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Migrant Health & Wellbeing in Belfast. Leslie Boydell Associate Medical Director, Public Health Belfast Health & Social Care Trust 5 th February 2010, Brussels. Belfast Health and Social Care Trust. Purpose: to improve health and wellbeing and reduce health inequalities
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Migrant Health & Wellbeing in Belfast Leslie Boydell Associate Medical Director, Public Health Belfast Health & Social Care Trust 5th February 2010, Brussels
Belfast Health and Social Care Trust Purpose: to improve health and wellbeing and reduce health inequalities Business: to deliver safe, modern, cost-effective health and social care 20,000 staff
Population • N Ireland: 1,775,000 • Belfast: 325,000
Migration in N.I. • 1970’s / 80’s - Net emigration • 1990’s - Balanced migration • >2000 - Net immigration and population growth • >2004 - Rapid increase from A8 @65,000 to NI (04-08) 2/3 from A8 Construction and Manufacturing 2% of population in Belfast
Sources of information on Migration • Health card registration • Worker Registration Scheme for A8 but not A2 countries • Work permits for those outside EU • National Insurance number registrations • School census for children with English as a second language
Health Card Registrations • Increase by 50% between 2005-2007 • Registrations 07 - 19,400 08 - 15,400 > 50% A8
Main applicants to Workers Registration Scheme 04-06 Poland 7,050 Lithunania 3,255 Slovakia 2,170 Total 14,395 (04-06) Year to June 07 9100 Year to June 08 7800
Work Permits 04/05 08/09 Indian 760 315 Philippines 685 85 Ukraine 530 <20 Roumania 265 20 Pakistan 420 <20 China 255 130 Bulgaria 115 290
English as an additional language 08/09 • Primary 4660 - 2% population • Secondary 2142 - 1% population
Births to mothers born outside NI Almost doubled between 2001-2006 from189 to 365 In 2008, 9% of all births to mothers born outside NI, from 3% in 2001 50% from new EU states
Issues • Language (Within HSC, requests for interpreting service increased dramatically 2004-2007 - Mandarin, Cantonese, Polish) • Access to information • Lack of understanding for the system • Isolation • Employment (exploitation and unrecognised qualifications) • Cultural differences and religious needs
Issues continued • Racial prejudice and harassment Hate crime, mainly assaults and criminal damage - 315 incidents in S.Belfast 08/09 under reported • Housing – overcrowding homelessness child exception
Health Problems • Diabetes - 12.4% Asians, 8.4% Black 5.4% NI • Mental health • High levels of suicide in Lithuanians • Drugs and alcohol Eligible for GP services and emergency care
Poverty • Especially child poverty • Especially A8 and A2 countries • Asylum seekers paid allowance 30% less than benefit level • A8 workers very vulnerable to economic downturn • If not worked continuously for 12/12 or registered with WRS no access to benefits • A2 limited access to labour
Issues continued • Poor organisational leadership • Need for co-ordination and inter-organisational collaboration • Need for professional training and support • Inadequate statistics • Small numbers from many countries with diverse needs
Study of Health Visitors’ caseload • Language – husbands interpreting for wives • Mobile families – no history of immunisations • High demand on professional time • Not registered with GP – go directly to A&E • Don’t know how to access services and support • Low car ownership • Social isolation • Work long hours • Child protection issues • Child health problems • Postnatal depression • Domestic violence
