Migration and health
Challenges and trends
Norwegian
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
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
· 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
· 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
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
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
Infectious diseases
Diabetes
Vitamin D deficiency
Consanguineous marriage in
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
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
Norwegians in multi-cultural
How many Norwegians live in
Norwegian ghettos?
Why
Permanent residents and tourists
Bibliography
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