Beha .Sci.2022,12,393.h ps://doi.o g/10.3390/bs12100393www.mdpi.com/jou nal/beha sci
Re iew
Explo ing heE ec so heCOVID‐19PandemiconMen al
Heal handWell‐Beingo Mig an Popula ionsinEu ope:An
Equi y‐FocusedScopingRe iew
Viole aAla cão
1,2,
*,AnaVi golino
2
,Miod agaS e ano ska‐Pe ko ska
2
andJúliaNe es
1,2
1
Cen odeIn es igaçãoeEs udosdeSociologia,Isc e—Ins i u oUni e si á iodeLisboa,A enidadasFo ‐
çasA madas,1649‐026Lisboa,Po ugal
2
Ins i u odeSaúdeAmbien al,FaculdadedeMedicina,Uni e sidadedeLisboa,A enidaP o esso Egas
Moniz,1649‐028Lisboa,Po ugal
*Co espondence: iole a_sabina_ala cao@isc e‐iul.p
Abs ac :Thepandemicisagg a a ingheal hinequali ies,pa icula lymen alheal hinequali ies,
while e ealing hesocialde e minan so heseinequali ies,includingmig a ionasasocialde e ‐
minan ha media es hein e ac iono social,economic,cul u al,ins i u ional,ands uc u al ac‐
o swi hheal hindica o s.The e o e,i iso mos ele ance oiden i y hemul iplein e connec ed
ac o s ha in luence hemen alheal handwell‐beingo mig an popula ions.Ascoping e iew
wasde eloped omap he esea chpe o medin hisa eaand oiden i yanygapsinknowledge,
ollowing hePRISMAex ension o scoping e iews.MEDLINE,Scopus,andWHOGlobalHeal h
esea chda abasesonCOVID‐19we esea ched omJanua y2020 oOc obe 2021.The e iew
ollowed heinclusionc i e iaPopula ion/Concep /Con ex (PCC):Popula ion‐Adul In e na ional
mig an s(including e ugees,asylumseeke s,andundocumen edmig an s);Concep ‐de e mi‐
nan so (and ac o sin luencing)men alheal handwell‐being;Con ex ‐COVID‐19anywhe ein
hewo ld.O hesix y‐ i eselec eds udies,ele enwe e omEu opeancoun iesandwe e he
ocuso his e iewwi hspeciala en ion oheal hinequali iesexpe iencedbymig an sinEu ope.
The esul sco e adi e si yo hemes ela ed o hee ec so COVID‐19on hemen alheal ho
mig an s(coun y‐le elen i onmen al ac o s,socialde e minan so men alheal h,men alheal h
indica o sandou comes), esponses(suchassolida i yand esilience),popula ions,ands udy
me hods.Thee idence oundcanin o m ecommenda ionsandin e en ions ocusedonheal h
p omo ionandmi iga iono heinequali iesaccen ua edby hepandemic.
Keywo ds:co ona i usdisease2019;men alheal handwell‐being;socialde e minan so heal h;
mig a ion
1.In oduc ion
As apidas heCOVID‐19pandemiceme ged,i ga e ise oase ieso dis up i econ‐
sequencesin heeconomic,heal h,andeduca ionalsec o s ha con ibu ed oascena ioo
disp opo ionaleconomicandsocial ulne abili y.Thesee ec so hepandemicseem obe
g ea e insocially ulne ableandma ginalizedg oups,mo especi icallymig an popula‐
ions.While heseg oupsa eo e ep esen edinCOVID‐19casesin e mso labo a o y
diagnosis,hospi aladmissions,in ensi eca e,anddea hs a is icsinallcoun iesacco ding
o hea ailableda a[1–4], heycon inue o aces uc u alba ie s oCOVID‐19con ol
e o s,suchas es ingand accina ion[5,6].Asa esul ,inaddi ion o head e see ec s
on hei physicalheal h, heya ep one o hede elopmen o men alheal handwell‐being
ill‐e ec s, husposi ioning hemasoneo hemos ulne ableandneglec edg oupsin he
COVID‐19pandemic[7–9].
Ci a ion:Ala cão,V.;Vi golino,A.;
S e ano ska‐Pe ko ska,M.;Ne es,J.
Explo ing heE ec so he
COVID‐19PandemiconMen al
Heal handWell‐Beingo Mig an
Popula ionsinEu ope:An
Equi y‐FocusedScopingRe iew.
Beha .Sci.2022,12,393.
h ps://doi.o g/10.3390/bs12100393
AcademicEdi o :And ewSoundy
Recei ed:17Sep embe 2022
Accep ed:13Oc obe 2022
Published:14Oc obe 2022
Publishe ’sNo e:MDPIs aysneu‐
alwi h ega d oju isdic ional
claimsinpublishedmapsandins i u‐
ionala ilia ions.
Copy igh :©2022by heau ho s.Li‐
censeeMDPI,Basel,Swi ze land.
Thisa icleisanopenaccessa icle
dis ibu edunde he e msandcon‐
di ionso heC ea i eCommonsA ‐
ibu ion(CCBY)license(h p://c ea‐
i ecommons.o g/licenses/by/4.0/).
Beha .Sci.2022,12,3932o 15
This esea chcen alizesa ound hep emise ha hepandemicisagg a a ingheal h
inequali ies,pa icula lymen alheal hinequali ies,while e ealing hesocialde e mi‐
nan so heseinequali ies,includingmig a ionasade e minan ha media es hein e ‐
ac iono social,economic,cul u al,ins i u ional,ands uc u al ac o swi hheal hindi‐
ca o s,a ec ing hedi e en sphe eso li e[10–13].The e o e,i is ele an andnecessa y
oiden i y hemul iple ac o s ha in e connec andin luencemen alheal handwell‐
being ounde s and hein e dependenciesbe weenmen alheal handglobalchallenges,
suchas hecu en con ex andimpac sa heindi idualandsocie alle els.
In e sec ionalapp oachesa eneeded oanalyze hecomplexi yo hepandemicsi ‐
ua ionandadap hepoli ical esponses odealwi h hiscomplexi y.In e sec ionali yis
a heo e ical‐me hodologicalpowe ul ool o e ealp ocesseso in e ac ionbe ween
powe ela ionsandca ego ies—suchasgende ,class, ace,ande hnici y—inindi idual,
collec i e,andcul u al/ins i u ionalcon ex s,ye s illwi hlimi eduseinmen alheal h.
Usinganin e sec ionallenso analysiscanhelp oiden i ydi e en ialsin hemen al
heal he ec so hepandemicbe weenindi idualsandsocialg oups, acili a ing heelab‐
o a iono poli ical esponses ailo ed opeoplea hemos ma ginalizedin e sec ions( a‐
cial/e hnicmino i ies,women,andundocumen edwo ke s)wi ha ocusonequi y[14–
17].
Thisscoping e iewaims oiden i yandsumma ize heexis ing esea chon hee ‐
ec so heCOVID‐19pandemicon hemen alheal ho mig an swi h e lec ionon he
Eu opeancon ex (anunde ‐ esea ched egionneedinga ocusedanalysis) oin o m
sui ed ecommenda ions o mig an ‐sensi i eandmig an ‐inclusi eheal hca e.The
o e a ching esea chques ionwas opinpoin hemul iple ac o sin luencing he
COVID‐19pandemic’se ec son hemen alheal ho in e na ionaladul mig an s(in‐
cluding e ugees,asylumseeke s,andi egula mig an s).
2.Me hods
2.1.S udyDesign
Inea lyOc obe 2021,weconduc edap elimina ysea chon heJoannaB iggsIns i‐
u e(JBI)Da abaseo Sys ema icRe iewsandImplemen a ionRepo sand heCoch ane
Da abaseo Sys ema icRe iews o iden i yingexis ingscopingandsys ema ic e iews
on he opic.Nos udieson hein e sec ionsbe weenCOVID‐19,men alheal h,andmi‐
g an swe e ound.The e o e,ascoping e iewwasde eloped omap he esea chca ‐
iedou in hisa eaand oiden i yexis ingknowledgegaps,sincescoping e iewsp o‐
ideacomp ehensi eo e iew oadd essb oade e iewques ions han adi ionally
mo especi icsys ema ic e iewso e ec i enesso quali a i ee idence[18].
Thep o ocolwas egis e edwi h heOpenScienceF amewo kon5No embe 2021.
The e iewwasunde aken ollowing heP e e edRepo ingI ems o Sys ema icRe‐
iewsandMe a‐Analysesex ension o scoping e iews—PRISMA‐ScR[19]and he ec‐
ommenda ionsmadeby heJBI,whichisaglobalo ganiza ionp omo ingandsuppo ing
e idence‐baseddecisions ha imp o eheal handheal hse icedeli e y[18].
2.2.Sea chS a egy
Asys ema icli e a u esea chwaspe o medusing he ollowingelec onicda a‐
bases:MEDLINE( iaPubMed),Scopus,andWHOGlobalHeal h esea chda abaseon
COVID‐19,usingcombina ionso hesea ch e ms, ailo ed o hesyn ax,and unc ion‐
ali yo eachda abase.Allsea cheswe econduc edon13Oc obe 2021and ailo ed o
eachelec onicda abase(See heexamplesea ch o MEDLINEinAppendixA).Ada e
angelimi a iono ‘2020—cu en ’wasde ined,andonlyEnglish‐w i endocumen s
we econside edeligible o inclusion.
2.3.InclusionandExclusionC i e ia
Beha .Sci.2022,12,3933o 15
TheIn e na ionalO ganiza ion o Mig a ion(IOM)de inesamig an as“anype son
whoismo ingo hasmo edac ossanin e na ionalbo de o wi hinaS a eaway om
his/he habi ualplaceo esidence, ega dlesso (1) hepe son’slegals a us;(2)whe he
hemo emen is olun a yo in olun a y;(3)wha hecauses o hemo emen a e;o
(4)wha heleng ho hes ayis”)wasconside ed[20].So,a iclesinwhich hepopula ion
o in e es didno mee hec i e ias a edin hisde ini ionwe eexcluded.
ThePCCme hod(Popula ion(o pa icipan s)/Concep /Con ex ) ecommendedby
heJBI oiden i y hemainconcep sin hep ima y e iewques ionswasused o he
sea chs a egyand hede ini iono inclusionc i e ia[18]:P(Popula ion=In e na ional
mig an ,Re ugee,Asylumseeke ,Undocumen edmig an ,age18andabo e),C(Concep
=empi icalda aonindi idual,social,cul u al,ins i u ional,ands uc u al ac o sin lu‐
encingmen alheal handwell‐beingou comes),C(Con ex =S udiesonanycoun yin
hewo ld epo ingin e na ionalmig an s’men alheal handwell‐beingdu ing he
COVID‐19pandemic).Onlyempi icals udieswe eincluded, ega dlesso esea chde‐
sign,samplesize,andme hodsused.Anexcep ionwasin e en ions udies,whichwe e
excluded,becauseo hei dis inguished ea u escompa ed oobse a ionals udies.Book
e iews,bookchap e s,con e encep oceedings,edi o ials,commen a ies,guidelines,
s udyp o ocols,and igne es udieswe ealsoexcluded.Each ele an eco dwas e‐
iewedindependen lyby woau ho s,whichsc eened i lesandabs ac s,andwhen
needed, ull ex s.A inaldecisionwasob ained o each eco d,wi hunce ain iesand
disag eemen s esol edinconsul a ionwi ha hi dau ho .
2.4.Da aEx ac ionandAnalysis
Fo all hea iclesincludedin he inalanalysis,da awe eex ac edby woo he
au ho sandincluded he ollowing a iables:(1)Au ho (s)andyea o publica ion,(2)
coun y,(3)popula ion(samplesize, ypeo mig an ,coun yo o igin,age,gende ),(4)
aim,(5)design,(6)men alheal hou come(s),(7)socialde e minan so heal h,(8)o e all
esul s,(9)o e alllimi a ions,(10)ando e all ecommenda ions.Bibliome icda a e‐
ga ding hejou nal’s i le,publica ionqua ile,anddomain/a eao wo k(i.e., hea ea
wi h hehighes qua ilein heyea o hes udypublica ionacco ding o heScimago
Jou nalandCoun yRank)we ealsocollec ed.Me hodologicalquali yo isko biaso
heincludeda icleswasno app aisedbecausei wasno ele an o hescoping e iew
objec i es,whichisconsis en wi hguidanceonscoping e iewconduc [18].Resul s
we esyn hesizedusinga hema icapp oach ocusingon heiden i ica iono ele an
hemes ela ed oindi idual,social,cul u al,ins i u ional,ands uc u al ac o sin luenc‐
ingmen alheal hou comes.
3.Resul s
A o alo 1938publica ionswe eiden i ied om he h eesea chedda abases.Once
duplica eswe e emo ed,1291a icles emained o sc eening.O hese,1226we eex‐
cludedbecause heywe eno empi icals udies,didno ocusonmen alheal hou comes,
o we eno conduc edamongmig an popula ions.Asa esul ,65s udiescouldbein‐
cluded.Ele ena icles(17%)we econduc edinEu opeancoun iesandwe especi ically
selec ed obeincludedin his e iewpape o mapping he esea chon hee ec so he
COVID‐19pandemicon hemen alheal ho mig an saswellas oiden i yknowledge
gapsinEu ope.A lowdiag amde ailing henumbe o s udiesincludedandexcluded
a eachs age o his e iewisp o idedinFigu e1.
Beha .Sci.2022,12,3934o 15
Figu e1.PRISMA2020 lowdiag am.
3.1.Cha ac e is icso Selec edA icles
Allo heselec eds udieswe epublishedinjou nalswi himpac ac o ,mainlyin
jou nals ankedin he i s qua ile(7/11).Th ees udieswe epublishedinjou nalsin he
secondqua ile,andones udyin he hi dqua ile.In e mso hesubjec a ea, ou a i‐
cleswe epublishedin hePublicheal h,En i onmen alandOccupa ionalHeal hdo‐
main, woinPsychia yandmen alheal h, woinGeog aphy,PlanningandDe elop‐
men ,andoneinClinicalpsychology,inLeade shipandManagemen ,andHeal h,Toxi‐
cologyandMu agenesis.
Thes udieswe econduc edineigh Eu opeancoun iesandonepublica ionwas
omaEu opeanConso ium, heApa Toge he Conso ium,ledby heGhen Uni e ‐
si yinBelgiumand heUni e si yo CopenhageninDenma k,and heMig a ionand
Heal hp og amo heWHORegionalO ice o Eu ope[21].
Twoo heele ens udieswe econduc edinI alywi hmig an pa ien sinmen al
heal hou pa ien depa men s,onepublishedin2020aiming oe alua e heimpac o he
COVID‐19– ela edlockdownon hedi icul iesin heu iliza iono men alheal hse ices
and ollow‐upadhe ence[22],and heo he publishedin2022 oin es iga e hee ec s
on hemen alheal hou comes[23].
Twoo he s udieswe econduc edin heUni edKingdom(UK),onewi hBlack,
Asian,andMino i yE hnici yg oup(BAME)heal hca ewo ke s[24],andano he wi h
da a om heUKHouseholdLongi udinalSu eyand he i s wowa es(Ap ilandMay
2020)o heCOVID‐19su ey iaweb‐basedques ionnai esapplied oUK‐bo nand o ‐
eign‐bo nmen[25].
Addi ionally, wos udieswe e ela ed o heNe he lands—mo especi icallyan
onlinesu eyamongChineseimmig an sli ingin heNe he lands[26]andaPolish
s udyo h eepopula iong oups:non‐immig an sli inginPoland,Du chci izens,and
Polishimmig an sli ingin heNe he lands[27].
Beha .Sci.2022,12,3935o 15
Finally, ou coun ies(Spain,Swi ze land,F ance,andGe many)hadonepublica‐
ioneach,wi hdi e en popula ionsandapp oaches.Resea chconduc edinSpainwas
cen e edon he oleo esilience o men alheal hin imeso COVID‐19ac ossg oupso
mig a ionandnon‐mig a ionindi iduals[28].Thes udyinSwi ze landwasconduc ed
du ing heCOVID‐19lockdowninAp il–May2020wi hundocumen edand ecen ly eg‐
ula izedmig an s[29],while he esea chinF ance ocusedon hechangesinmen al
heal hamongdisad an agedimmig an s omSub‐Saha anA icain heg ea e Pa is
a eawi hda acollec edbe o eanddu ing he i s COVID‐19‐ ela edlockdown[30].The
in es iga ionyieldinGe many eliesonacoho o ou pa ien sa apsychia icou pa ien
clinicwi hahighpe cen ageo pa ien swi hamig a ionbackg ound[31].
Thes udiesusedaquan i a i eapp oach,wi honlineand/o elephonesu eys.
The eisadi e si yin hemen alheal hou comesanalyzed, omdep ession,anxie y,
ands ess, osleepingp oblemsandsubs anceuse,sa is ac ionwi hli e,and esponses
( esilience,andsolida i y,amongo he s a egies).
Table1p esen smo ede ailson hecha ac e is icso hes udies.
Table1.Cha ac e is icso hes udies.
Au ho ,
Da eJou nal,Qua ileDomain/A eao
Wo kCoun y(ies)Popula ionand
SampleMe hods
Men alHeal hOu ‐
comesandIns u‐
men s
A agonae
al.,2022[23]
TheIn e na ional
jou nalo social
psychia yQ1
Psychia yand
men alheal hI aly
Mig an sin ea ‐
men inaMen al
Heal hUni a an
ou pa ien depa ‐
men (n=81)
Telephonesu ey
o
casuallyselec ed
adul sin ea men
be o e hepe iod
o lockdownby he
clinicians
‐Pos ‐ auma icin u‐
si e hough sand
nigh ma es(PTSD
Scale)
‐I i ablebeha io and
ang you bu s s,and
sleepdis u bances
‐Dep essedmoodand
psychicanxie y(Ham‐
il onDep essionRa ‐
ingScale)
A agonae
al.,2020[22]Publicheal hQ2
Publicheal h,En‐
i onmen aland
Occupa ional
Heal h
I aly
Pa ien s omamen‐
alheal hou pa ien
se iceinRome(n=
286);mainp o e‐
nanceA ica
Re ospec i e
c oss‐sec ional
s udywi hda a
ou inelyinmedi‐
cal eco ds
T endsin henumbe
o pa ien sandpsychi‐
a icca ego iesusing
heIn e na ionalClas‐
si ica iono Diseases
(ICD)‐9
Bujek‐Ku‐
basand
Mojs,2021
[27]
In e na ionaljou ‐
nalo occupa ional
medicineanden i‐
onmen alheal h
Q3
Publicheal h,En‐
i onmen aland
Occupa ional
Heal h
Polandand he
Ne he lands
Adul s(n=168)
Non‐immig an sin
Poland(n=50);
Du chci izens(n=
56);
Polishimmig an sin
heNe he lands(n=
62)
Onlinesu ey( ia
Facebook)
1s s udybe o e
hepandemicin
Janua y2020and
2nds udyin
Ap il–May2020
wi h hesamesu ‐
eyse
‐Posi i eandNega i e
Expe ienceScale
‐Pe cei edS ess
Scale,and
‐Sa is ac ionWi hLi e
Scalepandemic
Bu on‐
J
eang ose
al.,2020[29]
F on ie sinPublic
Heal hQ2
Publicheal h,En‐
i onmen aland
Occupa ional
Heal h
Swi ze land
Undocumen edand
ecen ly egula ized
mig an s(n=117 o
heonlineques ion‐
nai eandn=17 o
hein e iews)
C oss‐sec ional
mixedme hods
s udynes edwi h
acoho s udy;
onlineques ion‐
nai e ollowedby
phonein e iews
inasubsample
Sa is ac ionwi hli e,
li ingcondi ionsin
Gene a,andsocialiso‐
la ion
Beha .Sci.2022,12,3936o 15
Gosseline
al.,2021[30]
Jou nalo psycho‐
soma ic esea ch
Q1
Clinicalpsychol‐
ogyF ance
n=100immig an s
omsub‐Saha an
A icain
heG ea e Pa is
a ea
Communi y‐based
coho be o e he
COVID‐19pan‐
demic,wi hbase‐
lineda aon heli ‐
ingcondi ionsand
men alheal h,and
ollow‐up ele‐
phonein e iews
be weenAp iland
June2020
Dep essionse e i y—
Pa ien Heal hQues‐
ionnai e(PHQ9)
Mingand
DeJong,
2021[26]
Sus ainabili yQ1
Geog aphy,Plan‐
ningandDe el‐
opmen
Ne he lands
Chineseimmig an s
li ingin heNe he ‐
lands(n=268)
Onlinesu eydu ‐
ing hesecond
wa eo hepan‐
demic(No embe –
Decembe 2020)
Pa icipan scompa e
hei well‐beingwi h
he imebe o e
COVID‐19usingan
adap ed e siono he
Sho Dep ession‐
HappinessScale
(SDHS);
Moo hy
andSanka ,
2020[24]
Jou nalo public
heal hQ1
Publicheal h,En‐
i onmen aland
Occupa ional
heal h
Uni edKingdom
Black,Asian,and
Mino i yE hnici y
g oup(BAME)
heal hca ewo ke s
inLeices e shi e(n=
200);
78%bo nou sideo
heUK
C oss‐sec ional
su eyusing20
ques ionsinan
elec onic o ma
om2May
o17May2020
Impac o COVID‐19
onmen alheal h‐
Singleques ion
Mo ane
al.,2021[31]
F on ie sinPsychi‐
a yQ1
Psychia yand
men alheal hGe many
n=294psychia ic
pa ien sinanou pa‐
ien
clinicinBe lin,wi h
ahighpe cen ageo
pa ien swi hami‐
g a ionbackg ound
Mul imodesu ey
( elephonein e ‐
iewbyclinical
s a andsel ‐ad‐
minis e edbypa‐
ien s)be ween
Ap ilandJune
2020
‐Lockdown‐ ela ed
dis ess:
ea o lo edones;
sleep;physicalcom‐
plain s;anxie y;wo s‐
eningsymp oms;
d ugconsump ion;
ea o con agion;
‐Family‐ ela eddis‐
ess:mo ehousehold
ension,mo ewo k,
mo edomes ic io‐
lence
Shenand
Ba am,
2021[25]
Eu opeanSocie ies
Q1
Geog aphy,Plan‐
ningandDe el‐
opmen
Uni edKingdom
n=3778male,o
which3337a eUK‐
bo nand441a e o ‐
eign‐bo n
COVID‐19su ey
iaweb‐based
ques ionnai es;
da a omUnde ‐
s andingSocie y—
heUKHousehold
Longi udinalSu ‐
eyand he i s
wowa es(Ap il
andMay2020)o
he
Men alwell‐being,
(Gene alHeal hQues‐
ionnai e—GHQ)
Solà‐Salese
al.,2021[28]Heal hca eQ2Leade shipand
Managemen Spain
n=245Spanishnon‐
mig an s,Spanish
mig an s,
non‐Spanishmi‐
g an sand e ugees
Face‐ o‐ aceo
ideocallin e ‐
iews
be weenJanua y
andMay2021,
‐Spanish
adap a iono heDe‐
p ession,Anxie yand
S essScale(DASS‐21);
Beha .Sci.2022,12,3937o 15
h oughasnowball
sampling
‐Spanishadap a iono
heB ie Resilien
CopingScale(BRCS),
‐A i udes owa d he
COVID‐19ou b eak
Spi i us‐
Bee dene
al.,2021[21]
In e na ionalJou ‐
nalo En i onmen‐
alResea chand
PublicHeal hQ1
Heal h,Toxicol‐
ogyandMu a‐
genesis
Eu opeanconso ‐
ium*
n=20,742 e ugees
andmig an pa ici‐
pan solde han16
yea sold(su ey e‐
sponden sli edin
170coun iesand
o igina ed om159
coun ies)
Quan i a i eonline
globals udy,as
pa o he
Apa Toge he
s udy, omAp il
2020un ilNo em‐
be 2020in37lan‐
guages
11men al‐heal h‐ e‐
la edi emsscale: eel‐
ingso dep ession,
anxie y,wo ies, eel‐
ingso loneliness,an‐
ge ,unpleasan e‐
minde so pas au‐
ma icexpe iences,
physical eac ions o
s ess, eelingso i i‐
a ion,hopelessness,
sleepingp oblems,
andsubs anceuse
*TheApa Toge he Conso iumincludesBelgium,Denma k,I eland,Uni edS a eso Ame ica,
Sweden,Uni edKingdomo G ea B i ain,andNo he nI eland,Po ugal,Spain,G eece,I aly,
and heNe he lands.
3.2.Coun y‐Le elEn i onmen
TheCOVID‐19pandemichasposednewchallenges osocie iesand hei heal hsys‐
ems.Theincludedpape smen ionase ieso unp eceden edin e en ionsimplemen ed,
ommino (maskwea ingandhandhygiene) omajo eadjus men s oe e ydayli e,
suchas he“lockdown”pe iods ha i s ookplaceinmanycoun iesbe weenMa ch
andJune2020 o educe hesp eado SARS‐CoV‐2in ec ion[31],wi hI alybeing he i s
Eu opeancoun y obeb u allyimpac ed[23].
P e en i eac ionsin ol edase ieso escala ing es ic ionsone e ydayli e,includ‐
inglimi a ionsonga he ings, a el es ic ions,andminimiza iono mo emen ou side
o hehouse,wi hse e alse icesclosedandsocialac i i iessuspended.Inaddi ion o
he emendousconsequences o heeconomy,socio‐economicinequali ieswe eexace ‐
ba eddu ing helockdown.TheUni edKingdomisamong hecoun ieswhe ep e‐ex‐
is ingsocioeconomicinequali iesha ebecomewo se hanbe o e hepandemicdue o he
adop edmeasu es[25].
Swi ze landwasamong hecoun iesmos apidlyandse e elya ec ed ela i e o
i ssize,wi hapeakincidenceo newposi i e es son30Ma ch2020,inGene a,whe e
undocumen edmig an s ep esen abou 2.5%o he500,000 esiden s.Thedu a iono
hepublicheal hlockdownmeasu espu mig an s,especiallyundocumen edmig an s,
a inc eased isko no beingable omee hei basicneeds[29].Whiles onglyexposed
o hedisease,somemig an sdidno ha esu icien in o ma ionabou hepandemicand
policymeasu es.Thiswas hecaseinF ance,e enwi hin o ma ioncampaignslaunched
oadd ess hespeci icneedso hispopula ion[30].Da a om heF enchNa ionalIns i‐
u eo S a is ics e ealed ha hemo ali y a ewas wiceashighamongimmig an sas
amongna i esdu ing he i s wa eo heCOVID‐19pandemicinAp ilandMa ch,and
amongimmig an s omsub‐Saha anA ica,excessmo ali ywases ima eda +114%
[30].
Inaddi ion osocialisola ion,COVID‐19hasdemandedpeopleadap ono elsi u‐
a ionsand u u eunce ain y,which ep esen edag ea psychologicalbu den.As udy
conduc edinPolandand heNe he lands oexplo een i onmen als essand hequali y
o li econnec edwi hCOVID‐19hasshowncul u aldi e encesbe ween he wocoun‐
ies, ha canbelinked o hego e nmen ’sc isismanagemen in hesecoun ies[27].
Anxie ydec easedin heg oupo na i eDu chci izensdu ing hepandemic,possibly
due o heDu chgo e nmen ’sposi i e ein o cemen (e.g., hepolicep aisedci izens o
Beha .Sci.2022,12,3938o 15
keepingadis anceo 1.5m,and ewe bans).Mo eo e , hesenseo hequali yo li e
inc easeddu ing hepandemicamongPolishimmig an s,e en hough heyhad hehigh‐
es in ensi yo ea andnega i e eelings.On hecon a y,anxie yinc easedamongPoles
li inginPoland,whichmay esul ommo e igid es ic ions(e.g.,wea ingmasks,in‐
oducing a iousbans,o high ines o non‐compliancewi h he ules).Ano he expla‐
na ioncanbe hee iciencyo heal hca ein heNe he lands,whileplanned isi s ospe‐
cialis swe esuspendedinPoland[27].
3.3.SocialDe e minan so Men alHeal h
Economics abili y(employmen ,income,housing, oodsecu i y)
O he11a iclesselec ed,sixp esen ed indingsoneconomicandlabo ins abili y
inmig an popula ionsdu ingCOVID‐19[21,23–25,29,30].
Socioeconomicissueslinked ounemploymen andimmig a ions a usunce ain y
inc eased he isko men alsu e ingdue o hepandemic[23].COVID‐19hasbeenim‐
pac ingdisp opo ionally hemos socially ulne ableg oups,whoa ea highe isko
expe iencingnega i emen alheal hou comes.Mig an s epo ingmos challengesinse‐
cu ingma e ialandmedicaldailyneeds,suchashousing,wo k, ood,andclo hesalso
epo edmo enega i emen alheal hou comes,includingmo e eelingso anxie yand
dep ession[21,30].
Mos mig an swo kinjobs(domes ico cons uc ionwo k) equi ing hei p esence,
whichadded o hei densehousingcondi ions,pu s hema highe isko in ec ion han
hegene alpopula ion,ac ossse e alse ings[24,29,30].Findings om heUKUnde ‐
s andingSocie yCOVID‐19longi udinalsu eyshowed ha mig an wo kingmenwe e
mo eeconomicallya ec ed han hei na i e‐bo ncoun e pa s,namelyin e mso losing
wo khou s,and ha hiswideningo hesocialandeconomicdi isionswas ollowedby
aninc easinggapinmen alwell‐being[25].
Socio‐demog aphiccha ac e is icso hemig an popula ions(gende ,age,e hnici y,
educa ion)
Gende di e encesinheal hou comesin hecon ex o COVID‐19we eobse edin
heselec eds udies.Mo anandcollabo a o sconcluded ha whilemenha eahighe isk
o COVID‐19mo ali yandse e i y, heindi ec consequenceso he i us end oimpac
mo ewomen,due o hei g ea e socioeconomic ulne abili y.Impac s ange omjob
andincomelosses oinc easinggende ‐based iolenceandmen alheal h.Howe e ,men
whoa ema ginalizedo indisad an agedposi ionsa ealsopa icula ly ulne able[31].
A agonae al.p esen ed henega i eimpac so heCOVID‐19lockdownonaccess
omen alheal hse icesandillus a edhow hep e‐pandemicsi ua iono ulne abili y
pu somesubg oupso hepopula ionmo ea isk,includingpeoplewi hlowe economic
s a us,homelessness,mig an s,andpa ien swi hmen alheal hdiso de s.Addi ionally,
someindi iduals allin ose e alo hesesubg oups, hus acingasigni ican lyhighe
isko nega i emen alheal hconsequences.InI aly, he ea einc easingcaseso asylum
seeke swhoseclaimhasbeen ejec ed ha a ewi hou documen s,wi hou jobs,home‐
less,andli inginpo e y.Thosemos ulne ablemig an salsoo enha esymp omso
pos ‐ auma ics essdiso de (PTSD)due o hei mig a o yexpe ience,aswellasde‐
p essi eandadjus men diso de s[22].
In heApa Toge he onlineglobalsu eyo e ugeesandmig an s,indi idualswi h
ci izenship epo ed heleas e ec o COVID‐19on hei men alheal h,compa ed o he
mos ulne ableg oupso mig an s(i.e., hoseli inginasylumcen e so on hes ee ,
hosewi hou documen so wi h empo a ydocumen s).Younge pa icipan salso e‐
po edalessnega i ee ec o COVID‐19on hei anxie yanddep ession,indica ingan
agee ec [21].
Beha .Sci.2022,12,3939o 15
Heal hca eaccessand ea men compliance
Mig an smo e equen ly acelimi edaccess omedicalca e,diminishing heodds
o seekingmedical ea men ea lyenough o educe henumbe o unde ec edcasesand
sel ‐isola ea home,whichmayaccele a e he ansmissiono hedisease.Inaddi ion,
du ing heCOVID‐19pandemic,access opublichospi alshasbeencon olledbysecu i y
s a ,wi h helikelyconsequence o epelundocumen edmig an s.Da asince hebegin‐
ningo heCOVID‐19c isisindica es ha undocumen edmig an sha elowe u iliza ion
o heal hca e,compa ed o egula izedmig an s.Addi ionally,poo men alheal hwas
ela ed o hea oidanceo heal hca e[22].
Du ing helockdown,pa ien s epo edba ie s omen alheal hca eaccess(al ‐
houghpsychia icca e emaineda ailableonline).Thispe cei eduna ailabili yo se ‐
icesdue o heCOVID‐19eme gencyisno only ela ed oa educ ionin henumbe o
pa ien sand ollow‐up isi sbu alsoin luenced ea men discon inua ion[22,23].
A agonae al.,in hei s udyo mig an sin ea men a anou pa ien depa men , e‐
po eda32%discon inua ion a ein hepsychopha macological ea men and52%in
psycho he apy ea men [23].
Addi ionally, hes udyinF ancehasshown ha hespeci icpolicymeasu esimple‐
men edby heF enchgo e nmen ,suchas he alidi yo all esidencepe mi sand he
S a eMedicalAid(heal hinsu ance o undocumen edpe sons),we eonlyacknowl‐
edgedbya ewmig an s.Howe e , ega dings a egies op ese eone’sheal h,ama‐
jo i ymen ionedusingba ie measu es(masks,handwashing,physicaldis ancing)[30].
3.4.Men alHeal hIndica o sandOu comes
Men aland amily‐ ela eddis ess
Amongindi idualsal eadyin ea men be o e hepandemic, he ewasaninc ease
in he equencyo psychicanxie y,dep essi esymp oms, eelingso ension/ne ous‐
ness,andsleepdiso de s, angingbe ween74%and91%,andincludinganxie yspeci i‐
cally ela ed o heco ona i us(e.g., ea o con amina ion).In e mso hee ec so he
lockdown,men alsymp omswe eunchangedo imp o edinmanypa ien s.Howe e ,
anxie yandne ousnesswe e epo edas hemos equen lywo senedsymp oms,bu
ne e abo e50%[23].
As udyo mino i ye hnicheal hca ewo ke shasshown eelingso anxie yabou
hewo kingcondi ionandabou amily,pa icula lyli inginsocialisola iondu ing
COVID‐19,wi hasigni ican impac on hei men alheal h[24].
As udywi h emalepsychia icpa ien salsohas oundg ea e amily‐ ela eddis‐
ess,includingmo ehousehold ension,mo ehousewo k,andmo edomes ic iolence,
especiallyamong hosewi hamig a ionbackg ound[31].
S igma iza ionanddisc imina iono ulne ableg oups
Since heea lies caseswe e epo edinChina,se e als udiesha ed awna en ion
o he iseo s igma iza ionand acismagains ChineseandAsianimmig an s.As he
s udyconduc edamongChineseimmig an sin heNe he landshasshown, hepandemic
andi ssocie aldynamicsha medmig an s’ iewso hei hos coun y.Besides eelings
o ea o COVID‐19, inancialconsequences,socialisola ion, eelingso los ime,missing
China,andpe cei ed a el es ic ions oChina,mo eexpe ienceso acismwe e e‐
quen ly epo ed[26].
O he esul sha eshown ha e ugeesandmig an swi hhighe pe cei eddisc im‐
ina ionle elssince hepandemicalso epo edwo semen alheal hou comes[21].
3.5.CopingBeha io s
TheGe mans udye alua ing heexpe ienceo hepandemicamongacoho o ou ‐
pa ien sa ala gepsychia icou pa ien ins i u ionmeasu ed hele elo dis esscon‐
ce ningCOVID‐19lockdownand oundinc easedconce nabou ela i es,anxie y,wo se
sleep,andmo ephysicalsymp oms,wi hasmallg oupalso epo inginc easedd ug
