Tackling the health challenges of international migrant workers
Authors: Marie Norredam, Charles Agyemang
Journal: The Lancet Global Health (2019)

In 2017, the number of international migrants was estimated to be 258 million.1International Labour OrganizationILO global estimates on international migrant workers. International Labour Organization, Geneva2018https://www.ilo.org/wcmsp5/groups/public/---dgreports/---dcomm/---publ/documents/publication/wcms_652001.pdfDate accessed: May 13, 2019Google Scholar According to the International Labour Organization about 63% (164 million) of international migrants are migrant workers, of whom 58·4% are men.1International Labour OrganizationILO global estimates on international migrant workers. International Labour Organization, Geneva2018https://www.ilo.org/wcmsp5/groups/public/---dgreports/---dcomm/---publ/documents/publication/wcms_652001.pdfDate accessed: May 13, 2019Google Scholar 61% of all international migrant workers reside in North America (23%), northern, southern, and western Europe (24%), and the Arab States (14%).1International Labour OrganizationILO global estimates on international migrant workers. International Labour Organization, Geneva2018https://www.ilo.org/wcmsp5/groups/public/---dgreports/---dcomm/---publ/documents/publication/wcms_652001.pdfDate accessed: May 13, 2019Google Scholar Migrant workers are employed across a variety occupations from au pairs in European countries to construction workers in the Arabian Gulf. These workers contribute to growth and development in both the destination countries and their countries of origin. In 2015, worldwide remittances sent back to origin countries amounted to more than 60 billion US dollars, of which low-and middle-come countries were estimated to receive about 73% and high-income countries were the main source.2World Bank GroupMigration and remittances. Recent developments and outlook. Global Knowledge Partnership on Migration and Development for World Bank, Washington2018Google Scholar Furthermore, many migrant workers do jobs that residents of host countries are unwilling to take on, thereby filling an important gap in the labour markets in several countries worldwide. Despite the beneficial effects of international labour migration, migrant workers face many challenges including modern slavery, discrimination, contract violations, abuse and exploitation, and unsafe working conditions, which are often dirty, demeaning, and dangerous. The challenges that millions of migrant workers face, especially those in low-skilled jobs, could severely affect their physical and mental health.3Simkhada P Prescott GJ Health problems of Nepalese migrants working in three Gulf countries.BMC Int Health Hum Rights. 2011; 11: 3Crossref PubMed Scopus (40) Google Scholar, 4WHOPublic health aspects of migrant health: a review of the evidence on health status for labor migrants in the European Region. World Health Organization, Geneva2015Google Scholar Furthermore, migrant workers might not have access to health care—eg, not all migrants are provided health insurance coverage by their employers.5Simkhada P van Teijlingen E Gurung M Wasti SP A survey of health problems of Nepalese female migrants workers in the Middle-East and Malaysia.BMC Int Health Hum Rights. 2018; 18: 4Crossref PubMed Scopus (19) Google Scholar Undocumented migrant workers often have informal work arrangements and are therefore not covered by any health or social insurance because this depends on legal status. Additionally, migrant workers might be unaware of laws and their rights regarding health care, which might lead to poor access to health care.6Abdulle AM Nagelkerke NJ Abouchacra S Pathan JY Adem A Obineche EN Under-treatment and under diagnosis of hypertension: a serious problem in the United Arab Emirates.BMC Cardiovasc Disord. 2006; 6: 24Crossref PubMed Scopus (28) Google Scholar Despite the many health challenges that migrant workers face, data on their health status and needs are limited and fragmented. This paucity of data hinders national and international policy responses to the health needs of migrant workers. In The Lancet Global Health, Sally Hargreaves and colleagues4WHOPublic health aspects of migrant health: a review of the evidence on health status for labor migrants in the European Region. World Health Organization, Geneva2015Google Scholar have reported the results of their timely systematic review and meta-analysis to highlight the global prevalence of occupational health outcomes including injuries, mortality, and physical or psychiatric morbidity among international labour migrants. The authors identified 36 studies, of which 18 were included in a meta-analysis based on 7260 international migrant workers. The authors found that migrants experience a range of physical and psychiatric comorbidities, and workplace injuries and accidents were relatively common. In the meta-analysis, 47% (95% CI 29–64) of international migrant workers were estimated to have experienced at least one occupational morbidity, and among 3890 migrant workers, 22% (7–37) had experienced a workplace injury or accident. Although this systematic review and meta-analysis has provided important information about the occupational health outcomes among migrant workers, it has also highlighted the scarcity of data on this group of migrants. 17 of 36 studies were done in the USA, and only three studies were done in Europe despite the large number of migrant workers that reside in the region. Due to the unequal distribution of studies across the world, the findings and extrapolations of the study findings should be interpreted with caution due to differences in policies and circumstances in which migrant workers live in different regions of the world. However, the findings of this study emphasize the need for researchers and policy makers to pay more attention to the health needs of migrant workers and their access to health care. Many key issues still need to be addressed. First, more knowledge is needed on physical and mental health outcomes of migrant workers, which will require more investment in the collection of valid health data among migrant workers especially in the world regions with a high proportion of migrant workers such as northern, southern, and western Europe. Implementation of standardised approaches will be needed to measure and report occupational health outcomes among migrant workers to facilitate comparability across the world. Second, more research is needed on access to health care for different groups of migrant workers, their knowledge about their rights to care, and other potential factors limiting migrant workers health care access. This research should also include analyses of health care policy within and across countries and regions. Third, the health impact of labour migration on the family and relations of migrants in the country of origin and the health of host country populations also requires investigation.7Hargreaves S Rustage K Nellums LB et al.Occupational health outcomes among international migrant workers: a systematic review and meta-analysis.Lancet Glob Health. 2019; (published online May 20.)http://dx.doi.org/10.1016/S2214-109X(19)30204-9Summary Full Text Full Text PDF PubMed Scopus (107) Google Scholar Fourth, researchers need to explore the extent to which general migrant policies consider the health of migrant workers. Addressing the health needs of migrant workers is timely and will contribute towards the achievement of the UN's Sustainable Development Goal 8 to "Protect labour rights and promote safe and secure working environments for all workers, including migrant workers, in particular women migrants, and those in precarious employment."8UNSustainable Development Goal 8.https://sustainabledevelopment.un.org/sdg8Date accessed: May 2, 2019Google Scholar We declare no competing interests. Occupational health outcomes among international migrant workers: a systematic review and meta-analysisInternational migrant workers are at considerable risk of work-related ill health and injury, and their health needs are critically overlooked in research and policy. Governments, policy makers, and businesses must enforce and improve occupational health and safety measures, which should be accompanied by accessible, affordable, and appropriate health care and insurance coverage to meet the care needs of this important working population. Full-Text PDF Open Access