A metasynthesis of qualitative studies regarding opinions and perceptions about barriers and determinants of health services’ accessibility in economic migrants

Background: Access to health services is an important health determinant. New research in health equity is required, especially amongst economic migrants from developing countries. Studies conducted on the use of health services by migrant populations highlight existing gaps in understanding which factors affect access to these services from a qualitative perspective. We aim to describe the views of the migrants regarding barriers and determinants of access to health services in the international literature (1997–2011). Methods: A systematic review was conducted for Qualitative research papers (English/Spanish) published in 13 electronic databases. A selection of articles that accomplished the inclusion criteria and a quality evaluation of the studies were carried out. The findings of the selected studies were synthesised by means of metasynthesis using different analysis categories according to Andersen’s conceptual framework of access and use of health services and by incorporating other emergent categories. Results: We located 3,025 titles, 36 studies achieved the inclusion criteria. After quality evaluation, 28 articles were definitively synthesised. 12 studies (46.2%) were carried out in the U.S and 11 studies (42.3%) dealt with primary care services. The participating population varied depending mainly on type of host country. Barriers were described, such as the lack of communication between health services providers and migrants, due to idiomatic difficulties and cultural differences. Other barriers were linked to the economic system, the health service characteristics and the legislation in each country. This situation has consequences for the lack of health control by migrants and their social vulnerability. Conclusions: Economic migrants faced individual and structural barriers to the health services in host countries, especially those with undocumented situation and those experimented idiomatic difficulties. Strategies to improve the structures of health systems and social policies are needed.

Late life second move housing choices of international retiree migrants

Purpose – Many international retirement migrants are amenity movers undertaking the first move in the late life course model of migration. The purpose of this paper is to examine second moves within the retirement destination community to test whether the model of late life course migration accurately portrays the motivations and housing choices local movers make after retiring to another country. Design/methodology/approach – The paper combines secondary data and survey results to examine the composition of the retiree migrant population in the Alicante province of Spain. The socioeconomic characteristics and housing choices of those who have made a second move since retiring to Spain are compared with those who have not moved through a series of t-tests and chi-square tests. Findings – The paper finds that those who have made a second move within Spain are somewhat typical of second movers in the late life course. They are likely to cite mobility or health problems as a reason for moving and appear to recognize the need for a home that provides living area on one floor. Yet, they are choosing to move within an area that does not provide them with access to informal family care givers. Research limitations/implications – The data are restricted to retirees of two nationalities in one province of Spain. Further research is suggested in other locations and with retirees of other nationalities for comparison. Practical implications – Because many international retirees do not plan to return to their countries of origin, they will create demand for formal in-home care services and supportive retiree housing in the near future in their retirement destination countries. Originality/value – This paper provides understanding of a growing consumer housing segment in retirement destinations.

La integración cultural y social en las migraciones intraeuropeas

Cuando un migrante llega a una sociedad distinta, debe elegir cómo vivir en ella. En esta elección cuentan su pasado, su presente y especialmente su futuro en términos de expectativas de movilidad. Comprender cómo viven los residentes extranjeros en su país de destino implica considerar conceptos clave como procesos de socialización, shock cultural, competencia intercultural o procesos de aculturación que implican aprender nuevas competencias culturales. A partir de los datos de la Encuesta Social de Migraciones Internas Europeas (EIMSS) este trabajo se centra en el análisis de dos dimensiones, la integración cultural y la integración social, que van a caracterizar el modo en que los migrantes europeos viven en su nuevo entorno social, y su relación con la percepción de la discriminación que tiene el migrante o su adaptación psicológica, en términos de nostalgia y satisfacción con la vida.

Los inmigrantes como amenaza: procesos migratorios en la televisión española

La mayor parte de las investigaciones desarrolladas en torno a la imagen mediática de los procesos migratorios destacan la tendencia hacia su problematización, de forma que se asocia a la población inmigrante con amenazas sociales, económicas, culturales, con la desviación, delincuencia, ilegalidad, etc. Tomando como referencia el caso de España, en este artículo se analiza la manera en que los noticiarios televisivos construyen aquellas noticias relacionadas con la población inmigrante. Con este fin, se han recogido un total de 145 noticias emitidas en 105 programas informativos de cuatro cadenas de televisión (tres de ámbito nacional y una regional), a cuyos contenidos se han aplicado, fundamentalmente, técnicas cualitativas de análisis.

La nueva Estadística de Migraciones: una buena elección por parte del INE

El Instituto Nacional de Estadística ha decidido elaborar una nueva Estadística de Migraciones utilizando como base la Estadística de Variaciones Residenciales. En este artículo se aportan algunos argumentos que apoyan esta decisión, ante la persistente falta de coherencia entre las fuentes del sistema estadístico español para captar la movilidad. En particular, se profundiza en los problemas de subestimación e inconsistencia interna de la Encuesta de Población Activa para medir la inmigración, a la vista de las diferencias entre las tres series de flujos de inmigración internacional que es posible estimar a partir de la misma.

Condiciones de trabajo y salud de los trabajadores inmigrantes en España. Revisión bibliográfica

Fundamentos: La relación entre inmigración, trabajo y salud constituye uno de los retos más importantes en salud laboral y más concretamente en España por el importante incremento de proporción inmigrante acontecido en el mercado laboral. El objetivo de esta investigación es conocer la relación entre las condiciones de trabajo y sus efectos en la salud de trabajadores inmigrantes en España. Métodos: Revisión bibliográfica de artículos científicos originales en español e inglés Medline y Medes (1998-2012). Se revisaron los textos completos de los artículos incluidos. Resultados: Se incluyeron 20 estudios, 13 con metodología de investigación cuantitativa y 7 cualitativa. Los temas tratados abordaban problemas específicos de salud relacionados con el trabajo (principalmente lesiones por accidente de trabajo), incapacidad laboral y diferencias en condiciones de trabajo y empleo. Los hallazgos de los estudios mostraron mayor incidencia de lesiones por accidentes de trabajo, menores tasas de incapacidad laboral, mayor prevalencia de presentismo laboral, exposición a factores psicosociales y precariedad laboral en la población inmigrante. Conclusiones: A pesar de la singularidad del proceso demográfico migratorio, los problemas de salud y determinantes identificados no difieren de los referenciados en otros países, en otros contextos y en otros momentos.

Prácticas de autocuidado sexual y reproductivo en mujeres “parejas de” migrantes internacionales de San Luis Potosí, México

Los migrantes y sus parejas han sido incorporados en los discursos institucionales de salud como “sujetos en riesgo” frente a las Infecciones de Trasmisión Sexual (ITS), sin embargo la incorporación de esta población específica en la comunicación y gestión del riesgo de ITS ha sido ambigua en el contexto mexicano. El objetivo del presente acercamiento fue conocer las prácticas de autocuidado sexual y reproductivo que adoptan en su cotidianeidad mujeres parejas de migrantes y la relación de dichas medidas con la comunicación y gestión del riesgo que los Servicios de Salud realizan. Se trató de una aproximación de tipo cualitativo con 20 mujeres “de migrantes” localizadas mediante los servicios de salud, la información se recabó a través de entrevistas a profundidad que focalizaron en las esferas de “percepción del riesgo” y “Autocuidado sexual y reproductivo”. Se encontró que la mayoría de las mujeres no se reconoce vulnerable frente a las ITS y que la percepción del riesgo no es determinante en la confrontación que respecto a la amenaza puedan desarrollar, dado que los imaginarios patriarcales que prevalecen en ellas, sus parejas y el personal de salud desestiman la utilización de medidas de prevención y detección oportuna.

From the boom to the crisis: changes in employment conditions of immigrants in Spain and their effects on mental health

Background: Migrant workers have been one of the groups most affected by the economic crisis. This study evaluates the influence of changes in employment conditions on the incidence of poor mental health of immigrant workers in Spain, after a period of 3 years, in context of economic crisis. Methods: Follow-up survey was conducted at two time points, 2008 and 2011, with a reference population of 318 workers from Colombia, Ecuador, Morocco and Romania residing in Spain. Individuals from this population who reported good mental health in the 2008 survey (n = 214) were interviewed again in 2011 to evaluate their mental health status and the effects of their different employment situations since 2008 by calculating crude and adjusted odds ratios (aORs) for sociodemographic and employment characteristics. Findings: There was an increased risk of poor mental health in workers who lost their jobs (aOR = 3.62, 95%CI: 1.64–7.96), whose number of working hours increased (aOR = 2.35, 95%CI: 1.02–5.44), whose monthly income decreased (aOR = 2.75, 95%CI: 1.08–7.00) or who remained within the low-income bracket. This was also the case for people whose legal status (permission for working and residing in Spain) was temporary or permanent compared with those with Spanish nationality (aOR = 3.32, 95%CI: 1.15–9.58) or illegal (aOR = 17.34, 95%CI: 1.96–153.23). In contrast, a decreased risk was observed among those who attained their registration under Spanish Social Security system (aOR = 0.10, 95%CI: 0.02–0.48). Conclusion: There was an increase in poor mental health among immigrant workers who experienced deterioration in their employment conditions, probably influenced by the economic crisis.

A qualitative exploration of the impact of the economic recession in Spain on working, living and health conditions: reflections based on immigrant workers' experiences

Background: This study aimed to analyse how immigrant workers in Spain experienced changes in their working and employment conditions brought about Spain's economic recession and the impact of these changes on their living conditions and health status. Method: We conducted a grounded theory study. Data were obtained through six focus group discussions with immigrant workers (n = 44) from Colombia, Ecuador and Morocco, and two individual interviews with key informants from Romania living in Spain, selected by theoretical sample. Results: Three categories related to the crisis emerged – previous labour experiences, employment consequences and individual consequences – that show how immigrant workers in Spain (i) understand the change in employment and working conditions conditioned by their experiences in the period prior to the crisis, and (ii) experienced the deterioration in their quality of life and health as consequences of the worsening of employment and working conditions during times of economic recession. Conclusion: The negative impact of the financial crisis on immigrant workers may increase their social vulnerability, potentially leading to the failure of their migratory project and a return to their home countries. Policy makers should take measures to minimize the negative impact of economic crisis on the occupational health of migrant workers in order to strengthen social protection and promote health and well-being.

Limitaciones y recomendaciones metodológicas en las publicaciones sobre salud de la población inmigrante en España

El objetivo es describir las limitaciones y las recomendaciones metodológicas identificadas por los autores de artículos originales sobre inmigración y salud en España. Se realizó una revisión bibliográfica de artículos originales publicados en español e inglés entre 1998 y 2012, combinando descriptores de inmigración y salud. Se incluyeron 311 artículos; de ellos, 176 (56,6%) mencionaban limitaciones y 15 (4,8%) emitían recomendaciones. Entre las limitaciones más mencionadas destacan el reducido tamaño de las muestras, problemas de validez interna y representatividad de la muestra con infrarrepresentación o sobrerrepresentación de determinados grupos, problemas de validez de la información recogida y datos faltantes relacionados sobre todo con los instrumentos de medición, y ausencia de variables clave de ajuste o estratificación. En función de los resultados obtenidos, se proponen una serie de recomendaciones para minimizar las limitaciones habituales y avanzar en la calidad de los trabajos científicos sobre inmigración y salud en nuestro ámbito.

Narratives and counter-narratives on "marriage of convenience" : conjugality and (il)legality in portuguese migration policies and in couples’ experiences

Tese de doutoramento, Sociologia (Sociologia da Família, Juventude e das Relações do Género), Universidade de Lisboa, Instituto de Ciências Sociais, 2016

The Theory of Interhybridity: Socio-political Dimensions and Migration Experiences of Post-communist Western Balkan States

The Western Balkans integration within the EU has started a legal process which is the rejection of former communist legal/political approaches and the transformation of former communist institutions. Indeed, the EU agenda has brought vertical/horizontal integration and Europeanization of national institutions (i.e. shifting power to the EU institutions and international authorities). At this point, it is very crucial to emphasize the fact that the Western Balkans as a whole region has currently an image that includes characteristics of both the Soviet socialism and the European democracy. The EU foreign policies and enlargement strategy for Western Balkans have significant effects on four core factors (i.e. Schengen visa regulations, remittances, asylum and migration as an aggregate process). The convergence/divergence of EU member states’ priorities for migration policies regulate and even shape directly the migration dynamics in migrant sender countries. From this standpoint, the research explores how main migration factors are influenced by political and judicial factors such as; rule of law and democracy score, the economic liberation score, political and human rights, civil society score and citizenship rights in Western Balkan countries. The proposal of interhybridity explores how the hybridization of state and non-state actors within home and host countries can solve labor migration-related problems. The economical and sociopolitical labor-migration model of Basu (2009) is overlapping with the multidimensional empirical framework of interhybridity. Indisputably, hybrid model (i.e. collaboration state and non-state actors) has a catalyst role in terms of balancing social problems and civil society needs. Paradigmatically, it is better to perceive the hybrid model as a combination of communicative and strategic action that means the reciprocal recognition within the model is precondition for significant functionality. This will shape social and industrial relations with moral meanings of communication.

The Criminalisation of Migration in Europe: A State-of-the-Art of the Academic Literature and Research. CEPS Liberty and Security in Europe No. 61, October 2013

In the last 30 years, a clear trend has come to define modern immigration law and policy. A set of seemingly disparate developments concerning the constant reinforcement of border controls, tightening of conditions of entry, expanding capacities for detention and deportation and the proliferation of criminal sanctions for migration offences, accompanied by an anxiety on the part of the press, public and political establishment regarding migrant criminality can now be seen to form a definitive shift in the European Union towards the so-called ‘criminalisation of migration’. This paper aims to provide an overview of the ‘state-of-the-art’ in the academic literature and EU research on criminalisation of migration in Europe. It analyses three key manifestations of the so-called ‘crimmigration’ trend: discursive criminalisation; the use of criminal law for migration management; and immigrant detention, focusing both on developments in domestic legislation of EU member states but also the increasing conflation of mobility, crime and security which has accompanied EU integration. By identifying the trends, synergies and gaps in the scholarly approaches dealing with the criminalisation of migration, the paper seeks to provide a framework for on-going research under Work Package 8 of the FIDUCIA project.

Migration and Integration. Common Challenges and Responses from Europe and Asia

With the signing of the ASEAN Framework Agreement for the Integration of Priority Sectors (FA) in 2004, migration and integration issues gained significance on the agenda. Primarily concerned with increasing economic growth, this framework excludes the integration of low and unskilled migrant workers; instead, ASEAN efforts to address migration and integration issues have been limited to Mutual Recognition Agreements for skilled labour and professionals. After an analysis of migration policy in the region, we highlight specific barriers to the integration of labour migrants in two priority sectors – nursing, which is highly regulated by the state, and Information, Communications and Technology (ICT), which is typically selfregulated and privately run. Despite a MRA for nursing allowing registered nurses to practice in another ASEAN country under supervision of local nurses without registering with the host country’s nursing regulatory authority, in practice, there are major barriers to the free movement of nurses within ASEAN in terms of skills recognition, licensure requirements and other protectionist measures. Although regulations governing the inflow of ICT professionals are not as stringent as those for healthcare professionals, private costs associated with job search and gaining foreign employment are higher in the ICT sector, largely due to limited information on international mobility within the industry. Three sets of barriers to greater integration are discussed. First, the economic and political diversity within ASEAN makes integration more problematic than in the European Union. Second, the primary concern with value-adding economic growth means that regional agreements are focused on skilled and professional labour migration only. Third, the “ASEAN way” of doing things – via a strong emphasis on consensus and non-interference with domestic policies – often means that the FA provision for the free movement of labour is usually trumped by domestic policies that do not reflect the same desire for labour integration.

Migration and asylum: The movement of people in the Mediterranean Region - Future scenarios and the EU response. Jean Monnet Occasional Paper No. 11/2014

Introduction. In recent years, the global discussion on migration and asylum has evolved from polarization of perspectives and mistrust, to improving partnerships and fostering cooperation between countries and regions. The paradigm has shifted from control and security exclusively to an increased awareness of the ramifications of migration in development and labour markets, the increasing demographic gap1 and the dangers of exclusion faced by migrant workers (regular or irregular). Eastern Europe will suffer the biggest population decline in the coming years, and Nigeria’s population will reach one billion by 2100. In Europe, the work replacement ratio will be two pensioners for one active worker. It has become clear that these facts cannot be ignored and that there is a need for greater convergence of policies (migration/mobility, fundamental rights, and economic growth), with a migrant-centred approach.2. The assumption that Europe will remain a geopolitical and economic hub that attracts immigrants at all skill levels might not hold water in the long run. The evolving demographic and economic changes have made it evident that the competitiveness of the EU (Europe 2020 Strategy) is also at stake, particularly if an adaptable workforce with the necessary skills is not secured in view of shortfalls in skill levels and because of serious labour mismatches. Therefore, it is the right moment to develop more strategic and long-term migration policies that take into account the evolving position of Europe and its neighbours in the world. By the same token, labour market strategies that meet needs and promote integration of regular migrants are still a pending task for the Member States (MS) in terms of the free movement of people, but also in relation with neighbouring and partner countries.