Migrant health Wider Inequalities and Health Protection SW HP Workshop – Louise Dirks

Who are Migrants? SW HP Update workshop – Louise Dirks

Migrant - a Definition Migrants are people who have moved from their usual place of residence to live in another country for at least a year for reason of work, education, family, socio-political persecution or war. (United Nations 1998) Migration is dynamic – the only shared characteristic of migrants is that they come from another country. Migrant populations are Heterogeneous with diverse social, cultural and material assets and sometimes complex needs. Some will experience a disproportionate level of need which may be challenging to articulate and to be heard. Migration patterns are complex and circular migration is important to consider SW HP Update Workshop 2016 – Louise Dirks

Approximately how many people migrate to the UK each year? 300,000 600,000 900,000 1200,00 Correct answer? SW HP Update Workshop 2016 – Louise Dirks

Approximately how many people migrate to the UK each year? 300,000 600,000 900,000 1200,00 Correct answer: 600,00 SW HP Update Workshop 2016 – Louise Dirks

Types of Migrants in the UK

Workshop SW HP Update Workshop - Louise Dirks

Migrants as a heterogeneous group reflect a complex set of factors migration patterns, the demographic profile of migrants, experiences during migration, high-risk behaviour, patterns of disease in migrants’ countries of origin, the trauma that can be associated with the causes of migration, access to health services in both the country of origin and host country. Health risks to migrants may also continue for many years after arrival in Europe as a result of travel to visit friends and relatives in countries of origin. SW HP Update Workshop – Louise Dirks

Workshop Question? 1 What are determinants for health for migrants in your own locality area.? Presentation title - edit in Header and Footer

What may influence the health of migrants?

Identify FIVE most important ones Workshop Question? 2 What would you consider are the Public Health ENABLERS for Migrant Health? Identify FIVE most important ones Presentation title - edit in Header and Footer

PH Enablers for Migrant Health Screening Communicable disease – TB, AMR, Hep B, Malaria, Cholera Non communicable disease – Diabetes, Heart disease, chronic conditions Vaccination Measles, MMR, polio, Meningococcal, Diptheria, Vaccination Services Culturally appropriate, Accessible, Eligibility to service Health Education Information, sign posting, education of Health professionals on Migrant Health and how to assess risks of Syndromic Surveillance Respiratory track diseases, Pulmonary TB, bloody diahorrea, Bloody diahorrea, meningitis Partnership Working Joint working across agencies to address the range of social Problems and health problems and share good practise and case studies, health training in roles in meeting needs of migrants. Mental Health: Provision of services and screening adapted to understand and identify psychological sequalae resulting from post-traumatic stress disorder, traumatic bereavement issues, depression and anxiety related to migration. Contact with the criminal justice system:via prisons, immigration removal centres or the police and probation services, to identify and meet health needs among some migrants. PH SW Update workshop – Louise Dirks

Local Implementation Local areas across the UK face distinctive issues by composition of the population, Rate of change, and other social, economic and political factors within population Significant impact on local needs, and services Questions to Ask about your Geographical locality How many new people have arrived in the last year (relates to planning primary care provision)? What languages do they speak (relates to planning interpreting services)? What cultural and religious groups are there (relates to thinking about cultural competence and staff training)? Any groups with particular vulnerabilities? determine need for specific service for particular groups such as asylum seekers, students, workers from the Baltic states) SW HP Update Day Workshop – Louise Dirks

WORKSHOP QUESTION? 3 What would you consider are the Public Health BARRIERS for Migrant Health? Identify FIVE most important ones SW HP Update Day Workshop – Louise Dirks

Barriers to Migrant Health Economic Factors: Poverty, Housing - poor living conditions, unemployment. Mental Health Status: Depression, loss of control - deterioration over time Cultural Factors: Language barriers, religion, gender roles, health beliefs, Practices and perceptions about health services. Health Care Service: Understanding the health system of care Understanding entitlement to care and around legal status Language: Language(s) spoken, access to appropriate interpretation Social Issues: Include discrimination, stigma and isolation. Health Data currently Available: Does not differentiate adequately between migrant categories - data sources generally fail to capture outflows of migrants, within and beyond the UK No single data resource completely captures sufficient data to allow appropriate health needs assessment of this population. SW HP Update Workshop – Louise Dirks

END OF WORKSHOP Case Study SW HP Update Workshop – Louise Dirks

Workshop Case Studies DISCUSSION TIME ON EXAMPLES OF GOOD PRACTICE The Haven: Specialist primary healthcare care service for asylum seekers and refugees who are new to Bristol. The team assess and meet the initial health needs of asylum seekers and new refugees and enable people to access health services and other services they need. Health Links - service aims to improve access to healthcare for adults and children whose first language is not English. Language support and health advocacy. TB Services: Nurses led team, providing outreach and support to people with active or latent tuberculosis (TB) in Bristol and South Gloucestershire. Wellsprings Surgery research Work and health research on Polish Migrants and Somali Migrants SW Localities receiving Syrian Refugees – Health needs and Primary care issues SW HP Update Workshop – Louise Dirks Footer