Migration and Health[*]*

The process of migration includes the coping with and the overcoming of losses and usually entails tedious, prolonged adaptational processes, involving all kinds of strain. After the decisive event of changing their living environment and their outlook on life, migrants are almost always faced with a critical period of their lives, as migration implies rethinking, re-adjustment and assimilation in nearly all basic spheres of life. This is true for migrant workers, migrants from the former colonies and often even more so for refugees and asylum seekers and refers to housing, work, schools and education, leisure, but also to their social environment because they are often met with rejection, even repulsion. Successful coping requires a massive re-orientation with regard to thoughts, experiences, social behaviours and doings. It is not surprising, then, that this acculturation process is mostly very stressful and connected with both mental and physical strain reactions.

This situation is described in a number of studies on the health situation and especially the health risks of foreigners living in the EU Member States. Even if the validity of these studies is rather limited - only covering selected ethnic groups, selected health problems, limited comparisons between foreigners and the respective native population, selected international comparisons between (migrants’) country of origin and host country - one can conclude in general that the risk of illness is higher for people who are confronted with the adaptational strategies necessary in the process of migration. These higher risks can be observed for all ethnic groups, can concern different types of disease and can even increase when considering the incidence of accident at work and psychiatric or psychosomatic disturbances. The situation is furthermore marked by inadequate health care services which do not meet the specific demands of this clientele in the field of counselling and treatment.

The problems of migration in the EU Member States are quite varied with regard to the respected starting points and dealings with foreigners. Correspondingly, the difficulties arising in the context of disease burdens and health care system are also varied to a certain extent. But, whatever the differences, the EU Member States also have a lot in common in this respect. For example, a lot of experiences from the long prevailing south-north migrational processes can be largely applied to health-related issues of east-west migration.

Bearing this in mind and considering the European civil right of freedom of movement, which will lead to a further increase in the number of migrants - not least because of the planned eastern expansion of the EU - it seems imperative then to also develop common strategies for coping with migration-related health problems.

Against the background of the described situation we can draw the following conclusions:

The health implications of migration are the results of a complex set of social, economic and political factors. Thus, management of the health of migrants has to take this larger context into account. Furthermore, peace and the work with and for migrants are prerequisites for health. Migrant health is a topic of European dimension that needs co-operation and action on a European Union level. Migrant and ethnic health issues should be put on the agenda of health policy makers at both the EU and Member States level. The questions of health and well-being of migrants and ethnic minorities should be an integrated component of immigration and health policies of the European countries. Up to now health policy decision makers have not yet given the topic sufficient attention. Only some states have taken action to improve the health situation of migrants. European Union co-operation should include: Compilation of comparable data on the health situation of migrants in the European Union Establishing a network of partners working in the field of “Migration and Health” comprising experts, institutions, researchers, and application-oriented projects in European countries of origin and destination Development of means concerning information-sharing and co-operation between the Member States of the European Union Formulation of policy strategies In order to achieve the consensus needed and to set up the necessary structures the possibilities of the European Union should be utilized. This includes future activities on public health including health information, health monitoring and health status reports as well as the implementation of the 5th Framework Programme of Research including the “Information society”. Close co-operation with all partners working in this field such as WHO, IOM and the Council of Europe is essential.

1 Abstract of a report provided for the Commission of the European Communities under the title: „Migration and Health, A Health Status Report of the Situation in the European Union”, Magdeburg 1999

1 Abstract of a report provided for the Commission of the European Communities under the title: „Migration and Health, A Health Status Report of the Situation in the European Union”, Magdeburg 1999