In recent years, issues with immigration have risen alongside bias within our institutions and problems with accessing healthcare for certain migrant populations. With investigation and research into the correlation between immigration status and access to adequate healthcare, the inadequate access and non-comfortability which these populations have with health care institutions is revealed. By showcasing the inequities, suggestions are aimed to reform our medical institutions in order to create a more equal and opportunistic medical environment.
Within this document the term immigrant may refer to labour migrants, refugees and asylum seekers, family members of existing migrants, victims of trafficking, returnees, people without a valid entry permit or residence permit or work permits, as well as those awaiting permits.
What ties immigration status and unequal health care together?
Though our current medical and health institutions are modernized and aimed to be unbiased based on gender, race, sexual orientation, and class, often there is a correlation found between a person’s immigration status and evidence of inequities in accessibility, quality of treatment, and the relationship between doctor and patient within our medical systems. According to the World Health Organization’s constitution of 1948, the world’s 1 billion immigrants today, including the 65 million immigrants who are forcibly displaced have the right “To enjoy the highest attainable standard of physical and mental health…“. Yet, migrants whether illegally or legally residing, are still faced with a lack of universal health coverage, causing excessive costs and degradation of personal health. Migrants as a population are more likely to develop chronic diseases than their host country, yet the care they receive is often only at the end stages of these illnesses or within an emergency situation due to linguistic, economic and bureaucratic barriers (BMJ, 2019).
With a more global population, quality healthcare and provisions for dealing with an increased potential for the spread of infectious diseases are needed as well as equal treatment of migrants. These provisions and changes to the medical systems fall under the accessibility, the quality, and the legality of healthcare, and aim to improve education on healthcare, proper resources dedicated and create an institution with unbiased care.
Historically, migrants have encountered barriers when it came to the accessibility of medical treatment and care. These barriers usually stem from institutional and financial causes, and as the situational report by the United Nations on international migration states, this can place migrants in a “double jeopardy situation” where migrants are more likely than non-migrants to be in need of these healthcare institutions, yet are unable to access them. Migrants also face social and cultural issues when obtaining information and understanding how the medical system of their country they are residing in works.
The institutional barriers include healthcare provisions unavailable to asylum seekers or refugees as well as healthcare unavailable to undocumented or illegal immigrants. Such rings true with a United Kingdom case cited in a 2008 bulletin posted by the World Health Organization, where the UK restricted access to certain migrants to ensure they were not entering only to access the free healthcare (WHO, 2008).
Educational and awareness barriers are also present as migrants may not be aware they have access to or what types of access to health care. This may be due to cultural, language, or bureaucratic barriers faced by the migrant communities.
Political Debates over the legality of migrant health care has come to fruition within the past decades. The concerns are focused primarily on taxpayers who will have to pay for the medical care of migrants, however, strong opposition to this claim has been made as legally, every person no matter their predisposition has the right to “a standard of living adequate for the health and well-being of himself and of his family…” (UN, 1948).
Where do we go from here:
Equal, accessible and quality health systems are needed in migrant populations. With awareness and platforms created on the issue such as the multiple World health organization backed investigations, and the United Nations investigations, the key now is to implement recommendations, programmes and especially policies. With credited research on the benefits of health care education for migrants and how a major downfall with current programmes is there is no channel for migrants to become educated on such things, it is clear education reigns as a key premise on the progression and development towards a clearer and greater healthcare system for migrants. These provisions dedicated to education will play a key role in defining a new pathway into the creation and change of policies regarding migrant healthcare.
As figure 1 shows, there are multiple ways in which we can start to change immigrant healthcare. One example already in practice is the Migrants Clinicians Network which aims to create practical solutions between healthcare, poverty and migration (MCN, 2017). Another example in practice is the Centre for Culture, Ethnicity and Health, in Melbourne Australia, which focuses on advising health care institutions on how to improve “access to health services for culturally diverse communities”. Demos Krouskos, the director of the centre, said: “Institutions have to be reformed on a philosophy of social inclusion.” (WHO, 2008) when discussing the need for social and cultural inclusivity of migrant health services. By choosing to promote these health education programs and centres, we are able to use the steps which are already in place, towards the equality of all peoples.
Alongside the use of programmes already in place, it is vital to extend the reach of these programmes and to implement new ones focused on policy and legal changes.
What are your thoughts?
Arie, Sophie. “Countries Must Do More to Help Migrants Access Healthcare, Says WHO.” The BMJ, British Medical Journal Publishing Group, 23 Jan. 2019, www.bmj.com/content/364/bmj.l354.
“Our Story.” Migrant Clinicians Network, 10 Nov. 2014, www.migrantclinician.org/about/our-story.
“Overcoming Migrants’ Barriers to Health.” Bulletin of the World Health Organization, World Health Organization, Aug. 2008, www.ncbi.nlm.nih.gov/pmc/articles/PMC2649480/.
“Refugee and Migrant Health.” World Health Organization, World Health Organization, 11 Jan. 2019, www.who.int/migrants/en/.
“Situation Report.” Barriers to Access to Health Services for Migrants | Situation Report, sitreport.unescapsdd.org/health/barriers-access-health-services-migrants.
“Social Determinants of Migrant Health.” International Organization for Migration, 9 Mar. 2017, www.iom.int/social-determinants-migrant-health.
“A Threat to Immigrant Healthcare with Potential Consequences for All.” Giving Compass, 24 Oct. 2018, givingcompass.org/article/a-threat-to-immigrant-healthcare-with-potential-consequences-for-all/.
“Universal Declaration of Human Rights.” United Nations, United Nations, www.un.org/en/universal-declaration-human-rights/index.html.