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International Journal of Public Health

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01-09-2019 | Post-Traumatic Stress Disorder | Original article

Gender differences in the association of living and working conditions and the mental health of trafficking survivors

Authors: Lisbeth Iglesias-Rios, Siobán D. Harlow, Sarah. A. Burgard, Ligia Kiss, Cathy Zimmerman

Published in: International Journal of Public Health | Issue 7/2019

Abstract

Objectives

To assess the association of living and working conditions experienced during trafficking with mental health of female and male survivors.

Methods

We analyzed a cross-sectional study of 1015 survivors who received post-trafficking services in Cambodia, Thailand, and Vietnam. Modified Poisson regression models were conducted by gender to estimate prevalence ratios.

Results

For females, the elevated prevalence of anxiety, depression, and post-traumatic stress disorder (PTSD) symptoms was associated with adverse living conditions, while for males the prevalence of anxiety (PR = 2.21; 95% CI 1.24–3.96) and depression (PR = 2.63; 95% CI 1.62–4.26) more than doubled and almost tripled for PTSD (PR = 2.93; 95% CI 1.65–5.19) after adjustment. For males in particular, excessive and extreme working hours per day were associated with more than a four- and threefold greater prevalence of PTSD. Being in a detention center or jail was associated with all three mental health outcomes in males.

Conclusions

Providers and stakeholders need to consider the complex mental health trauma of the differential effects of living and working conditions for female and male survivors during trafficking to support treatment and recovery.

Afonso P, Fonseca M, Pires J (2017) Impact of working hours on sleep and mental health. Occup Med 67:377–382. https://doi.org/10.1093/occmed/kqx054 CrossRef

American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders: DSM-IV, 4th edn. DC, Washington

Boschman JS, van der Molen HF, Sluiter JK, Frings-Dresen MHW (2013) Psychosocial work environment and mental health among construction workers. Appl Ergon 44:748. https://doi.org/10.1016/j.apergo.2013.01.004 CrossRefPubMed

Cohen S, Janicki-Deverts D, Miller GE (2007) Psychological stress and disease. JAMA 298:1685–1687. https://doi.org/10.1001/jama.298.14.1685 CrossRefPubMed

Commission on the Social Determinants of Health (2008) Closing the gap in a generation: health equity through action on the social determinants of health. Final report of the Commission on Social Determinants of Health. World Health Organization, Geneva

Evans GW, Cohen S (1987) Environmental stress. In: Stokols D, Altman I (eds) Handbook of environmental psychology, vol 1. Wiley, Hobobken, pp 571–610

Evans GW, Wells NM, Chan H-YE, Saltzmand H (2000) Housing quality and mental health. J Consult Clin Psychol 68(3):526–530CrossRefPubMed

Hossain M, Zimmerman C, Abas M, Light M, Watts C (2010) The relationship of trauma to mental disorder among trafficked and sexually exploited girls and women. Am J Public Health 100:2442–2449. https://doi.org/10.2105/AJPH.2009.173229 CrossRefPubMedPubMedCentral

Iglesias-Rios L, Harlow DS, Burgard AS, Kiss L, Zimmerman C (2018) Mental health, violence and psychological coercion among female and male trafficking survivors in the greater Mekong sub-region: a cross-sectional study. BMC Psychol 6(56):15. https://doi.org/10.1186/s40359-018-0269-5 CrossRef

International Labour Office (2005) Report III (Part 1B)-General survey of the reports concerning the hours of work (industry) convention, 1919 (No. 1), and the hours of work (commerce and offices) convention, 1930 (No. 30). In: 93rd session. Geneva

International Labour Office (2017) Global estimates of modern slavery: forced labour and forced marriage. Geneva

Keller AS, Rosenfeld B, Trinh-Shevrin C, Meserve C, Sachs E, Leviss JA (2003) Mental health of detained asylum seekers. The Lancet 362(9397):1721–1723. https://doi.org/10.1016/S0140-6736(03)14846-5 CrossRef

Kiss L, Pocock NS, Naisanguansri V, Suos S, Dickson B, Thuy D, Koehler J, Pongrunqsee N, Nguyen VA, Borlans R, Dhavan P, Zimmerman C (2015a) Health of men, women, and children in post-trafficking services in Cambodia, Thailand, and Vietnam: an observational cross-sectional study. Lancet Glob Health 3(3):e154–e161. https://doi.org/10.1016/S2214-109X(15)70016-1 CrossRefPubMed

Kiss L, Yun K, Pocock N, Zimmerman C (2015b) Exploitation, violence, and suicide risk among child and adolescent survivors of human trafficking in the Greater Mekong Subregion. JAMA pediatr 169:e152278–e152278. https://doi.org/10.1001/jamapediatrics.2015.2278 CrossRefPubMed

Kleijn WC, Hovens JE, Rodenburg JJ (2001) Posttraumatic stress symptoms in refugees: assessments with the Harvard Trauma Questionnaire and the Hopkins symptom checklist-25 in different languages. Psychol Rep 88(2):527–532. https://doi.org/10.2466/PR0.88.2.527-532 CrossRefPubMed

Kristen E, Banuelos B, Urban D (2015) Workplace violence and harassment of low-wage workers. J Employ Lab Law 36:169–214

Labour Department Hong Kong (2012) Report of the policy study on standard working hours. The government of the Hong Kong special administrative region. https://www.labour.gov.hk/eng/plan/pdf/whp/swh_report.pdf. Accessed 13 Dec2018

Lipscomb HJ, Dement JM, Epling CA, Gaynes BN, McDonald MA, Schoenfisch AL (2007) Depressive symptoms among working women in rural North Carolina: a comparison of women in poultry processing and other low-wage jobs. Intern J Law Psychiat 30(4):284–298. https://doi.org/10.1016/j.ijlp.2007.06.003 CrossRef

Malhotra R, Arambepola C, Tarun S, de Silva V, Kishore J, Ostbye T (2013) Health issues of female foreign domestic workers: a systematic review of the scientific and gray literature. Intern J Occup Environ Health 19(4):261–277. https://doi.org/10.1179/2049396713Y.0000000041 CrossRef

Mollica RF, Wyshak G, de Marneffe D, Khuon F, Lavelle J (1987) Indochinese versions of the Hopkins Symptom Checklist-25: a screening instrument for the psychiatric care of refugees. Am J Psych 144(4):497–500. https://doi.org/10.1176/ajp.144.4.497 CrossRef

Mollica RF, Donelan K, Tor S, Lavelle J, Elias C, Frankel M, Blendon RJ (1993) The effect of trauma and confinement on functional health and mental health status of cambodians living in Thailand–Cambodia border camps. JAMA 270(5):581–586. https://doi.org/10.1001/jama.1993.03510050047025 CrossRefPubMed

Mollica RF, Caspi-Yavin Y, Lavelle J, Tor S, Yang T, Chan S et al (1996) Harvard Trauma Questionnaire (HTQ) Manual: Cambodian, Lao, and Vietnamese Versions. Torture 1(Suppl):19–42

Ottisova L, Hemmings S, Howard LM, Zimmerman C, Oram S (2016) Prevalence and risk of violence and the mental, physical and sexual health problems associated with human trafficking: An updated systematic review. Epidemiol Psych Sci 25:317–341. https://doi.org/10.1017/S204579601600013 CrossRef

Pearson E, Punpuing S, Jampaklay A, Kittisuksathit S, Prohmmo A (2006) The Mekong challenge: underpaid, overworked and overlooked: The realities of young migrant workers in Thailand (vol 1). International Programme on the Elimination of Child Labor. International Labor Organization. https://www.ilo.org/wcmsp5/groups/public/—asia/—ro-bangkok/documents/publication/wcms_bk_pb_67_en.pdf. Accessed 12 Sept 2018

Silove D (1999) The psychosocial effects of torture, mass human rights violations, and refugee trauma: Toward an integrated conceptual framework. J Nerv Ment Dis 187(4):200–207. https://doi.org/10.1097/00005053-199904000-00002 CrossRefPubMed

Song SJ, Subica A, Kaplan C, Tol W, de Jong J (2018) Predicting the mental health and functioning of torture survivors. J Nerv Ment Dis 206(1):443–462. https://doi.org/10.1097/NMD.0000000000000678 CrossRef

Stansfeld S, Candy B (2006) Psychosocial work environment and mental health—a meta-analytic review. Scand J Work Environ Health 32(6):443. https://doi.org/10.5271/sjweh.1050 CrossRefPubMed

Tsutsumi A, Izutsu T, Poudyal AK, Kato S, Marui E (2008) Mental health of female survivors of human trafficking in Nepal. Soc Sci Med 66(8):1841–1847. https://doi.org/10.1016/j.socscimed.2007.12.025 CrossRefPubMed

United Nations Office on Drugs and Crime (2004) United nations convention against transnational organized crime and the protocols Thereto: Protocol to prevent, supress, and punish trafficking in persons, especially women and children, supplementing the United Nations convention against transnational organized crime. United Nations. https://www.unodc.org/documents/middleeastandnorthafrica/organised-crime/UNITED_NATIONS_CONVENTION_AGAINST_TRANSNATIONAL_ORGANIZED_CRIME_AND_THE_PROTOCOLS_THERETO.pdf. Accessed 12 Sept 2018

Virtanen M, Ferrie JE, Singh-Manoux A, Shipley MJ (2011) Long working hours and symptoms of anxiety and depression: a 5-year follow-up of the Whitehall II study. Psychol Med 41(12):2485–2494. https://doi.org/10.1017/S0033291711000171 CrossRefPubMed

Wieclaw J, Agerbo E, Mortensen PB, Burr H, Tüchsen F, Bonde JP (2006) Work related violence and threats and the risk of depression and stress disorders. J Epidemiol Commun H 60(9):771–775. https://doi.org/10.1136/jech.2005.042986 CrossRef

Wong DFK, Chang Y-L (2010) Mental health of Chinese migrant workers in factories in Shenzhen, China: effects of migration stress and social competence. Soc Work Ment Health 8(4):305–318. https://doi.org/10.1080/15332980903217768 CrossRef

Woo JM, Postolache Τ (2008) The impact of work environment on mood disorders and suicide: evidence and implications. Int J Disabil Hum Dev 7(2):185–200. https://doi.org/10.1515/IJDHD.2008.7.2.185 CrossRefPubMedPubMedCentral

World Health Organization (2000) Mental health and work: impact, issues and good practices. Mental Health Policy and Service Development Department of Mental Health and Substance Dependence Noncommunicable Diseases and Mental Health. Accessed 07 Sept 2019

World Health Organization (2014) Social determinants of mental health. World Health Organization. http://apps.who.int/iris/bitstream/handle/10665/112828/9789241506809_eng.pdf;jsessionid=B3F9608248C016ED54CBF81734DEB03E?sequence=1. Accessed 05 Sept 2018

Yelland LN, Salter AB, Ryan P (2011) Performance of the modified poisson regression approach for estimating relative risks from clustered prospective data. Am J Epidemiol 174(8):984–992. https://doi.org/10.1093/aje/kwr183 CrossRefPubMed

Zimmerman C, Kiss L, Pocock N, Naisanguansri V et al. (2014) Health and human trafficking in the greater Mekong subregion: findings from a survey of men, women and children in Thailand, Cambodia and Vietnam. London School of Hygiene and Tropical Medicine & International Organization for Migration. http://publications.iom.int/system/files/pdf/steam_report_mekong.pdf. Accessed 17 June 2018

Zimmerman C, Schenker MB (2014) Human trafficking for forced labour and occupational health. Occup Enviro Med 71(12):807–808. https://doi.org/10.1136/oemed-2014-102452 CrossRef

Zimmerman C, Watts C. (2003)WHO ethical and safety recommendations for interviewing trafficked women. Reprod Health Matters, pp 1–29. http://apps.who.int/iris/handle/10665/42765. Accessed 15 May 2019

Zimmerman C, Hossain M, Yun K, Roche B, Morison L, Watts C (2006) Stolen smiles: a summary report on the physical and psychological health consequences of women and adolescents trafficked in Europe. The London School of Hygiene & Tropical Medicine, p 23

Zimmerman C, Hossain M, Yun K, Gajdadziev V, Guzun N, Tchomarova M et al (2008) The health of trafficked women: a survey of women entering posttrafficking services in Europe. Am J Public Health 98(1):55–59. https://doi.org/10.2105/AJPH.2006.108357 CrossRefPubMedPubMedCentral

Zou G (2004) A modified poisson regression approach to prospective studies with binary data. Am J Epidemiol 159(7):702–706. https://doi.org/10.1093/aje/kwh090 CrossRefPubMed

Title: Gender differences in the association of living and working conditions and the mental health of trafficking survivors
Authors: Lisbeth Iglesias-Rios
Siobán D. Harlow
Sarah. A. Burgard
Ligia Kiss
Cathy Zimmerman
Publication date: 01-09-2019
Publisher: Springer International Publishing
Keywords: Post-Traumatic Stress Disorder
Affective Disorder
Affective Disorder
Anxiety
Published in: International Journal of Public Health / Issue 7/2019
Print ISSN: 1661-8556
Electronic ISSN: 1661-8564
DOI: https://doi.org/10.1007/s00038-019-01269-2

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Gender differences in the association of living and working conditions and the mental health of trafficking survivors

Abstract

Objectives

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

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