Migrant Health

Since 1965 the foreign-born population of the United States has swelled from 9.6 million or 5 percent of the population to 45 million or 14 percent in 2015. Today, about one-quarter of the U.S. population consists of immigrants or the children of immigrants. Given the sizable representation of immigrants in the U.S. population, their health is a major influence on the health of the population as a whole. On average, immigrants are healthier than native-born Americans. Yet, immigrants also are subject to the systematic marginalization and discrimination that often lead to the creation of health disparities. To explore the link between immigration and health disparities, the Roundtable on the Promotion of Health Equity held a workshop in Oakland, California, on November 28, 2017. This summary of that workshop highlights the presentations and discussions of the workshop.

In this time of large-scale global migration at levels unrivalled since World War II, primary care practitioners are providing the first line of care to economic immigrants and refugees. In doing so, they face daily the considerable challenges that this heterogenic group brings in terms of communication, culture, and legal status as well as physical and mental health. This accessible book has been carefully crafted to enable primary health care professionals to develop the skills and competencies required to deliver appropriate services to this diverse group of patients and, in turn, to ensure equity in health care for all. Key features: Highly practical focus, with clinical cases, learning objectives, concept and ‘What this Means in Practice’ boxes, and ‘Practical Tools for Meeting the Patient’ sections Covers widely applicable themes in health care including health literacy, communication, the cultures and sub-cultures of systems Fully referenced, combining policy, academic literature and practical advice with a broad international scope Prestigious author team with chapters written by international contributors with in-depth subject expertise curated by expert editors Endorsed and supported by the WONCA Special Interest Group on Migrant Care, International Health and Travel Medicine The book satisfies the urgent need for a hands-on guide to support and help general practitioners and other members of the primary health care team improve their provision of care not only to immigrants, but to other vulnerable groups and the whole society.

Voluntary migrants to Canada are generally healthier than the average Canadian, but after ten years in the country they report poorer health and higher rates of chronic disease than those born here. Troublingly, women — particularly those from non-European countries — experience the most precipitous decline in health. What contributes to this deterioration, and how can its effects be mitigated? Engendering Migrant Health brings together researchers from across Canada to address the intersections of gender, immigration, and health in the lives of new Canadians. Focusing on the context of Canadian policy and society, the contributors illuminate migrants' testimonies of struggle, resistance, and solidarity as they negotiate a place for themselves in a new country. Topics range from the difficulties of Francophone refugees and the changing roles of fathers, to the experiences of queer newcomers and the importance of social unity to communal and individual health.

Bringing together diverse approaches and case studies of international health worker migration, Global Migration, Gender, and Health Professional Credentials critically reimagines how we conceptualize the transfer of value embodied in internationally educated health professionals (IEHPs). This volume provides key insights into the economistic and feminist concepts of global value transmission, the complexity of health worker migration, and the gendered and intersectional intricacies involved in the workplace integration of immigrant health care workers. The contributions to this edited collection uncover the multitude of actors who play a role in creating, transmitting, transforming, and utilizing the value embedded in international health migrants.

The provision of effective health care to linguistically and culturally diverse migrant populations has been identified as a crucial public health issue. This scoping review examines strategies which have been implemented and evaluated to address communication barriers experienced by refugees and migrants in health care settings across the WHO European Region. Four main types of strategy were identified: cultural mediation interpretation translation of health information and guidance and training for health care providers. These have been used to support access to health care management of specific diseases and promotion of health across a wide variety of health care settings. Intersectoral collaboration was seen as important in the development and implementation of strategies. Policy considerations include the development of national policies and the promotion of intersectoral dialogue to augment the knowledge base and resolve the common issues identified such as provision of training and confusion regarding the roles of mediators/interpreters that affect strategy implementation and evaluation.

Immigration and health care are hotly debated and contentious issues. Policies that relate to both issues—to the health of newcomers—often reflect misimpressions about immigrants, and their impact on health care systems. Despite the fact that immigrants are typically younger and healthier than natives, and that many immigrants play a vital role as care-givers in their new lands, native citizens are often reluctant to extend basic health care to immigrants, choosing instead to let them suffer, to let them die prematurely, or to expedite their return to their home lands. Likewise, many nations turn against immigrants when epidemics such as Ebola strike, under the false belief that native populations can be kept well only if immigrants are kept out. In The Health of Newcomers, Patricia Illingworth and Wendy E. Parmet demonstrate how shortsighted and dangerous it is to craft health policy on the basis of ethnocentrism and xenophobia. Because health is a global public good and people benefit from the health of neighbor and stranger alike, it is in everyone’s interest to ensure the health of all. Drawing on rigorous legal and ethical arguments and empirical studies, as well as deeply personal stories of immigrant struggles, Illingworth and Parmet make the compelling case that global phenomena such as poverty, the medical brain drain, organ tourism, and climate change ought to inform the health policy we craft for newcomers and natives alike.

Human migration is a global phenomenon and is on the increase. It occurs as a result of 'push' factors (asylum, natural disaster), or as a result of 'pull' factors (seeking economic or educational improvement). Whatever the cause of the relocation, the outcome requires individuals to adjust to their new surroundings and cope with the stresses involved, and as a result, there is considerable potential for disruption to mental health. This volume explores all aspects of migration, on all scales, and its effect on mental health. It covers migration in the widest sense and does not limit itself to refugee studies. It covers issues specific to the elderly and the young, as well as providing practical tips for clinicians on how to improve their own cultural competence in the work setting. The book will be of interest to all mental health professionals and those involved in establishing health and social policy.

The increasing number of refugees, asylum seekers, and irregular migrants poses a challenge for mental health services in Europe. This review found that these groups are exposed to risk factors for mental disorders before, during, and after migration. The prevalence of psychotic, mood, and substance-use disorders in these groups varies but overall resembles that in the host populations. Refugees and asylum seekers, however, have higher rates of post-traumatic stress disorder. Poor socioeconomic conditions are associated with increased rates of depression five years after resettlement. Refugees, asylum seekers, and irregular migrants encounter barriers to accessing mental health care. Good practice for mental health care includes promoting social integration, developing outreach services, coordinating health care, providing information on entitlements and available services, and training professionals to work with these groups. These actions require resources and organizational flexibility.