Health and Social Effects of Migration

Equality, Equity and Policy: Health and Social Effects of Migration

©Rebecca Steinbach 2009, Margaret Eni-Olotu 2016

Migration

Migration is the permanent relocation of an individual from one country to another.

The number of international migrants has increased rapidly over recent years,
reaching 244 million in 2015. (UN Department of Economic and Social Affairs) There
are a variety of different reasons for migration, and migration is often split into two
categories - voluntary migration and forced migration. However, some reasons for
migration apply to both voluntary and forced migrants, therefore it is more useful to
think of reasons for migration in two categories: ‘push’ and ‘pull’ (see Table 1). Push
factors drive a migrant out of their country of origin while pull factors attract
migrants towards a particular destination country.

Table 1: Push and pull factors

Push Factors Pull Factors

war
poverty employment opportunities
hunger political and religious
environmental or natural freedom
disasters study/academic opportunities
political instability family members
discrimination quality of life
economic depression

Migrants are a diverse group (e.g. economic migrants, students, refugees, asylum
seekers) and therefore the relationship between health and migration is complex. On
the one hand, there is a social selection involved in migration (known as the ‘healthy
migrant’ effect), since migrants are often younger and healthier compared to both
their population of origin and people from the host country of a similar ethnicity.
Most evidence of the healthy migrant effect comes from North America, where
researchers have found that migrants have a health advantage, which diminishes as
individuals become more assimilated into the host society. On the other hand, the
migration process may involve a number of stressors and strains that may increase
migrants’ morbidity in several ways (figure 1).
Figure 1: The influence of the migration process on migrant’s morbidity

Source: Kristiansen et al, 2007

Conditions affecting health in the country of origin and during the journey may
include war, torture, loss of relatives, long stays in refugee camps (which may have
poor sanitation and overcrowding), imprisonment, and socioeconomic hardship.
After arriving in the host country migrants may experience imprisonment, long-
lasting asylum seeking processes, language barriers, lack of knowledge about health
services, loss of social status, discrimination and marginalisation.

Kristiansen and colleagues (2007) note that coping with a new language, as well as a
new political and social context can be extremely stressful. The effect of migration on
the mental health of individuals depends on the magnitude of strains in the recipient
country and can be mediated by the migrant’s social resources (i.e. social networks,
language skills, education level, etc.).

Migration may also affect risk perception and risk behaviour. Feelings of loss and
psycho-social issues related to lower social positions, unemployment and being in a
minority may lead to a feeling of lack of connection between current risk behaviour
and future health effects (i.e. migrants may be forced to focus on their current
feelings rather than the future health effects of their current health behaviour). For
example, a new migrant, separated from friends and family in an urban
environment (feeling more anonymous and less constrained by social norms) may
turn to prostitution or drugs as a way to escape loneliness, frustration and social
isolation.

Migration also has health implications for the country migrants have left.
Individuals who emigrate for economic opportunities may cause a ‘brain drain’ in
their country of origin, when a large number of individuals with technical skills or
knowledge leave, potentially depleting the local infrastructure. This particularly
affects healthcare because there are often economic incentives for healthcare
professionals to migrate. The World Health Organisation (WHO) has long
recognised that migration of health personnel from developing to developed
countries increases the existing imbalances in the global health workforce and can
cause deficiencies in local provision of services in developing countries (Mejia et al,
1979). This migration is often demand-led when developed countries experience
shortages in medical professionals. Hagopian et al (2004) estimate that 23% of
American physicians received their medical training outside the USA. The majority
of foreign trained physicians (64%) in the USA came from middle or low-income
countries. In the UK, 31% of doctors and 13% of nurses were born overseas
(Glover et al, 2001). While countries of origin may benefit from some remittances
(e.g. migrant’s wages sent back), the adverse implications for developing countries
greatly outweigh these relatively small benefits. To address the problem of brain
drain, Pang and colleagues (2002) recommend “a global perspective, agreed ethical
principles between countries, and a systematic approach using the convening power
of international organisations.”

Finally, there are health implications of migration in the host (destination) country.
Some host countries are worried about the presence of infectious diseases in
migrants, and screening of migrants (though a contentious human rights issue) has
been adopted, to varying degrees, by several countries throughout the world
(Patterson, 2003). While some migrants may be generally healthier than the
population (i.e. the ‘healthy migrant’ effect), other migrants may have pre-existing
health conditions that can strain local health care systems. For example, increasing
retirement migration (where older adults, who often require more health care,
migrate to warmer destinations - e.g. Spain, Florida), can present a challenge for
recipient health care systems.

Source: Health Knowledge

https://www.healthknowledge.org.uk/public-health-textbook/medical-sociology-policy-
economics/4c-equality-equity-policy/migration