Challenges in researching migration status, health and health service use: an intersectional analysis of a South London community

Abstract

Objectives. This study aimed to investigate the associations between migration status and health-related outcomes and to examine whether and how the effect of migration status changes when it is disaggregated by length of residence, first language, reason for migration and combined with ethnicity. Design. A total of 1698 adults were interviewed from 1076 randomly selected households in two South London boroughs. We described the socio-demographic and socio-economic differences between migrants and non-migrants and compared the prevalence of health-related outcomes by migration status, length of residence, first language, reason for migration and migration status within ethnic groups. Unadjusted models and models adjusted for socio-demographic and socio-economic indicators are presented. Results. Migrants were disadvantaged in terms of socio-economic status but few differences were found between migrant and non-migrants regarding health or health service use indicators; migration status was associated with decreased hazardous alcohol use, functional limitations due to poor mental health and not being registered with a general practitioner. Important differences emerged when migration status was disaggregated by length of residence in the UK, first language, reason for migration and intersected with ethnicity. The association between migration status and functional limitations due to poor mental health was only seen in White migrants, migrants whose first language was not English and migrants who had moved to the UK for work or a better life or for asylum or political reasons. There was no association between migration status and self-rated health overall, but Black African migrants had decreased odds for reporting poor health compared to their non-migrant counterparts [odds ratio = 0.15 (0.05–0.48), p < 0.01]. Conclusions. Disaggregating migration status by length of residence, first language and reason for migration as well as intersecting it with ethnicity leads to better understanding of the effect migration status has on health and health service use.

Taking an intersectional approach to define latent classes of socioeconomic status, ethnicity and migration status for psychiatric epidemiological research

“…Only the less privileged migrant class had increased odds of CMD. This is consistent with the wider literature which suggests a key role for SES factors in explaining any ethnic inequalities in health (Darlington et al, 2015) and differences in health at the intersection of ethnicity and migration status (Gazard et al, 2014, Smith et al, 2009. Another potential explanation for differences between these classes is whether the decision to migrate was by force or choice.…”

Paediatric emergency department utilisation rates and maternal migration status in the Born in Bradford cohort: A cross-sectional study

“…Migrants are not a homogeneous group; populations will have had different experiences in their host country and are ethnically, socio-economically, and socio-demographically diverse, which may affect health and healthcare use [19]. To gain a deeper understanding of the relationship between migration status and health, sub-group analyses were conducted by mother's region of birth, according to World Bank regions, and by mother's time since arrival in the UK at time of recruitment: short-term migrant (<1 year in UK), long-term migrant (living in UK �1 to <5 years), or established migrant (�5 years in UK).…”

Black-White health inequalities in Canada at the intersection of gender and immigration

“…[1][2][3][4] Systemic relations of power along the lines of race, gender and nationality are thought to be contingent upon one another rather than analytically distinct systems. One outcome of the entanglement of these axes of inequality at the macro levels of society is that the social identities they form (immigrant Black woman, native-born White man, etc.)…”