Eero Lilja

The Prevalence of Potentially Traumatic Pre-Migration Experiences: A Population- Based Study of Russian, Somali and Kurdish Origin Migrants in Finland

Background: On-going mass conflicts and the resulting flow of displaced persons have increased interest in potentially traumatic experiences (PTEs) of migrants. However, studies on the topic using population-based samples are still scarce. Aims: The present study aims 1) to assess the prevalence of specific PTEs in Finlands migrant population and 2) to determine whether socio-demographic and migration-related factors are associated with PTEs. Methods: Data from the Finnish Migrant Health and Wellbeing Study (Maamu), a cross-sectional interview and health examination survey, was used. The sample comprised Russian; Somali and Kurdish migrants aged 18-64. PTEs, with eight specified traumatic event items common among those exposed to war and conflict, were measured using interview questions. Results: The prevalence of having at least one PTE was 21% among Russian, 58% among Somalian and 77% among Kurdish origin migrants, higher in Kurdish men than women and lower in Somali men than women. The most typical forms of PTEs among Kurds and Somalis were war and witnessing a violent death or injury. The most severe events (e.g. torture) were more common and the highest cumulative number of PTEs was among Kurds. Migrating as a refugee or asylum seeker was not associated with higher prevalence of PTEs. Conclusions: Results indicated an alarmingly high overall PTE prevalence among Kurdish and Somali migrants in Finland, especially among Kurds. Results suggest that effort to identify PTEs and interventions should be targeted not only at those migrating with a refugee of asylum seeker status but all migrants from conflict areas.

The association between discrimination and health: findings on Russian, Somali and Kurdish origin populations in Finland

Background The Second European Union Minorities and Discrimination Survey recently demonstrated widespread discrimination across EU countries, with high discrimination rates observed in countries like Finland. Discrimination is known to negatively impact health, but fewer studies have examined how different types of perceived discrimination are related to health. Methods This study examines (i) the prevalence of different types of perceived discrimination among Russian, Somali and Kurdish origin populations in Finland, and (ii) the association between different types of perceived discrimination (no experiences; subtle discrimination only; overt or subtle and overt discrimination) and health (self-rated health; limiting long-term illness (LLTI) or disability; mental health symptoms). Data are from the Finnish Migrant Health and Wellbeing Study (n = 1795). Subtle discrimination implies reporting being treated with less courtesy and/or treated with less respect than others, and overt discrimination being called names or insulted and/or threatened or harassed. The prevalence of discrimination and the associations between discrimination and health were calculated with predicted margins and logistic regression. Results Experiences of subtle discrimination were more common than overt discrimination in all the studied groups. Subtle discrimination was reported by 29% of Somali origin persons and 35% Russian and Kurdish origin persons. The prevalence of overt discrimination ranged between 22% and 24%. Experiences of discrimination increased the odds for poor self-reported health, LLTI and mental health symptoms, particularly among those reporting subtle discrimination only. Conclusions To promote the health of diverse populations, actions against racism and discrimination are highly needed, including initiatives that promote shared belonging.

Births and induced abortions among women of Russian, Somali and Kurdish origin, and the general population in Finland –comparison of self-reported and register data

BackgroundSince reproductive health is often considered a highly sensitive topic, underreporting in surveys and under coverage of register data occurs frequently. This may lead to inaccurate information about the reproductive health. This study compares the proportion of women having births and induced abortions among migrant women of Russian, Somali and Kurdish origin in Finland to women in the general Finnish population and examines the agreement between survey- and register-based data.MethodsThe survey data from the Migrant Health and Wellbeing Study conducted in 2010–2012 and data from the Health 2011 Survey with corresponding information on women in the general population were used in this study. The respondents were women aged 18–64: 341 Russian, 176 Somali and 228 Kurdish origin women and 630 women in the general population. The survey data were linked to the Finnish Medical Birth Register and the Register of Induced Abortions.ResultsIn the combined (survey and register) data, migrant groups aged 30–64 had a higher proportion (89–96%) compared to the general population (69%) of women with at least one birth. Under-coverage of registered births was observed in all study groups. Among women aged 18–64, 36% of the Russian group and 24% of the Kurdish group reported more births in the survey than in the register data. In the combined data, the proportions of Russian origin (69%) and Kurdish origin (38%) women who have had at least one induced abortion in their lifetime are higher than in the general population (21%). Under-reporting of induced abortions in survey was observed among Somali origin women aged 18–29 (1% vs. 18%). The level of agreement between survey and register data was the lowest for induced abortions among the Somali and Russian groups (− 0.01 and 0.27).ConclusionBoth survey- and register-based information are needed in studies on reproductive health, especially when comparing women with foreign origin with women in the general population. Culturally sensitive survey protocols need to be developed to reduce reporting bias.