Have We Been Measuring Migrant Wellbeing all Wrong? Conceptualizing Migrant Wellbeing: A Systematic Review.

Wellbeing is a widely used concept yet lacks a universal definition and standardized measurement. Migrants, especially those forcibly displaced, face challenges that impact their quality of life and wellbeing. To understand how the wellbeing of people who migrate from low/middle-income countries to middle/high-income countries has been conceptualized, defined, and measured. Four databases (MEDLINE, PubMed, EMBASE, and PsycINFO) were searched. Two researchers independently screened all articles, with narrative synthesis and the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) checklist used for analysis. The search returned 5,610 articles, with 126 included in this review. Of these 126 articles, 89 did not explicitly define nor conceptualise wellbeing. Forty-three measurement tools were used to measure the wellbeing of 281,478 migrants in more than 35 countries. Seven tools were used in three or more articles, two of which were not specifically designed for wellbeing measurement. Two tools Personal Wellbeing Index (PWI) and WHO Quality of life Brief (WHOQoL-BREF) had satisfactory COSMIN scores. Fewer than half (47.6%) of the articles reported translating tools into respondents' languages. Tools designed and developed in the context of Global North, middle-class populations, might not accurately measure wellbeing in migrant groups. This review highlights critical gaps in the way migrant wellbeing is measured. Without culturally informed tools, understanding of migrant wellbeing will remain fragmented, limiting development of effective and equitable public health interventions and policies.