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Health education and migration

Despite the vastly differing ideological and political standpoints that it provokes, migration has become a firmly embedded global policy issue in the 21 century. In 2015, an estimated 244 million people were defined as international migrants, an increase of 71 million since the year 2000 (UNDESA, 2015). A further 740 million people are estimated to migrate within their own country (International Organisation for Migration [IOM], 2015). Many millions more, even if not moving themselves, are directly affected by migration. As well as increasing in its extent, migration has also increased in complexity, involving mixed flows of economic, forced and irregular migration, generating an increasingly diverse demographic profile of migrant people. Migration is increasingly recognised as a determinant of health (Casteñeda et al., 2015; Davies et al., 2010). On one hand, migration can extend and improve people’s wellbeing in a myriad of ways: improving access to required health technologies to treat certain conditions; widening opportunities for employment, training or education, thus enhancing aspects of economic and social wellbeing; providing political freedom to exercise choice and control over one’s life or offering security and safety away from conflict and/or persecution. On the other hand, migration can negatively impact on those who move and those who stay behind, through a whole range of new stresses, pressures and demands. These range from strenuous journeys (for some marked by extreme violence and trauma) to physical and arduous work, to pressures to support families far away and sustain a life in the host country, to challenges with respect to integration, language, social isolation and fears about legal status and security. At another level, health economies and systems can be sustained through certain migratory flows, while simultaneously stretched by new demands and pressures from other forms of migration. Migration trajectories can thus positively or negatively impact health outcomes at multiple levels, just as health status can affect migration outcomes. However, the interactional relationships between migration and health are not clearly understood, and the policy and practice arena remains largely uncoordinated and inconsistent, with major discrepancies between policy implementation and practical need. While this disjointed and inadequate situation is in part reflective of the politicised and security-focused context in which migration is often played out, it is also the product of a widespread lack of understanding and agreement on how best to promote the health and wellbeing of increasingly diverse populations. Indeed, recent research has emphasised that international targets, such as the