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Abstract
Should migrants have the same rights as citizens to health care services? What do we mean by rights and by health? And how do we uphold such rights when diasporic networks provide a diversity of opportunities and constraints for people seeking to maintain or restore their health?
Answering these pressing questions, this book highlights recent developments in the areas of migration, human rights and health from a range of countries. Looking at diverse health issues, from HIV to reproductive and maternal health, and a variety of forms of migration, including asylum seeking, labour migration and trafficking, this timely volume exposes the factors that contribute to the vulnerability of different mobile groups as they seek to uphold their wellbeing.
Migration, Health and Inequality argues that we need to look beyond host country responses and biomedical frameworks and include both the role of transnational health networks and indigenous, popular or lay ideas about health when trying to understand why many migrants suffer from low levels of health relative to their host population. Offering a broad range of linkages between migrant agency, transnationalism and diaspora mechanisms, this unique collection also looks at the impact of migrant health on the health and rights of those communities that are left behind.
'Recent decades have seen a major increase in migration and global "flows", of peoples, populations and ideas. Against this background, this landmark volume sets out to examine fundamental questions of health and inequality. It provides essential reading for all interested in migration and health.'
Professor Peter Aggleton, The University of New South Wales, Australia
'A collection of thought provoking and engagingly written selections, the book provides a nuanced, multi-layered examination of migrants' right to health in the context of shifting power relations under contemporary globalization. An important read for researchers, policymakers and service providers.'
Dr Denise L. Spitzer, Canada Research Chair in Gender, Migration and Health, University of Ottawa
'This edited collection provides timely and thought-provoking insights into understanding migrants' physical and mental health status and their health-seeking behaviours. Going beyond a biomedical approach to health to consider alternative understandings of wellbeing and illness, as well as dimensions of inequality such as gender, socio-economic status and migrant status, this wide-ranging book represents an excellent source for understanding migrant health inequalities and the associated human rights challenges.'
Katie Willis, Professor of Human Geography & Director of the Politics, Development & Sustainability (PDS) Group, Royal Holloway, University of London
Dr. Felicity Thomas is a lecturer at the University of Exeter and a research associate at the University of Sussex.
Dr. Jasmine Gideon is a lecturer in development studies at Birkbeck College, University of London.
Table of Contents
Section Title | Page | Action | Price |
---|---|---|---|
About the editors | i | ||
Title page | iii | ||
Copyright page | iv | ||
Contents | v | ||
Tables and figures | vii | ||
Acknowledgements | ix | ||
Abbreviations | x | ||
Introduction | 1 | ||
Current migration patterns and processes | 5 | ||
Global policy-making and implementation | 5 | ||
Health, migration and vulnerable groups | 6 | ||
Transnationalism, diaspora and health | 7 | ||
References | 8 | ||
1 | Context and perspectives: who migrates and what are the risks? | 10 | ||
Introduction | 10 | ||
The larger context: international migration today | 10 | ||
Figure 1.1 Traditional and modern migration paradigms | 13 | ||
Phases of the migration process and health effects | 13 | ||
Returning to communities of origin | 18 | ||
Policy frameworks affecting migrant health, and the role of international organisations | 19 | ||
Needs and challenges | 22 | ||
References | 23 | ||
2 | Impact on and use of health services by new migrants in Europe | 27 | ||
New migration to Europe | 27 | ||
What are the implications for health services? | 28 | ||
Barriers to healthcare and their influence on service use | 31 | ||
Table 2.1 Key barriers to healthcare for new migrants | 32 | ||
System and provider level barriers | 33 | ||
Conclusions | 38 | ||
References | 39 | ||
3 | Do migrants have an enforceable right to healthcare in international human rights law? | 44 | ||
Introduction | 44 | ||
Is there a right to health? | 45 | ||
Does human rights protection extend to migrants? | 46 | ||
Equality arguments as a basis for migrants’ entitlement to healthcare | 46 | ||
The ‘justification’ defence to discrimination against migrants | 48 | ||
Protection for special groups as a basis for migrants’ entitlement to healthcare | 49 | ||
Regional human rights protection as a basis for migrants’ entitlement | 51 | ||
Migrant-specific human rights protection | 54 | ||
Domestic law as a basis for migrants’ entitlement | 56 | ||
Conclusion | 57 | ||
Notes | 58 | ||
References | 59 | ||
4 | International health worker migration: global inequality and the right to health | 62 | ||
Introduction | 62 | ||
Human rights analysis | 63 | ||
‘Source’ country governments and the right to health | 64 | ||
Caveats in the right to health | 66 | ||
Conclusion | 74 | ||
Notes | 75 | ||
References | 76 | ||
5 | Socioeconomic vulnerability and access to healthcare among immigrants in Chile | 79 | ||
Introduction | 79 | ||
The Republic of Chile and the Chilean healthcare system | 80 | ||
Immigration patterns in Chile | 81 | ||
Legal rights to healthcare and policies to support access among immigrants in Chile | 82 | ||
Demographic characteristics of international immigrants in Chile | 83 | ||
Socioeconomic conditions of international immigrants in Chile | 85 | ||
Healthcare provision among international immigrants and its association with socioeconomic status | 86 | ||
Are international immigrants in Chile a vulnerable group and why? | 89 | ||
References | 91 | ||
6 | Unaccompanied young asylum seekers in the UK: mental health and rights | 94 | ||
Introduction | 94 | ||
Ontological security | 94 | ||
Unaccompanied young people seeking asylum in the UK | 95 | ||
Rights as instruments or moral claims | 96 | ||
Methodology | 97 | ||
Threats to ontological security | 98 | ||
The limitations of a clinical response | 102 | ||
Discussion | 105 | ||
Conclusion | 106 | ||
Notes | 108 | ||
References | 108 | ||
7 | Healthcare for trafficked migrants: UK policy 2000–10 and consequences for access | 112 | ||
Introduction | 112 | ||
Trafficked migrants’ access to NHS care: policy environment 2000–10 | 114 | ||
Impact of the NHS charging regulations on trafficked migrants’ access to healthcare, 2000–08 | 117 | ||
Implications of NHS access policies 2008–10 | 120 | ||
Conclusion | 122 | ||
Notes | 123 | ||
References | 123 | ||
8 | Vulnerable migrant women and charging formaternity care in the UK: advocating change | 126 | ||
Introduction | 126 | ||
Charging for maternity care | 126 | ||
Access to maternity care | 128 | ||
Poor health outcomes | 131 | ||
Political environment | 132 | ||
Advocating for change | 133 | ||
References | 135 | ||
9 | Multiple medicaments: looking beyond structural inequalities in migrant healthcare | 137 | ||
Introduction | 137 | ||
HIV in the UK | 137 | ||
Thinking beyond the biomedical | 139 | ||
Interpreting and responding to ill-health | 141 | ||
Treatment seeking following an HIV positive diagnosis | 144 | ||
Conclusion | 147 | ||
Notes | 147 | ||
References | 148 | ||
10 | Harnessing ‘diasporic’ medical mobilities | 150 | ||
Mobilising ‘diaspora’ for development in the ‘homeland’ | 150 | ||
Capitalising on structural inequalities | 152 | ||
Claiming diaspora as the ‘natural’ market for cultural reasons | 153 | ||
Using ‘their’ diaspora as a bridge to access new markets around the globe | 156 | ||
Conclusion | 159 | ||
Note | 160 | ||
References | 160 | ||
11 | Access versus entitlements: health seeking for Latin American migrants in London | 163 | ||
Introduction | 163 | ||
Latin American migrants in the UK | 164 | ||
Migrants’ access to NHS services in the UK | 164 | ||
Migration, gendered vulnerability and ill-health | 165 | ||
Migrants’ access to healthcare services | 167 | ||
The role of transnational networks and health seeking behaviour | 167 | ||
The case study | 171 | ||
Return to Latin America | 172 | ||
Use of Spanish-speaking doctors in the UK | 174 | ||
Conclusion | 176 | ||
Notes | 176 | ||
References | 177 | ||
12 | Wellbeing and community self-help:Turkish-speaking women in London | 180 | ||
Introduction | 180 | ||
Post-migration wellbeing | 181 | ||
Migration and women | 181 | ||
Issues for migrant women | 182 | ||
Community self-help and user empowerment in health services | 183 | ||
Research with Turkish-speaking migrant women | 185 | ||
Gendered empowerment experiences of Turkish-speaking women: findings from a quantitative large scale survey | 185 | ||
Figure 12.1 Women’s health problems before and after their arrival in the UK | 186 | ||
Table 12.1 Health and mental health problems | 187 | ||
Figure 12.2 Percentage of women accessing health services for their problems | 188 | ||
Findings from a small scale qualitative study with Turkish-speaking women’s self-help groups | 189 | ||
Discussion | 191 | ||
Note | 194 | ||
References | 194 | ||
Contributors | 198 | ||
Index | 201 | ||
About Zed Books | 210 |