Monday, October 19, 2009

[EQ] Migration and health - Challenges and trends

Migration and health
Challenges and trends

Norwegian Directorate of Health, 2009

Available online as PDF file [96p.] at:
http://www.helsedirektoratet.no/vp/multimedia/archive/00133/Migration_and_healt_133289a.PDF

 

“………. Migration has been a phenomenon throughout the ages. The reasons for migration across national borders are many and complex: fleeing war, persecution and disasters are among the key reasons, but the vast majority of migrants move in order to find work or obtain education. Many migrants also seek to be reunited with family members who emigrated before them. Migration challenges society, offers new opportunities and contributes to diversity and change. For many, migration brings positive outcomes and opportunities for a better life.….

 

People lead transnational lives. People’s identities break away from the single national identity, and many individuals have and seek to form strong ties with several countries and environments. Increasing migration and the adoption of a new sense of Norwegian national identity embodying greater diversity holds new opportunities. This also entails the interaction of cultures and religions with other traditions and perceptions of health and disease.

 

The migrant group is heterogeneous and made up of a diverse range of people: from unaccompanied asylum-seeking minors to Swedish café workers, the members of Pakistani family reunifications, Turkish grocers, British stockbrokers and Indian IT experts. It follows that there will be great variation between different patient and user groups.

At present there are some 460,000 persons residing in Norway who either immigrated themselves or were born in Norway of immigrant parents. All told, these persons make up 9.7 percent of the population…..”

 

 

Migration and health is a complex of issues and concerns, and the present document is not an exhaustive report on this field. By way of introduction,

the report presents a wide backdrop to the issues surrounding migration and health.



·          Chapter 1: “The big picture”, migration is described in terms of a global phenomenon. Here we address the problem of inequitable distribution of welfare and good health globally, and emphasise Norway’s means of influencing this state of affairs.

·          Chapter 2 “Health and ethnicity” deals with the issues surrounding health status, risk factors and the use of health services by different immigrant groups. There are great health disparities throughout the Norwegian population, and this is also true with regard to the health of immigrants. Disease patterns vary from one ethnic group to the next. The causes of health disparities are associated just as much with factors such as education, financial and social circumstances as they are with ethnic, genetic, cultural or linguistic determinants.

·          In Chapter 3 we turn our attention to the challenges associated with interaction with the health services – from the perspective of both the user and the service. The emphasis is on ensuring that the service picks up on and caters for the diversity of the population.

·          Chapter 4 deals with mental health among immigrants, with special emphasis on refugees and asylum seekers. We describe factors affecting health after fleeing and crises.

·          Chapter 5 offers input on the debate concerning the rights of paperless immigrants. The report advocates action to clarify the right of paperless immigrants to health care, and the responsibilities of the authorities.

·          Chapter 6 describes the new wave of labour immigrants. This immigration has provided Norway with much-needed labour, but has also created challenges for the health services, especially as regards the provision of information, organisation and scaling of the services.

·          Chapter 7 There is currently substantial international migration of health personnel. Here we examine the increasing demand for health and care personnel in rich countries in the years to come. Some countries will resort to recruiting health personnel from other countries which are then drained of the health personnel they themselves need. Solidarity with other nations in long-term planning and distribution of global health personnel resources will be essential.

·          Chapter 8 sheds light on ethnic Norwegians as a migrants and emigrants, and also as immigrants in another country; Norwegians in Spain. Who are they, what needs do they have for health and welfare services, and what expectations do they have of the Norwegian authorities? How do they relate to the society they live in? This chapter raises issues and challenges.

 

Main message

A new international convention on health will ensure basic health care for all The global distribution of welfare and good health is inequitable. The Directorate of Health is calling for an international convention recognizing the right to basic health care for all people.

 

Contents

 

Preface

Summary and main message

1 The big picture

Changes in migration flows

Opportunities and challenges

Society in a state of constant flux

Global health

Poverty and health

The UN Millennium Development Goals for health

Norwegian initiative for child and maternal health

A framework convention on global health

Effective health care is a key factor

2 Health and ethnicity

Ethnicity and life phases from a health perspective

Ethnicity and social factors

Life phases

Adults

Elderly persons

Variation between national groups

Differing incidence of risk factors

Disparities in disease patterns

Gender differences in integration

Selected issues of concern

Diseases that were formerly rare in Norway

Infectious diseases

Diabetes

Vitamin D deficiency

Consanguineous marriage in Norway

Female genital mutilation

Male circumcision

Drugs and adolescents

Prevention and public health work

3 Interaction with the Norwegian health service

An equitable health service

Migrant Friendly Hospitals

Adapted medical care

Language and communication – a special challenge

Use of interpreters improves communication

How to achieve equitable health care

Active participation

User participation and coordination in practice

Mutual comprehension

Supervision – an important tool in equitable service provision

Interaction with the Norwegian health service

Regular GP scheme

Maternal and Child Health Centres and the Schools Health Service

Midwifery services

Dental health care

Care services for elderly persons of immigrant origin

Services for persons of immigrant origin with dementia

People with special needs

People with disabilities

4 Mental health

Norway as a receiving country – a historical perspective

Statistics on refugees and asylum seekers

Places at reception centres

Mental health

Especially vulnerable groups: child refugees

Access to and use of health services at reception centres

Mental health screening in the various phases of the process

5 Paperless immigrants – and human rights

A life lived in constant fear

The right to health care is indisputable

The right to basic health care

Costs are prohibitive

6 Labour immigrants

7 Health personnel across borders

8 Emigrants – Norwegians in Spain

Norwegians in multi-cultural Spain

How many Norwegians live in Spain?

Norwegian ghettos?

Why Spain?

Permanent residents and tourists

Bibliography

 


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