The health of migrants can be considered at various stages of the migration process. Gushulak and MacPherson (2000) and Zimmerman and others (2011) argue that each stage of the migration process—the pre-departure phase, the journey itself, arrival, adjustment at the place of destination and return to the place of origin—is associated with a particular set of health parameters and influences which impinge upon a migrant’s health. These impacts can be both positive and negative. On the positive side, some migrants may have better access to health services at the place of destination than at the place of origin. For example, health services in general are more readily available in urban areas as compared to rural areas. So consequently, migrants to urban areas may be able to access those services more than they could in their origin area. On the other hand, migrants’ journeys can be dangerous and expose them to injury or disease. At the place of destination, they may be exposed to new diseases to which they have no immunity, or they may adopt new behavioural practices, or living and work arrangements that place them at risk. Moreover, marginalization and discrimination at the place of destination may prevent them gaining access to health services. Migrants may also introduce new diseases to their place of origin when they return home.
In examining the relationship between migration and health it is essential to consider the differences that may exist between a migrant and the population in the host country, including culture and language, age, socio-economic status and financial circumstances. However, determining these differences is very difficult, as many migrant groups are invisible in standard data collections (Gushulak and MacPherson 2000). A key focus area has been on the healthy migrant effect which operates in many international migrations, especially those crossing international boundaries. Migration is invariably selective of young adults and of the healthier among them. Indeed, the international migration regulations of most countries exclude less healthy people and require medical testing of all intending migrants and migrant workers (Asis 2005).
However, once at the destination the ‘healthy migrant effect’ can be quickly compromised due to:
- substandard living conditions;
- low income, poor food;
- exposure to dangerous work situations;
- barriers to accessing health care;
- social marginalization;
- negative health effects associated with the process of migration;
- migrants adopting less healthy practices, lifestyle and diet (Jatrana and Chan 2005);
- possible exposure to health risk for those with an irregular migrant status.