This project explored the relationship between migration variables (country of birth, length of residence in the UK), ethnicity, material circumstances, health, and access to health care by analysing quantitative evidence on migrants’ health status and access to health care in the UK. While concern is growing about the health of some categories of migrant and barriers that they face in accessing health care, much of the evidence available in national data sets such as the Health Survey for England and the Millennium Cohort Study has not yet been analysed specifically for foreign born sections of the population, and particularly recent migrants with residence of 10 years or less in the UK.
The intention of the project was to undertake secondary analysis of national data to provide an account of the health of migrants and their access to and uptake of health care in the UK, including the extent to which length of residence in the UK affects health status and access to care. The findings provide an evidence base and new insights for future policy making and service delivery as well as identify gaps in the evidence base for a future research agenda.
Maria Quigley (National Perinatal Epidemiology Unit, University of Oxford)
ESRC (COMPAS core funds)
A challenge to linear acculturation models for migrants’ health in showing that a linear trend in improving socio-economic circumstances for mothers in some ethnic groups is not always associated with better health outcomes or changes in health behaviour.
The method involved secondary analyses of an existing large scale national dataset, the Millennium Cohort Study Sweep 1. The survey focuses specifically on families who are at an early stage of parenthood, therefore enabling exploration of health experiences around pregnancy and birth. The focus in this project was mothers of infants born in the UK or born abroad. Univariate and multivariate analyses were conducted on associations between mothers’ country of birth, ethnicity, length of residence in the UK (if migrants), and indicators of their physical and mental health, health behaviour and access to healthcare.
There are both positive and negative health indicators associated with ethnicity, birth abroad and length of residence, and presenting results on a single factor in isolation could lead to a misinterpretation of associations. For mothers, ethnicity has an important relationship with most health indicators independent of country of birth, length of residence and socio-demographic circumstances. Once adjusted for ethnicity and socio-demographic variables, association with birth abroad disappears for most health outcomes, suggesting that there may not be an independent migrant penalty in health. There is a linear trend in decreasing health status with increasing length of residence but no independent association between length of residence and healthcare use. This suggests that while there are continuing barriers to good health for migrants in the receiving society, as shown in other studies, factors important for one health outcome may not apply to another.
This project lead to a Race Equality Foundation Briefing that has been widely disseminated, and to several conference and workshop presentations on the topic of ‘migration and health’, including as part of Global Health Week, organised by Barts and the London School of Medicine, and as part of the knowledge exchange events held with health sector stakeholders, organised by the West Midlands Strategic Migration Partnership.