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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.
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.
Here is the first comprehensive cross-disciplinary work to examine the current health situation of our immigrants, successfully integrating the vast literature of diverse fields -- epidemiology, health services research, anthropology, law, medicine, social work, health promotion, and bioethics -- to explore the richness and diversity of the immigrant population from a culturally-sensitive perspective. This unequalled resource examines methodological issues, issues in clinical care and research, health and disease in specific immigrant populations, patterns of specific diseases in immigrant groups in the US, and conclusive insight towards the future. Complete with 73 illustrations, this singular book is the blueprint for where we must go in the future.
The adoption by WHO's Member States of the Global Code of Practice in the International Recruitment of Health Personnel, and the implementation of it by so many countries, represent two of the biggest steps in recent years towards solving the shortage of health-care workers around the world. The countries' response has been a momentous achievement. Now, a third big step is being taken with the publication of this book. It underlines WHO's unwavering commitment to supporting the implementation of the Code and provides a wide range of detailed examples from the countries themselves of how they are tackling the many complex issues involved. It provides not just numerous insights into progress but also gives other countries valuable guidance and recommendations on how they, too, can implement the Code. Countries are encouraged to learn from the shared experiences, domestic solutions and multi-lateral cooperation described in this book, and move ahead to support and advance the Code's aspirational principles. By doing so, they also strengthen the campaign towards Universal Health Care -- a campaign that requires innovative solutions to the health workforce shortage in order to be successful. The crux of the Code is the development of human resources for health through all aspects of education, improved retention and fair recruitment practices while encouraging technical collaboration and financial support. WHO is playing a leading role in these initiatives and stands ready to assist all its Member States in implementing the Code. We strongly recommend this book to health policy-makers and decision-takers in governments, nongovernmental organizations and other partners and stakeholders, including civil society. They will find it an indispensable guide to a better future for health-care personnel and the people they serve.
Immigrant children and youth are the fastest-growing segment of the U.S. population, and so their prospects bear heavily on the well-being of the country. Children of Immigrants represents some of the very best and most extensive research efforts to date on the circumstances, health, and development of children in immigrant families and the delivery of health and social services to these children and their families. This book presents new, detailed analyses of more than a dozen existing datasets that constitute a large share of the national system for monitoring the health and well-being of the U.S. population. Prior to these new analyses, few of these datasets had been used to assess the circumstances of children in immigrant families. The analyses enormously expand the available knowledge about the physical and mental health status and risk behaviors, educational experiences and outcomes, and socioeconomic and demographic circumstances of first- and second-generation immigrant children, compared with children with U.S.-born parents.
In their later years, Americans of different racial and ethnic backgrounds are not in equally good-or equally poor-health. There is wide variation, but on average older Whites are healthier than older Blacks and tend to outlive them. But Whites tend to be in poorer health than Hispanics and Asian Americans. This volume documents the differentials and considers possible explanations. Selection processes play a role: selective migration, for instance, or selective survival to advanced ages. Health differentials originate early in life, possibly even before birth, and are affected by events and experiences throughout the life course. Differences in socioeconomic status, risk behavior, social relations, and health care all play a role. Separate chapters consider the contribution of such factors and the biopsychosocial mechanisms that link them to health. This volume provides the empirical evidence for the research agenda provided in the separate report of the Panel on Race, Ethnicity, and Health in Later Life.
"This book can be read by anyone with an interest in migration and health, whether as an advocate for migrants health, as a student in a health profession, researcher or policy maker. It provides an ample orientation to the field in the European context. Among other important raised issues, it underlines an all too often neglected fact; health is a human right. By involving broad issues and problem areas from a variety of perspectives, the volume illustrates that migration and health is a field that can not be allocated to a single discipline." Carin Bjrngren Cuadra, Senior Lecturer, Malm University, Sweden Migrants make up a growing share of European populations. However, all too often their situation is compounded by problems with accessing health and other basic services. There is a need for tailored health policies, but robust data on the health needs of migrants and how best these needs can be met are scarce. Written by a collaboration of authors from three key international organisations (the European Observatory on Health Systems and Policies, the EUPHA Section on Migrant and Ethnic Minority Health, and the International Organization for Migration), as well as leading researchers from across Europe, the book thoroughly explores the different aspects of migration and health in the EU and how they can be addressed by health systems. Structured into five easy-to-follow sections, the volume includes: Contributions from experts from across Europe Key topics such as: access to human rights and health care; health issues faced by migrants; and the national and European policy response so far Conclusions drawn from the latest available evidence Comprehensive information on different aspects of health and migration and how they can best be addressed by health systems is still not easy to find. This book addresses this shortfall and will be of major value to researchers, students, policy-makers and practitioners concerned with migration and health in an increasingly diverse Europe.
What do undocumented migrants experience when they try to access healthcare? How do they navigate the (often contradictory) challenges presented by bureaucratic systems, financial pressures, attitudes to migrants, and their own healthcare needs? This urgent study uses a grounded theory approach to explore the ways in which undocumented migrants are included in or excluded from healthcare in a Swiss region. Marianne Jossen explores the ways migrants try to obtain healthcare on their own, with the help of NGOs or via insurance, and how they cope if they fail, whether by using risky strategies to access healthcare or leaving serious health issues untreated. Jossen shows that even for those who succeed, inclusion remains partial and fraught with risks. Based on interviews with migrants, health practitioners and NGO staff and using a rigorous academic approach, Undocumented Migrants and Healthcare is an important contribution to a vital contemporary issue. It is necessary reading for researchers in Public Health and Migration Studies, as well as government and non-governmental organisations in Switzerland and beyond. It will be of interest to anyone concerned with healthcare and migration in the twenty-first century.
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.
In our globalised world, where inequality is deepening and migration movements are increasing, states continue to maintain strong regulatory control over immigration, health and social policies. Arguments based on state sovereignty can be employed to differentiate irregular migrants from other groups and reduce their right to physical and mental health to the provision of emergency medical care, even where resources are available. Drawing on the enabling and constraining factors of human rights law and public health, this book explores the scope and limits of the right to health of migrants in irregular situations, in international and European human rights law. Addressing these peoples' health solely with an exceptional medical paradigm is inconsistent with the special attention granted to people in vulnerable situations and non-discrimination in human rights, the emerging rights-based approach to disability, the social priorities of public health and the interdependence of human rights.