Exploring correlates of depression, quality of life and alcohol misuse: a nationwide cross-sectional study of international migrants during the COVID-19 epidemic in China

OBJECTIVES: The COVID-19 pandemic has overwhelmed health systems globally. With the increase of global migration, quantifying the health needs and key correlates of these outcomes is a global health priority. This study assessed migration characteristics, COVID-19 attitudes and the postmigration social environment as key correlates of depression, quality of life and alcohol misuse among international migrants in China. DESIGN: A nationwide cross-sectional online survey was conducted from 17 February and 1 March 2020. SETTING: Links to the online survey were disseminated by migrant-focused community-based organisations through WeChat. PARTICIPANTS: English speaking international migrants who met the inclusion criteria. Inclusion criteria were being born in a country outside of China, aged 18 years or over, cumulatively living in China for 1 month or more and staying in China between December 2019 and February 2020. OUTCOME MEASURES: Depression, quality of life and alcohol misuse. RESULTS: Regression models indicated that planning or considering leaving China due to COVID-19, lacking the confidence to protect themselves and not being confident that the epidemic would end soon was associated with greater depression, lower quality of life and greater levels of alcohol misuse. Worry about contracting COVID-19 and feeling helpless to prevent infection were associated with greater depression and lower quality of life. General perceived social support, and trust in Chinese people, institutions and systems were protective factors for depression and associated with higher reported quality of life. CONCLUSIONS: This study identifies key correlates that, if adequately addressed through public health outreach, may safeguard migrant well-being during a public health emergency. Trust in people and systems within the postmigration environment is an important consideration for future public health planning efforts.