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What is Migration Health?. Alfonso Rodriguez-Lainz, PhD CDC Division of Global Migration and Quarantine 5 th Summer Institute on Migration and Health May 11, 2010. Outline. What is migration health? What is migration? Who is an international migrant?
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What is Migration Health? Alfonso Rodriguez-Lainz, PhD CDC Division of Global Migration and Quarantine 5th Summer Institute on Migration and Health May 11, 2010
Outline What is migration health? What is migration? Who is an international migrant? Sources of international migration data Migrant health data sources Migration data: the way forward
What is Migration Health? Migration + Health
What is Migration Health? Migration + Health
What is Health? “Health is a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity” (WHO, 1948)
What is Health? “Health is a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity” (WHO, 1948) … it also applies to migrant populations (IOM, 2006)
Migration Health:beyond migrants themselves Health issues, conditions and risks related to migrant populations, and the way in which it also affects: Population of origin, Communities in theplaces of transit and destination, and Second and later migrant generations • (Roux, 2004)
Biological Behavioral Social environment Physical environment Policies and interventions Access to care MIGRATION-Related factors HEALTH Migration and the determinants of health
Migration-related factorsExamples Migration process Reasons for migration (forced vs. voluntary) Mode of travel Country of birth Duration of residence (e.g., recent vs. long-term) Migration status (e.g., legal residents, temporary workers, refugees, unauthorized) Language proficiency Multi-country exposures (origin, transit, destination) Culture Environment Disease prevalence Living and working conditions Access to care
What is Migration Health? Migration + Health
What is Migration Health? Migration + Health
What is migration? Photo: IOM
What is migration? There is no universally accepted definition and consistency in the use of terminology to describe migration
What is migration? • Any process of movement of people, • either across an international border (i.e., international migration) or within a country (i.e., internal migration) • permanently or an a temporary basis, • whatever its causes Source: J. Weekers (IOM) Global Consultation on Migrant and Health, Madrid, Spain (3–5 March 2010); adapted from IOM Glossary on Migration (2004)
Who is an International Migrant? • No internationally adopted definition
Immigrants? Aliens? Migrants? Illegals? Foreign-born? Migrant workers? Mexicans? Refugees? Foreigners? Ethnic groups? Minorities? Farmworkers? Seasonal workers Etc. Who is an International Migrant?
Why do we care about definitions? • To better understand migrant communities and migration patterns • Limit contradictory or misleading information • Achieve comparability of migration statistics among countries • Evidence-based program/policy-making
Country of birth Migration pattern Reasons for migration Culture SES Education Occupation Language Migration status Health Risks Great diversity among migrants Source: California Immigrant Integration Initiative of Grantmakers Concerned with Immigrants and Refugees
Migration Data Limitations Available data on migration has many limitations “Enormous blind spot” Even basic questions: e.g., How many? Demographics? “Old problem” Some improvements in recent years • (Source:Commission on International Migration Data, 2009)
Initiatives to Harmonize and Improve Migration Data United Nations Recommendations on statistics of international migration rev. 1 (1998) Principles and Recommendations for Population and Housing Censuses rev. 2 (2007) European Parliament and the Council of the EU Regulation (EC) No. 862/2007 (2007) Commission on International Migration Data (2009)
International migrant definitions UN Recommendations
International MigrantUN Recommendations (1998) • A person changing his/her country of usual residence • “Country of usual residence”: Where a person has lived (or intends to live) continuously for at least 12 months Sources: • UN Recommendations on International Migration Statistics (1998) • UN Expert Group Meeting on the use of censuses and surveys to measure international migration, ESA/STAT/AC.132/1 (2007)
International migrants:Immigrant vs. Emigrant • From the perspective of … • the country of departure the person will be an “emigrant” • the country of arrival the person will be an “immigrant” • “Migrant”: • More neutral term • It disregards the direction of movement UN Recommendations on International Migration Statistics (1998)
Internal MigrantUN Recommendations (1998) • A person changing his/her usual residence but within the same country • Rural to urban migration • Internally displaced persons (forced migration)
International Visitors • Persons traveling to another country, and who are admitted for short stays for purposes of: • Tourism • Visits to friends or relatives • Business • Religious pilgrimages • Do not intend to establish a usual residence in the destination country • Not generally considered international migrants
International migrants:Major categories • Authorized migrants (temporary or permanent residence visas) • Refugees • Asylum-seekers • Unauthorized migrants
Refugees • A person with a well-founded fear of being persecuted for reasons of race, religion, nationality, social group or political opinion, • is outside the country of his/her nationality and • is unable or unwilling to avail himself of the protection of that country • 15.2 million (2009) • (Source: UN Convention Related to the Status of Refugees and the 1967 Protocol)
Asylum-seekers • Similar to a refugee, but the person is in the country of intended residence at the time of his/her application • 838,000 (2009)
Unauthorized migrants • “A person who, owing to illegal entry or the expiry of his/her visa, lacks legal status in a transit or host country” • A.K.A: irregular, clandestine or illegal migrant (IOM Glossary of Migration, 2004)
Post-migration mobility patterns • Settled permanently • Internal migration • Migrate to other country(ies) • Return migration • Circular migration
WEB DATA SITES UN Population Division Organization for Economic Cooperation and Development (OECD) Research Centers, Think Tanks, Advocacy Groups: e.g., Migration Policy Institute
UN Population Divisionhttp://www.un.org/esa/population/migration/index.html Global Migration Database (1960-2010) CDs for purchase: Trends in International Migration Stock: The 2008 Revision (CD) International Migration Flows to and from Selected Countries: The 2008 Revision (CD) International Migration 2009 Excel Table and Wall chart (Note: estimates of 2010 data)
Organization for Economic Cooperation and Development 30 countries(e.g., E.U. States, U.S, Canada, Australia, Mexico, Japan) OECD Migration Databases http://stats.oecd.org/Index.aspx?datasetcode=MIG International Migration Data 2009 Excel Tables (2007 data) Reports: Sources and Comparability of Migration Statistics Report: International Migration Outlook, 2009
Migration Policy Institute Migration Information Sourcehttp://www.migrationinformation.org/ “Non-partisan” U.S and Global data Many reports and statistics
International migrant • Countries use different criteria: • Country of birth (i.e., native vs. foreign born) • Country of citizenship (i.e., nationals vs. foreigners) • Duration of residence • Legal admission categories • Purpose of entry • Country of residence • Ethnicity (e.g., Ethnic-Russian)
International migrant:U.S definitions • Department of Homeland Security • U.S Census Bureau
Department of Homeland Security Immigrants (LPRs or Green Card): Aliens (or foreign nationals) admitted to the U.S. for lawful permanent residence, as defined in the Immigration & Nationality Act Naturalized citizens: immigrants that acquire the U.S citizenship (Nonimmigrant) temporary admissions Temporary visitors (tourists and business travelers) Temporary workers, students, others Refugees and asylees Unauthorized migrants (estimates)
Department of Homeland Security(Annual) Yearbook of Immigration Statistics Source: http://www.dhs.gov/files/statistics/immigration.shtm
U.S Census Bureau • Native: anyone who was a U.S. citizen at birth. Includes: • born in the U.S, Puerto Rico, American Samoa, Guam, the Northern Marianas, or the U.S. Virgin Islands, or • born abroad of at least one U.S. citizen parent • Foreign-born: anyone who is not a U.S citizen at birth
U.S Census Bureau • Foreign-born population: 37.9 million • Naturalized citizens: 16.0 million • Non U.S citizens 21.9 million • Does not collect additional migration status information (e.g., LPRs, temporary visas, unauthorized, refugees)
Race/ethnicity vs. Foreign-born Source: American Community Survey, 2008
Migrant (Farm-) Workers • Occupational group • ~1 million (average in 2006) • 78% are foreign-born • ~50% are undocumented • Migration patterns • Settled53% • Shuttler migrants* 21% • Follow-the-crop migrants* 13% • Newcomers 13% • Source: Kandel, William. Profile of Hired Farmworkers, A 2008 Update, Economic Research Report No. 60, Economic Research Service, U.S. Department of Agriculture, June 2008. *International or within the U.S)
American Community Survey (ACS)U.S Census Bureau Started in 2004 Replaces Decennial Census long form (in 2010) By mail => phone => personal visit Annual sample: 3 million households Local-level data Response rate: ~98% Annual release of data!
ACSMigration Data Place of birth/nativity U.S. citizenship Year of entry Ancestry Language spoken at home Year of naturalization(starting in 2008) Place of residence 1 year ago Health insurance coverage (since 2008) and food stamp participation
Accessing U.S Census Data Public Use Microdata Samples (IPUMS) http://usa.ipums.org/usa/ Individual household level (no identifiers) American Factfinder (pregenerated tables) Website: http://factfinder.census.gov/