Catherine A. O'Donnell
This is an advance summary of a forthcoming article in the Oxford Research Encyclopedia of Global Public Health. Please check back later for the full article.
Migration is a reality of today’s world, with over 1 billion migrants worldwide. While many choose to move voluntarily, others are forced to migrate due to economic reasons or to flee war, conflict, or persecution. Such migrants often find themselves in precarious and marginalized situations. This is especially true of asylum seekers, refugees, and undocumented or irregular migrants. While often viewed as a single population, the legal status and entitlements of these three groups are distinct. Differences between these peoples affect access to health care with rights and entitlements varying across the 28 countries of the European Union as well as across different parts of national health systems. The lack of entitlement to receive care, including primary and secondary care, is a significant barrier for many asylum seekers and refugees and an even greater barrier for undocumented migrants. Other barriers include different health profiles and awareness of chronic disease risk among migrants, awareness of the organization of health systems in host countries, and language and communication. The use of professional interpreters can help to overcome communication barriers, but entitlement to free interpreting services is inconsistent. Host countries need to consider how to ensure that their health systems are “migrant-friendly.” Solutions include provision of professional interpreters; ensuring that health care staff are aware of migrants’ rights to health care access; increasing knowledge of migrants in relation to the organization of the health care system in their host country; and how to access care, for example, through the use of patient navigators. Perhaps the greatest facilitator for migrants’ improved health care access would be a reduction of the stigma that demonizes those who are forced to migrate due to political situations outside of their control.
Maria Cecília de Souza Minayo and Saul Franco
Violence is a problem that accompanies the trajectory of humanity, but it presents itself in different ways in each society and throughout its historical development. Despite having different meanings according to the field of knowledge from which it is addressed and the institutions that tackle it, there are some common elements in the definition of this phenomenon. It is acknowledged as the intentional use of force and power by individuals, groups, classes, or countries to impose themselves on others, causing harm and limiting or denying rights. Its most frequent and visible forms include homicides, suicides, war, and terrorism, but violence is also articulated and manifested in less visible forms, such as gender violence, domestic violence, and enforced disappearances.
Although attention to the consequences of different forms of violence has always been part of health services, its formal and global inclusion in health sector policies and guidelines is very recent. It was only in 1996 that the World Health Organization acknowledged it as a priority in the health programs of all countries. Violence affects individual and collective health; causes deaths, injuries, and physical and mental trauma; decreases the quality of life; and impairs the well-being of people, communities, and nations. At the same time, violence poses problems for health researchers trying to understand the complexity of its causes, its dynamics, and the different ways of dealing with it. It also poses serious challenges to health systems and services for the care of victims and perpetrators and the formulation of interdisciplinary, multi-professional, inter-sectoral, and socially articulated confrontation and prevention policies and programs.