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Challenges for Health in the Age of Migration

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Challenges for Health in the Age of Migration Challenges for health in the age of migration Executive summary igration to European countries is not a new phenomenon. We can the crucial role that health and health care play in this process. Caring for date the first significant waves of migration to the end of World migrants’ health is first and foremost a matter of human rights and a matter MWar II and the economic revival of the northern industrialized of tackling unacceptable inequalities in health and health care. But not only countries. During the 1950s, the close relationship between European this: caring for migrants’ health is beneficial both for migrant populations countries and their former colonies increased the possibilities of moving to and the host country. Indeed, the socioeconomic promise of migration will Europe. The period 1960 to 1973 saw the important needs of a fast growing not be realized if migrants live in unhealthy circumstances, do not have economy lead to labour-related waves of migration, followed by family- access to health services and have poorer health conditions than host reunification movements in the 1970s. Finally, the 1980s saw a larger influx populations. of refugees, asylum seekers and irregular migrants. Yet, the question of Frequent ill-health and denial of access to health care increase the migration was, by and large, absent from public debate until the 1980s, likelihood of exclusion and delayed integration, hampering the capacity of when economic crisis, the rise of unemployment, a large increase in asylum migration to realize its aforementioned potential. Meanwhile, seekers and the emergence of extremist parties drew increased attention to acknowledging the necessity to remove barriers in access to care can also migration policies. represent an improvement for health systems which is beneficial to the The consensus nowadays is that migration represents a great opportunity whole population. for the European Union, provided that governments rise to its challenges. Based on these premises, the present report provides a wide overview of Indeed, it counteracts the ageing of its population, fosters its economic the complex question of health and migration. Indeed, little is known about potential by meeting the challenges of an increasingly demanding labour migration as a health determinant; data are scarce, and the topic has been market and constitutes undeniable socio-cultural enrichment. However, largely neglected in the scientific literature. This report is thus among the migration is also a challenge for the European Union: new needs emerge as first attempts to systematically collect relevant information and data, and the population becomes more heterogeneous and increasingly mobile, and use it to display a large array of findings and policy recommendations. It is societies have to adapt to the new context of coexistence of migrants and an encompassing project, undertaken by recognized experts in the field, host populations. and it aims at becoming a useful reference tool for policy-makers, workers By focusing on the “health and migration” issue, we wish to emphasize in the field and, more generally, the interested audience. I 016 CHALLENGES FOR HEALTH IN THE AGE OF MIRATION Challenges for health in the age of migration Introduction n integral part of the organization of a conference on health and migration influxes, the demographic sustainability of populations is a migration, the Ministry of Health’s principal initiative during the structural element that justifies a common policy for the integration of APortuguese Presidency of the European Union, was the immigrants. commissioning of two preliminary documents. These aimed to bring The pattern of low reproductive capacity and low mortality has led to a together knowledge and information from this already controversial policy pronounced ageing of the demographic structures within the EU. area, made more so against a background of enlargement and consolidation Meanwhile, it is recognized that immigrants play an essential role in of the European Union, and the increasing mobility of the population today’s global economy, and migrations are expected to become one of the between and into member states. This is the first of these documents1 with most important determinants of social and economic development. Europe the title Challenges for Health in the Age of Migration: Health and Migration is facing the ageing of its population and immigrants could represent in the European Union and its purpose is to provide knowledge on the demographic sustainability and development. From this perspective, it is relationship between health and the challenges it faces in view of the pertinent to make the process of migration a healthy and socially productive complex phenomenon of migration in an era of globalization. one. Migrations are the result of the increase in the speed of populations’ The multidimensional view of migration requires an active process based mobility thanks to technological development and the reduction in the cost on European health values. These are the distinctive set of beliefs about of traveling. This fact, which can be witnessed in the daily life of big health rights and obligations that reflect European history and identity. European cities, has caused significant changes, both in the host, and origin This Report, one of the preliminary studies for the Health and Migration countries. Population influxes across borders defy national sovereignty and Conference, highlights two areas: 1) demography of migrations, where multicultural diversity and threaten the ability to culturally define a national there is a description of the intensity and direction of migration influxes and European identity. between and into member states; 2) the epidemiological impact of Economically, the EU is one of the richer and most thriving regions of the migrations. The main objective is to provide scientific knowledge about globe. There is also a high level of social well being, a fact that is single- populations’ mobility within the European area and the epidemiological handedly sufficient to attract emigration. At a global level, emigration gives dimension of this phenomenon for policy-makers, professionals, academics rise to a social and economic situation that is difficult in terms of political and everyone working in this field in order to build a knowledge base about border control. Emigration has also become one of the main transformation a problem that concerns every member state. forces of contemporary societies. The scientific research about the health of migrant populations and The number of people who organize their lives between two or more health policies has increased somewhat in the last decade of the 20th countries is on the rise not only because of the accessibility of information century with the creation of the European Union. The wide open territory, technologies and the increase in speed and falling cost of transportation, but the increase of mobility between regions and countries, the ethnic, cultural also because of the vitality and efficiency of informal networks. There are an and linguistic diversity constitute big challenges for health and school increasing number of people who migrate temporarily. These can be systems and also for social security. However, quality information and transitory, cyclical or recurrent migrations. According to this new pattern of scientific research in the field of health and migration continue to be contemporary migrations, called transnational migrations, it is foreseeable insufficient to allow for comparisons and decisions based on scientific that migration influxes will be maintained or even increase, in the near evidence. future. The report consists of six chapters. Key ideas and thematic connections The increases in mobility and cultural diversity raise serious political among the chapters are briefly described here. issues for member states and for the European Union. These issues, for The report opens with a document which details the vision of the which finding solutions has not been easy, concern security, well being and Portuguese presidency about the “health and migration” issue. José Pereira the definition of cultural and national identity. The impact this increase will Miguel and Beatriz Padilla discuss in this First Chapter the relevance of the have on host countries will depend on populations reaching agreement topic for the European Union, emphasizing the demographic and economic platforms that are based on the universal values of human rights. challenges presented by migration. The authors then provide an overview of Although there are differences within the EU concerning the intensity of the crucial issues that should be accounted for when dealing with migration and health. They first emphasize the complexity of the migration process 1. The second preliminary document for the conference is mainly technical and compiles a and the necessity to improve our knowledge of migration, showing the number of “Good Practices” at the European level. variability in the causes of migration and the migrant’s profile. Secondly, 016 CHALLENGES FOR HEALTH IN THE AGE OF MIRATION Challenges for health in the age of migration migration policies across EU member states are briefly reviewed, pointing to to the demographic equilibrium of Europe. This chapter analyzes the flows the problems that still remain: the difficulty in reaching agreements across of particularly vulnerable groups such as asylum seekers, refugees, illegal member states,
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