Thursday, December 06, 2018

The Health Facts on Migrants

"In too many countries, the issue of migration is used to divide societies and advance a populist agenda,” said the Lancet’s editor, Dr Richard Horton.

Myths that migrants are responsible for spreading disease and a burden to health services have been used in support of the hostile and restrictive policies introduced in the US, UK and elsewhere around the world, a two-year commission of 20 experts, set up by University College London and the Lancet medical journal, has concluded. Their analysis shows that migrants who are usually working, studying or have joined their families often have better health than the general population.

"Whenever we published our TB figures, they extracted the bit that says X proportion is among migrants and created fear stories along the lines of migrants are spreading these bugs,” said the chair of the group, Prof Ibrahim Abubakar from UCL. The evidence shows that the risk of migrants transmitting TB to their host communities is low, the commission says.

The study used mortality estimates on more than 15.2 million migrants from 92 countries and found that international migrants had lower rates of deaths for cardiovascular, digestive, endocrine, neoplasms, nervous and respiratory diseases, mental and behavioural disorders and injuries than people in the general population in the receiving country. There was no evidence of a difference for blood, genitourinary, or musculoskeletal disorders.

"We come to the conclusion that there is no evidence migrants are contributing to any harmful effects on the health of the countries. If anything, they are adding a lot of value,” said Abubakar.

There were more than a billion people on the move in 2018, a quarter of whom were crossing international borders, says the commission. About 65% are labour migrants.
“Populist discourse demonises the very same individuals who uphold economies and bolster social care and health services,” he said. “Questioning the deservingness of migrants for healthcare on the basis of inaccurate beliefs supports practices of exclusion, harming the health of individuals, our society, and our economies.” While he understood NHS funding and the need to assess entitlement, “as a medic, the last thing I’d want in this world is to be sitting in a clinic and to have to take decisions about whether an individual should get treatment for a life-threatening illness based on their immigration status”.
The NHS had a memorandum of understanding to share immigration details of patients with the Home Office. It set up a “perverse incentive” to shun healthcare.
“If I was sitting in a vulnerable position and I’m aware that if I present with early symptoms of a particular disease that might lead to my deportation, the logical reaction would be not to show up and the consequence of that is awful for the migrant, it’s awful for UK public health and the taxpayer,” said Abubakar.
 In the US, the Trump administration has plans to take into account whether individuals have utilised social health insurance schemes when decisions are taken on residency. “That’s as powerful an incentive as the hostile environment. That would discourage people from accessing healthcare because they are trying to guard against a future immigration decision,” said Abubakar.
Prof Cathy Zimmerman, from the London School of Hygiene and Tropical Medicine and senior author of the report, said: “Governments around the world are well aware that their economies depend on migrant workers, both for low-wage work in destination countries and for remittances in sending countries. Yet, states have done disappointingly little to assure the health and safety of migrant workers, or to stop the exploitation and human trafficking of millions of hard-working women and men who toil invisibly in every corner of the globe. Low-wage workers must stop being treated as disposable and be offered adequate numbers of work visas that are fair and not tied to employers or to extortionate labour brokers. Until states stop siding with employers over migrant workers, individuals around the world will remain vulnerable to 3D jobs: dirty, dangerous and demeaning.”

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