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The years 2014 and 2015 saw a dramatic rise in the number of migrants entering Europe via the Mediterranean. This rise was mostly accounted for by refugees fleeing the civil war in the Syrian Arab Republic. Since that time Europe has been gripped in a political and humanitarian crisis as the incoming numbers overwhelmed individual state and collective European Union ability to respond effectively. In this article, I explore the European Migrant Crisis in geographical, political and humanitarian perspectives, describing and explaining the key events of the crisis. I then go on to a study of the major health issues arising from the crisis in terms of communicable and non-communicable disease, mental health, gender-related health and access to healthcare. Finally, I discuss the global dimensions of the refugee crisis and enter into a discussion of the roles and effectiveness of the UNHCR and the European Union's response as a whole.

Background: It is not well understood how economic crises affect infectious disease incidence and prevalence, particularly among vulnerable groups. Using a susceptible-infected-recovered framework, we systematically reviewed literature on the impact of the economic crises on infectious disease risks in migrants in Europe, focusing principally on HIV, TB, hepatitis and other STIs., Methods: We conducted two searches in PubMed/Medline, Web of Science, Cochrane Library, Google Scholar, websites of key organizations and grey literature to identify how economic changes affect migrant populations and infectious disease. We perform a narrative synthesis in order to map critical pathways and identify hypotheses for subsequent research., Results: The systematic review on links between economic crises and migrant health identified 653 studies through database searching; only seven met the inclusion criteria. Fourteen items were identified through further searches. The systematic review on links between economic crises and infectious disease identified 480 studies through database searching; 19 met the inclusion criteria. Eight items were identified through further searches. The reviews show that migrant populations in Europe appear disproportionately at risk of specific infectious diseases, and that economic crises and subsequent responses have tended to exacerbate such risks. Recessions lead to unemployment, impoverishment and other risk factors that can be linked to the transmissibility of disease among migrants. Austerity measures that lead to cuts in prevention and treatment programmes further exacerbate infectious disease risks among migrants. Non-governmental health service providers occasionally stepped in to cater to specific populations that include migrants., Conclusions: There is evidence that migrants are especially vulnerable to infectious disease during economic crises. Ring-fenced funding of prevention programs, including screening and treatment, is important for addressing this vulnerability., (© The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association.)

Background: Populations in Europe are becoming increasingly ethnically diverse, and health risks differ between ethnic groups. The aim of the HELIUS (HEalthy LIfe in an Urban Setting) study is to unravel the mechanisms underlying the impact of ethnicity on communicable and non-communicable diseases., Methods/design: HELIUS is a large-scale prospective cohort study being carried out in Amsterdam, the Netherlands. The sample is made up of Amsterdam residents of Surinamese (with Afro-Caribbean Surinamese and South Asian-Surinamese as the main ethnic groups), Turkish, Moroccan, Ghanaian, and ethnic Dutch origin. HELIUS focuses on three disease categories: cardiovascular disease (including diabetes), mental health (depressive disorders and substance use disorders), and infectious diseases. The explanatory mechanisms being studied include genetic profile, culture, migration history, ethnic identity, socio-economic factors and discrimination. These might affect disease risks through specific risk factors including health-related behaviour and living and working conditions. Every five years, participants complete a standardized questionnaire and undergo a medical examination. Biological samples are obtained for diagnostic tests and storage. Participants' data are linked to morbidity and mortality registries. The aim is to recruit a minimum of 5,000 respondents per ethnic group, to a total of 30,000 participants., Discussion: This paper describes the rationale, conceptual framework, and design and methods of the HELIUS study. HELIUS will contribute to an understanding of inequalities in health between ethnic groups and the mechanisms that link ethnicity to health in Europe.

Objectives: Roma health issues are under-studied from a comprehensive, epidemiological perspective. The Roma peoples (including 'Travellers') have been living in and around Central and Eastern Europe for centuries, and may be one of the oldest systematically oppressed minority groups in Europe. This review examines the research literature in regard to the health and epidemiology of this group with the aim of examining the breadth and depth of the literature and reflecting on the primary and applied research needed to address the health needs of Roma groups., Design: Internet, database and ancestral searches were conducted via such electronic databases as Medline and PubMed. Ancestral searches involved consulting previous literature reviews in select topical areas and obtaining all appropriate, primary literature. The time parameters of the search began with the year 1990 to current but was later expanded to 1985-2003 in order to capture slightly older published work., Results: This paper describes what is known concerning Roma health via a review of the published studies, with special emphasis on population health and epidemiological studies. One hundred and twenty-nine articles are reviewed and discussed. The majority of research (50%) examines the genetic characteristics of this group., Conclusions: Surveillance and population health indices for this international minority population is scarce to lacking in the published literature. Concluding comments focus on the unique character of the study population and the need for scientific studies of Roma health issues and the cultural concerns which might affect them.

The purpose of this review is to identify complex genetic diseases that might be common in Polynesian ethnic groups because of a high frequency of susceptibility genes. Since a number of Polynesian ethnic groups are descended from recent founder populations, they may be especially suitable for studies designed to identify these genes. We have reviewed the epidemiological literature looking for diseases that i) have a higher frequency in at least two Polynesian groups than in Europeans living in the same geographic areas, ii) are not at high frequency in Polynesia entirely because of high levels of known environmental risk factors, and iii) are known to be inherited in other ethnic groups. Twenty-one diseases fulfilling these three criteria were identified. It may be possible to design studies to identify the genes that cause these diseases in Polynesian ethnic groups.