In the UK, Germany, France and many other countries, equal and affordable access to healthcare is legislated. However, sub-populations with different cultural and socio-economic backgrounds may differ in their attitude to health.
For example, there may be no tradition or habit of preventative care and early diagnosis, while disregarding mild chronic conditions can lead to deterioration in later life. Some migrants, and indeed other minority groups, may be wary of health intervention or experience stigma of poor physical health even within their own families and community, and, perhaps, more so with regards to mental health. In some cultures, the detrimental effects of wariness, stigma, and privacy on women’s health may be even worse.
For these and other reasons, the healthcare system is likely to be under-utilised by some groups of migrants, especially in the first generation. There is no systematic evidence and analysis of this in the literature.
Our research will fill this gap. Identifying these drivers of health inequality will help to shape and target policies aiming at the reduction and improvement of health outcomes for migrants and other disadvantaged groups.
Our aims
The aims of our project "Migration and Dynamics of Health Inequality" are:
- To measure health inequality, investigate its components and development over time, and analyse how it is affected by migration; and
- To explore the role of cultural and socio-economic background differences in attitude to health by analysing the dynamics of intersectional health inequality among first and second-generation migrants.
At this pilot stage, our team of researchers in Microeconometrics, Education, Feminist Sociology and Public Economics, with expertise in the measurement and analysis of inequality, is carrying out data analysis and developing a framework for policy recommendations. We are using the German Socio-Economic Panel (SOEP), a longitudinal survey of approximately 11,000 private households from 1984 to 2019 produced by the German Institute for Economic Research (DIW-Berlin). We will also explore Understanding Society, the UK household survey. The team will be expanded to include other disciplines, such as Public Health and Social Psychology, to explore the economic, educational, psychological and societal factors of health inequality, in particular, among migrants and minority groups.
Impact
We will use our results on the rigorous measurement of health inequality and the analysis of its dynamics and determinants by taking an intersectional intra-categorical and inter-categorical approach to health inequality to formulate policy recommendations for (i) more efficient utilisation of the healthcare infrastructure and (ii) promotion of health awareness and primary prevention, towards better integration of migrants in the host communities and wider society.
This will pave the way to healthier and more equal communities and societies. This pilot study will form a base for larger project with the objective to create a framework for evidence-based policies and interventions in the measurement and reduction of population-specific health inequalities at both national and community levels.
The short- and medium-term impact of our research will be higher health awareness and health infrastructure utilisation by migrants and minority groups, leading to better health outcome. The long-term impact will be a decrease in health inequality especially through reduction in preventable poor health conditions in later age. This will be achieved through health education work among migrants and minority groups in local communities. We envision working with community-based charitable organisations, societies, and networks with links to migrants on targeted dissemination of materials on healthcare infrastructure and its use. The materials will emphasise the importance of regular health checks, immunisation, prevention of chronic conditions, early diagnostics and treatment. This basic health awareness information can be included in the local activities on migrant integration, language or citizenship lessons.