Migration and Health: An International Perspective Flashcards
Where did humans originate from?
Africa
Migration from here started 100,000 years ago.
What happened during WW2?
3-7 million people were forced to move during the war
11 to 12 million were forced to move afterwards.
How many people were displaced in the partition of India?
Partition of India (1947) displaced over 14 million people along religious lines.
Large scale violence led to estimates of several hundred thousand to 2 million dead.
Why do people migrate?
Work, educational, or family reasons.
Migration creates vulnerabilities even in favorable circumstances, such as distancing from habitual support mechanisms.
What was the data from 2020 about migrants?
281 million people are international migrants, which is 3.6% of the world population.
Around 1 in 28 people live in a country other than that of their birth, three times as many as in 1970.
How is data gathered on who migrates and why?
Data is gathered from various sources like national insurance numbers, GP registrations, and population surveys.
It is almost impossible to gain an accurate picture of undocumented migration.
What did the Windrush crisis show?
Some people are unaware of their own immigration status, and official bodies may not be aware of their status.
This complicates gaining an accurate picture of undocumented migration.
How many people have irregular or undocumented immigration status?
An estimated 674,000 people have irregular or undocumented immigration status, with around 400,000 living in London.
The number of undocumented children increased 56% between 2011 and 2017.
What are the reasons for immigration to the UK (excluding asylum)?
49% work, 27% for study, 13% other/no reason stated, 12% joining or accompanying family.
By how much has the population of West Midlands increased since 2011?
The population has increased by 6.7%.
The West Midlands has significantly lower life expectancy than the UK as a whole.
How diverse is Birmingham?
Birmingham is very diverse, home to people of more than 187 different nationalities.
In the 2021 Census, 26.7% of the population had been born overseas.
What is forced migration?
Refers to the movements of refugees and internally displaced people due to conflicts or disasters.
What are some other reasons for forced migration?
Climate change impacts, persecution based on religious or political beliefs, or sexual orientation.
How has forced migration changed over time?
Forced displacement is now more widespread and often a long-term phenomenon.
How many people are forcibly displaced worldwide?
Over 52,760 dead and over 18,000 children missing in Europe/Mediterranean since 1993.
What is mixed migration?
Refers to flows of people traveling together, often forced from their homes or in search of a better life.
What type of people are traveling as part of mixed movements?
Asylum-seekers, refugees, stateless people, victims of trafficking, and unaccompanied children.
When does mixed migration occur?
Occurs in various political and social contexts, such as the opening of borders in 2015.
What is the migration cycle?
Migration isn’t a single journey; it involves moving from origin to destination and possibly returning.
What is trafficking?
Recruitment, transportation, or receipt of persons by means of coercion for exploitation.
What is the National Referral Mechanism?
An official 45-day recovery program for victims of trafficking after which they may claim asylum.
What is smuggling?
Transporting individuals illegally from one country to another for a fee.
Define modern slavery.
Holding a person in slavery or requiring forced or compulsory labor, as defined by the Modern Slavery Act (2015).
What does slavery include/overlap with?
Includes trafficking and exploitation, and overlaps with smuggling.
What is resettlement?
Official programs to move recognized refugees from low- to middle-income countries to high-income countries.
What are the 4 phases of the refugee experience?
Anticipation, Adversity, Survival, Integration.
What problems are faced during the immigration process?
Culture of disbelief, age disputes, limited access to legal advice, and indefinite immigration detention.
Describe the ‘hostile environment’ in the UK.
Proof of ‘right to reside’ needed for accommodation, employment, and healthcare.
Describe the 2022 immigration bill.
Applies to arrivals from June 2022; those arriving irregularly face removal to Rwanda.
Describe the illegal migration bill (2023).
Places a legal duty on the Home Secretary to remove anyone arriving irregularly to the UK.
Does the 2023 bill apply to everyone?
No, it does not apply to unaccompanied children.
What happens to people arriving after 20th July 2023 in this bill?
Their asylum claims will be declared ‘inadmissible’ and they will be detained and swiftly removed.
Is there a legal duty on the Home Secretary to detain people?
No, there is only a power to detain people.
What are the 2 circumstances experienced for people claiming asylum in the UK?
Pre July 2023: route to full refugee status; Post July 2023: inadmissibility and threat of removal.
Describe the path to ‘Indefinite leave to remain’ (ILR) - regular migration.
Initial status is usually ‘Limited Leave to Remain’ for 2-5 years, needing 10 years in the UK for ILR.
What is admissibility in the context of asylum?
Admissibility refers to the threat of removal to Rwanda or other ‘Third Country’, where many face basic isolated accommodation in refugee camp-like conditions with limited freedom of movement. A small number of people in very limited circumstances will have admissible claims.
What is the path to Indefinite Leave to Remain (ILR) in the UK?
The initial status is usually ‘Limited Leave to Remain’ (LLR) for 2-5 years. To obtain ILR, one must accumulate 10 years in the UK, with LLR granted in 30-month chunks necessitating recurrent applications. The total cost of achieving ILR and citizenship exceeds £20,000.
What is destitution?
Destitution is going without the bare essentials needed for survival, such as home, food, heating, lighting, clothing, shoes, and basic toiletries. It is defined as lacking two or more of these essentials over the past month due to affordability issues or having an income of less than £70 a week for a single adult.
What percentage of refused asylum seekers remain in the UK and face destitution?
90% of refused asylum seekers remain in the UK and face destitution rather than electing to leave. This situation is exacerbated by the Illegal Migration Act, which may increase destitution and restrict access to accommodation, education, and healthcare.
What does NRPF stand for in regular migration?
NRPF stands for ‘No Recourse to Public Funds’, which applies to individuals granted the right to stay in the UK but who cannot access welfare benefits or housing support.
What confusion exists around NRPF?
There is confusion about what individuals with NRPF are entitled to claim or access. NRPF does not refer to healthcare or social services, meaning individuals cannot claim welfare benefits or housing support.
What backlash has occurred due to migration?
Public discourse in high-income countries often presents migrants as a burden, leading to stigma, hostility, and hate crimes. However, migration benefits the economy, such as the NHS, more than it costs.
What statistics support the benefits of migrants in the UK?
37% of doctors in the UK gained their qualifications abroad, and a 1% increase in migration correlates with a 2% increase in GDP per person.
What problems do migrants face internationally when integrating into new societies?
Migrants face cultural and language barriers, loss of status, family separation, and difficulties gaining employment, often ending up in low-wage occupations with high risks.
What is the ‘healthy migrant’ phenomenon?
The ‘healthy migrant’ is a debated concept; data shows that migrants to high-income countries often have a mortality advantage compared to non-migrants, with lower self-reported long-term conditions.
Who has better reported mental health, migrants or UK born individuals?
Migrants who arrive under favorable circumstances report better mental health than UK-born individuals (5% vs 10%).
What adversities may migrants face that affect their mental health?
Migrants may face torture, detention, ongoing uncertainty regarding asylum cases, and challenges with integration, which can lead to mental health issues.
What is the hierarchy of needs?
The hierarchy of needs is a psychological theory that ranks basic physiological needs at the bottom and self-actualization at the top. Migration often drives individuals down this hierarchy, negatively impacting mental health.
What percentage of refugees have been tortured?
21% of refugees have been tortured, and 30% of torture survivors meet the diagnostic criteria for PTSD.
Are torture survivors safe from harm from their clinicians?
A substantial proportion of torture survivors report direct or indirect involvement of clinicians in their abuse, and their experiences are often under-recognized.
What levels does torture impact a person’s wellbeing?
Torture impacts physical, psychological, integrity, and spiritual wellbeing, contributing to social stigma and marginalization.
What are the aims and effects of torture?
Torture aims to degrade, dehumanize, and debilitate individuals, leading to a breakdown of cognitive and behavioral functions with pervasive and long-lasting effects.
What is the result of migration?
Migration can lead to fear and sadness, with ongoing risks of destitution, detention, and deportation. Many individuals, especially the undocumented, may remain in limbo for years.
What risks do both genders face during migration?
Both genders are at risk of sexual violence, exploitation, and transactional sex before, during, and after migration, with girls and women facing increased risks of early and forced marriage.
What is the access to reproductive health and contraception for migrants?
Access to reproductive health and contraception is often poor, influenced by host nation culture and legal/social structures.
What is maternity care like for migrants?
Migrant maternal and infant mortality and morbidity rates are very high compared to resident populations, affecting access to care during the antenatal period, labor, and post-natal care.
What are migrants, especially women, with unstable immigration status at risk of?
Migrants with unstable immigration status are at risk of intimate partner and domestic violence.
What is a damaging myth regarding migrants and disease?
The suspicion that migrants are the cause of disease outbreaks is a persistent and damaging myth, as migrants often come from countries with different infectious disease profiles.
As a clinician, what should you always ask migrants?
Always ask about immunization status and offer catch-up immunizations, as these can be disrupted by migration.
What are the benefits and criticisms of screening migrants for diseases?
Screening can benefit individuals and reduce healthcare costs but may lead to stigmatization and negative media messages.
Do migrants transmit disease to host populations?
It is highly unlikely that migrants transmit diseases to host populations; transmission is more likely within migrant communities.
What diseases should clinicians screen for in migrants?
Clinicians should screen for TB, HIV, Hep B, and Hep C based on the country of origin risk.
What is universal access to healthcare?
Universal access to healthcare means all people can use necessary health services without financial hardship.
What advantages does equitable access to healthcare bring to society?
Equitable access to healthcare reduces health inequalities, which can lead to social inequality, economic instability, higher crime rates, and lower happiness.
What access is there to primary care for migrants?
Access to primary care does not depend on nationality or immigration status; anyone in the UK can register with a GP without charge.
Why is access to healthcare important?
Access to healthcare is crucial for ensuring the health and wellbeing of all individuals, particularly in the context of public health.
What are the rules on charging in secondary care for migrants?
Only clinicians should decide what care is ‘urgent and immediately necessary’, and recent regulatory changes caution against assuming someone will return home within six months.
What is the NHS surcharge?
The NHS surcharge is a fee for using NHS services during a stay in the UK, payable by anyone applying for a visa over six months. It doubled from £200 to £400 in January 2019.
What are the criticisms of restricting access and charging for NHS services?
Critics argue that it undermines the principle of free care at the point of delivery, can lead to erroneous charging, racial profiling, and deter individuals from seeking care.
