A report presented on 8 December at a side event to the UN Intergovernmental Conference to adopt the Global Compact for Safe, Orderly and Regular Migration in Marrakech, Morrocco has laid bare many of the harmful misconceptions about migration (1). Common myths about migration and health are often not supported by evidence and ignore the important contribution of migrants to global economies. Some of the most pervasive and harmful myths include suggestions that migrants are disease carriers and a burden on services. In reality, migrants generally contribute more to the wealth of host societies than they cost.
The data analysis was carried out by the new University College London (UCL)-Lancet Commission on Migration and Health, set up to inform public discourse and policy using evidence-based approaches. The two-year project was an international effort led by 20 leading experts from 13 countries and has resulted in two research papers, which describe the findings in more detail (2, 3). The analysis incorporated international evidence and expertise from various perspectives, including sociology, politics, public health science, law, humanitarianism, and anthropology
It was found that, on average, migrants in high-income countries have lower mortality than the host country population. However, increased morbidity ― for example, increased rates of depression ― were found in certain subgroups, such as those exposed to trafficking or fleeing conflict. Fewer health data exists on undocumented migrants, people with disabilities, or lesbian, gay, bisexual, transsexual, or intersex (LGBTI). In addition, the health of migrants depends enormously on the reasons for migration, journey conditions, and destination. Negative health effects were repeatedly found to be the result of discrimination, gender inequalities, and exclusion from health and social services.
The work is “a call to action for civil society, health leaders, academics, and policymakers to maximise the benefits and reduce the costs of migration on health locally and globally.” Furthermore, as per international conventions, all human beings should be entitled to universal human rights without discrimination. These include “underlying social, political, economic, and cultural determinants of physical and mental health, such as clean water and air and non-discriminatory treatment.” As such, four key messages were outlined to provide a focus for future action:
- The UN is urged to appoint a Special Envoy on Migration and Health and suggest national governments should have a country-level focal point for migration and health.
- Health leaders and practitioners should be fully engaged in the discussions at high-level policy-making forums on migration.
- Racism and prejudice should be confronted with a zero-tolerance approach.
- Governments should provide universal and equitable access to health services to migrants.
The report was, in part, driven by the huge gap between the international legal requirements guaranteeing the human rights of migrants. Many unfounded ‘facts’ are used to deny migrants entry, restrict healthcare access, and detain people unlawfully. Unauthorised border crossings are sometimes treated as criminal offences, resulting in arrests or jail, and children separated from their parents. Detention centres including Naru Island, an Australian offshore detention facility, where migrants receive appalling treatment, as well as the zero-tolerance policy introduced by the US, are in clear violation of international law.
Migration is the defining issue of our time and as the authors write, “should be treated as
a central feature of 21st-century health and development.” Unfortunately, beliefs are often not supported by evidence. Moreover, the important contribution of migration to global economies is frequently ignored. Too often, migration issues are used by politicians as a “lightning rod” to bolster their populist agendas. The authors write, “populist discourse demonises the very same individuals who uphold economies, bolster social services, and contribute to health services in both origin and destination locations.” The “us versus them rhetoric” has led to “moral emergency.” Fortunately, this new evidence, at the very least, challenges these harmful myths.
(1) Abubakar, I. et al. The UCL–Lancet Commission on Migration and Health: the health of a world on the move. The Lancet (2018) DOI: 10.1016/S0140-6736(18)32114-7
(2) Aldridge, R.W. et al. Global patterns of mortality in international migrants: a systematic review and meta-analysis. The Lancet (2018). DOI: 10.1016/S0140-6736(18)32781-8
(3) Fellmeth, G. et al. Health impacts of parental migration on left-behind children and adolescents: a systematic review and meta-analysis. The Lancet (2018). DOI: 10.1016/S0140-6736(18)32558-3