Differential Probability in Unmet Healthcare Needs Among Migrants in Four European Countries

Abstract

Migrants and refugees try to reach Europe to seek protection and a better life. The responsiveness and stewardship of the European countries health system have an impact on the ability to access healthcare. This study aims to investigate the differential probability of healthcare unmet needs among migrants living in four European countries. We used a 2019 cross-sectional data from the European Union Income and Living Conditions survey. We performed a two-stage probit model with sample selection, first to identify the respondents with need for care, then those who need it but have not received it. We analysed reasons for unmet needs through accessibility, availability and acceptability. We then performed country studies assessing the national health systems, financing mechanisms and migration policies. Bringing together data on financial hardship and unmet needs reveals that migrants living in Europe have a higher risk of facing unmet healthcare needs compared to native citizens, and affordability of care remains a substantial barrier. Our results showed the country heterogeneity in the differential migrants’ unmet needs according to the place where they live, and this disparity seems attributed to the health system and policies applied. Given the diversity of socioeconomic conditions throughout the European countries, the health of migrants depends to a large degree on the integration and health policies in place. We believe that EU policies should apply further efforts to respect core health and protection ethics and to acknowledge, among others, principles of ‘do-no-harm’, equity and the right to health.

Better data on unmet healthcare need can strengthen global monitoring of universal health coverage

“… 13 For example, a cross sectional study using 2019 data from the European Union Income and Living Conditions survey shows that migrants have higher unmet healthcare needs than non-migrants. 14 …”

“…13 For example, a cross sectional study using 2019 data from the European Union Income and Living Conditions survey shows that migrants have higher unmet healthcare needs than non-migrants. 14 In many countries, over half of older adults have chronic conditions and disabilities that health systems are poorly equipped to manage, giving rise to unmet need. 15 A WHO Kobe Centre analysis of survey data in 2021-22 from 83 countries showed that the prevalence of self-reported unmet healthcare needs of adults aged 60-69 tends to be lower in countries with higher SCI values, but outliers like the US have both high SCI and high unmet need.…”