals' learning and is effective in improving cultural competency. CREST has the potential to be embedded within health professional curricula across Australian universities to address issues of health inequalities arising from a lack of cultural sensitivity training. Significance for public healthThere are significant health inequalities for migrant populations. They commonly have poorer access to health services and poorer health outcomes than the Australian-born population. The factors are multiple, complex and include language and cultural barriers. To address these disparities, culturally competent patient-centred care is increasingly recognised to be critical to improving care quality, patient satisfaction, patient compliance and patient outcomes. Yet there is a lack of quality in the teaching and learning of cultural competence in healthcare education curricula, particularly in rural settings where qualified trainers and resources can be limited. The Cultural Respect Encompassing Simulation Training (CREST) program offers opportunities to health professional students and practitioners to learn and develop communication skills with professionally trained culturally and linguistically diverse simulated patients who contribute their experiences and health perspectives. It has already been shown to contribute to health professionals' learning and is effective in improving cultural competency in urban settings. This study demonstrates that CREST when delivered via live video-streaming and simulation can achieve similar results in rural settings.

Exploring cultures of belonging in Darwin, Australia

This paper argues that the use of visual methods such as participatory video is crucial to co-producing sensory and embodied knowledges of belonging in Australian cities. These knowledges of belonging that focus on affectivity and passion have the potential to expand the worlds that racialised bodies of colour inhabit, but contemporary urban research shows an overwhelming focus on ‘talk’. This paper therefore takes the risk by engaging in a research process that is experimental, flexible and adaptive to explore diverse sensory cultures of belonging through a focus on Darwin, a small north Australian city. This is a city with a polyethnic history where Indigenous-migrant-settler race relations are recognised as more complex in comparison to large south Australian cities. The paper draws on participatory videos of two eventsin suburban Darwin - a Vigil on the side of the road opposite Airport
Lodge, an asylum seeker detention centre, and an afternoon walk along Casuarina beach where Aboriginals who live ‘rough’ camp. Using short video clips, long-term residents, migrant newcomers and asylum seekers (on bridging visas) compose an expressive narrative of the road and beach in Darwin, as places where refrains of welcome expand worlds that racialised bodies of colour inhabit. Using digital technologies the flow and juxtaposition of video clips of these events provides the possibility to craft sensory and embodied knowledges of belonging in a north
Australian city with a history of assimilationist and racially discriminatory policies.