Migrant Groups and Health: Issues and Trends in Europe

1. Laboratoire d’Anthropologie des Mondes Contemporains Migrant Groups and Health: Issues and Trends in Europe Raluca Nagy Healthy & Wealthy Together First Transnational Workshop

2. Laboratoire d’Anthropologie des Mondes Contemporains Short introduction to migration 1965 - 75 million migrants 2002 - 175 million migrants Stillunder 10 % of the total population last 30 years - global dimension large and irregular transnational fieldworks change of terminology: immigrants → migrants, third country nationals (TCN), etc. Healthy & Wealthy Together First Transnational Workshop

3. Laboratoire d’Anthropologie des Mondes Contemporains We don’t know much number duration remittances small studies, questions added to other data collection exercises more data available on migration as flow, easier to collect settled migrants, second and third generation mixed within the host country data internal EU migration – partial data follows the person from one country to another gaps in information about the impact of culture and religion on health beliefs difficult to avoid protect confidentiality – increased stigmatisation Healthy & Wealthy Together First Transnational Workshop

4. Laboratoire d’Anthropologie des Mondes Contemporains EU, from and to Moroccan - Spain, Belgium, France, Italy Ukrainian - Czech Republic, Spain, Portugal Chinese – Spain, United Kingdom Indian - United Kingdom Bolivian - Spain Albanian – Greece, Italy American (United States) Turkish – Germany, Austria, France, the Netherlands Brazilian - Spain Russian – Finland, Latvia Romanian – Italy, Spain (Eurostat, 2008) Healthy & Wealthy Together First Transnational Workshop

5. Laboratoire d’Anthropologie des Mondes Contemporains Categories Permanent residents / legally-residing migrants, guestworkers, workers, expats, etc. Irregular (rather than illegal) / Undocumented / no Visa migrants Education migrants Forced migrants Refugees Asylum Seekers Refused Asylum Seekers Healthy & Wealthy Together First Transnational Workshop

6. Laboratoire d’Anthropologie des Mondes Contemporains Migrants’ access to welfare – EU budgeting Y = generally available ? = wide variation and / or doubt N = generally not available Healthy & Wealthy Together First Transnational Workshop

7. Laboratoire d’Anthropologie des Mondes Contemporains Migrants and health All EU Member States - the right of everyone to the “highest attainable standard of physical and mental health”Council of Europe - Programme of Community Action in the Field of Health 2008–2013From theory to practice: low access, lack of information and regulation migrants: irregular status, lack of health insurance, fear of being reported healthcare systems: bureaucratic procedures, discrimination, language barriers, lack of interpretation services , lack of appropriately trained health professionals (e.g. TB) Healthy & Wealthy Together First Transnational Workshop

8. Laboratoire d’Anthropologie des Mondes Contemporains Main areas of consultation Infectious diseases:Sexual health issues (STD / STI – sexually transmitted diseases / infections, HIV / AIDS, Hepatitis C, etc.)Communicable Diseases (TB - tuberculosis)Women, children, maternity careDependence on drugs, alcohol or other substancesChronic diseases (diabetes, cardiovascular diseases, weight-related disorders, etc.)Mental health Healthy & Wealthy Together First Transnational Workshop

9. Laboratoire d’Anthropologie des Mondes Contemporains Infectious diseases UK - 70% newly diagnosed TB and HIV in people born outside the UK (HPA, 2006)Pre-entry countries where prevention and control is inadequate higher risk of exposure lower childhood vaccination programmes outbreaks of childhood diseases (controlled in the EU)Post-entry vulnerable to diseases in host country but also food, climate, etc. poor living conditions: overcrowded housing, domestic accidentspoorworking conditions / high risk sectors: construction and agriculture unfamiliarity with safe use of equipment / inadequate trainingStigma and discrimination prevent migrants from seeking screening, counselling or testing Healthy & Wealthy Together First Transnational Workshop

10. Laboratoire d’Anthropologie des Mondes Contemporains HIV / AIDS 2005 - 45% heterosexually acquired HIV infection in Western Europe involved migrants from high prevalence countries (EuroHIV, 2006).Spain, increased HIV among migrant women involved in sex work is changing the epidemiological profile of the disease UK, 70% of HIV incidence is accounted for by migrantsBelgium, more than 50% of all reported HIV cases are TCN France, reported AIDS cases among migrants increased by 20% (1999 to 2004)TCNs are disproportionately represented in HIV statistics in the Netherlands, Germany, Sweden, Ireland, Spain and Italy Healthy & Wealthy Together First Transnational Workshop

11. Laboratoire d’Anthropologie des Mondes Contemporains Childhood diseases Difficult to measure, except general tendency of decreased vaccination: parents choose not to have their children vaccinated (adverse effects, increase immunity system, etc.) migrant parents often unaware of these services or unwilling to use them for cultural, religious or other reasons Healthy & Wealthy Together First Transnational Workshop

12. Laboratoire d’Anthropologie des Mondes Contemporains Women’s health, maternity care Feminisation of migration - double discriminationeconomic - human rights abuses gender - ethnic origin in host society – in migrant community - protection from violence- access to medical care- education for children and themselves- access labour market, equal treatment for working conditions- forced marriage, polygamy, honour crimes, genital mutilation, sex trade- access to family planning education and maternity servicesSpouses of migrants (family reunion) – disempowered child benefit, social welfare, health and other services social isolation, no support (family) networks Healthy & Wealthy Together First Transnational Workshop

13. Laboratoire d’Anthropologie des Mondes Contemporains Mental health Psychological / mental health may be affected by :leaving family and home countrypermanent stress and pressure labour and economic insecurity coping with time-related insecurity administrative and legal issuesunfamiliar language, cultural and social marginalisationclimate: e.g. brightness, temperature, etc. Healthy & Wealthy Together First Transnational Workshop