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International Migrants’ Day

By USCRI December 18, 2023

By: Rosalind Ghafar Rogers, PhD, LMHC, Clinical Behavioral Health Subject Matter Expert

with USCRI’s Refugee Health Services in Arlington, VA

 

December 18th marks International Migrants Day – a day to highlight the increasingly complex challenges migrants face, collectively explore and mobilize efforts to improve migrants’ circumstances, and celebrate their resilience and their important contributions.

 

The United Nations defines an international migrant as any person who has changed his or her country of residence, and includes all migrants, regardless of their legal status, or the nature, or motive of their movement. Today, war, conflict, insecurity, and the effects of climate change heavily contribute to the forced migration of people all over the world, whether within countries or across borders. In 2020, over 281 million people were international migrants, comprising about 3.5% of the global population, while over 59 million people were internally displaced (UN, 2020). While most people migrate out of choice, others migrate out of necessity, such as the estimated 35.3 million refugees by the end of 2022 (UNHCR, 2023).

 

Regardless of the reasons that compel people to migrate, displaced people represent some of the most vulnerable and marginalized groups in society and are often exposed to various health risks associated with pre-migration trauma and perilous journeys, including exposure to infectious and communicable diseases, severe psychosocial stressors, violence, and abuses. They may also suffer from post-migration trauma and stressors after resettlement in a host country, including discrimination and stigmatization, social isolation and exclusion, unemployment or underemployment, financial hardship, and inadequate, unsafe, or overcrowded housing. These adverse conditions have a direct negative impact on the health and well-being of migrants and refugees, their families, and communities. Yet health and mental health often remain marginal in discussions on migration, and migrants and refugees are a frequently forgotten population in health strategies. Physical and mental health are a fundamental right of every human being and therefore, migration and health are inexplicably linked to one another.

 

Migrants and refugees face considerable barriers in accessing equitable physical, mental, and social health care services, which in turn, compromise their ability to work, be productive, contribute to development, and improve their livelihoods. Research has consistently found that migrants are less likely to seek, access, and receive professional health services than U.S. born individuals due to various cultural, acculturation-related, and structural factors.

 

Cultural and acculturation-related factors that prevent migrants and refugees from seeking help or accessing health services include competing needs, language barriers, poor accessibility and acceptability of services, and mental health stigma. Due to many competing needs during post-migration, health care, especially mental health care, is not considered a priority by migrants and refugees until their basic needs are met, such as financial and employment security, adequate housing, food, legal issues, and host language training. Lack of host language proficiency and the limited number of trained interpreters are key barriers for migrants receiving accurate information, communicating effectively with health care professionals, and understanding and navigating the daunting healthcare system in the U.S. (Mohammadifirouzeh et al., 2023; WHO, 2023). Even when migrants and refugees have some proficiency in the host language, services are often not culturally sensitive and health care professionals lack cultural competency. Cultural beliefs and stigmatizing attitudes, particularly surrounding mental health, prevent migrants and refugees from seeking help due to feelings of shame, or fears of being labelled as crazy or damaging their family’s reputation.

 

In addition to those discussed above, there are additional structural barriers to accessing health care for migrants and refugees. The high cost of physical and mental health services, a lack of health insurance, and a range of obstacles to enrollment are key barriers for migrants and refugees. In 2023, half of undocumented immigrant adults and one in five lawfully present immigrant adults reported being uninsured (KFF, 2023). Logistical barriers, such as lack of transportation or unfamiliarity with public transportation and inflexibility of services, also serve to reduce help-seeking and access to health care services among migrants and refugees. Among migrants and refugees living in the U.S., complicated booking systems, difficulty locating services, the lack of childcare, long wait lists, and inflexible appointment schedules were all identified as barriers to seeking and accessing health and mental health services (WHO, 2023).

 

The essential component in providing physical and mental health care for migrant and refugee populations is context. Services that are flexible, culturally responsive, linguistically appropriate, and community-based will facilitate the help-seeking behaviors of migrants and refugees and the acceptability of services. Migrants and refugees should be provided with complete and accessible physical and mental health-related information through community-based educational forums or sessions where health, legal, and resettlement orientations are offered in conjunction with one another in order to reduce barriers and encourage attendance and participation.

 

On this International Migrants Day, USCRI recognizes the need for concerted, comprehensive, and multi-sector approaches to improving migrants’ access to equitable and quality health care and mental health services. Investing in and improving the health and well-being of migrants and other displaced people contributes to healthier and more resilient communities across the U.S.

 

References

KFF. (2023). Key Facts on Health Coverage of Immigrants. Retrieved from https://www.kff.org/racial-equity-and-health-policy/fact-sheet/key-facts-on-health-coverage-of-immigrants/

Mohammadifirouzeh, M., Oh, K. M., Basnyat, I., & Gimm, G. (2023). Factors Associated with Professional Mental Help-Seeking Among U.S. Immigrants: A Systematic Review. Journal of immigrant and minority health25(5), 1118–1136.

(2020). International Migration 2020 Highlights. United Nations Department of Economic and Social Affairs, Population Division. Retrieved from https://www.un.org/development/desa/pd/sites/www.un.org.development.desa.pd/files/undesa_pd_2020_international_migration_highlights.pdf

UNHCR. (2023). Data and Statistics: Global Trends. Retrieved from https://www.unhcr.org/global-trends

WHO. (2023). Mental health of refugees and migrants: Risk and protective factors and access to care. (Global Evidence Review on Health and Migration (GEHM) series). Retrieved from https://www.who.int/publications/i/item/9789240081840

 

USCRI, founded in 1911, is a non-governmental, not-for-profit international organization committed to working on behalf of refugees and immigrants and their transition to a dignified life.


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