Abstract
This paper aims to explore the burgeoning burden of cardiovascular and metabolic disease (CMD) risk factors among South Asian labor migrants to the Middle East. We conducted a qualitative synthesis of literature using PubMed/Medline and grey literature searches, supplemented by a policy review of policies from the South Asian countries. We found a high burden of cardio-metabolic risk factors among the migrants as well as among the populations in the home and the host countries. For example, two studies reported the prevalence of diabetes mellitus (DM) ranging between 9 and 17% among South Asian migrants. Overweight and obesity were highly prevalent amongst South Asian male migrants; prevalence ranged from 30 to 66% (overweight) and 17–80% (obesity) respectively. The home country population had a significant CMD risk factor burden. Nearly 14 to 40% have three or more risk factors: such as hypertension (17 to 37%), diabetes (3 to 7%), overweight (18 to 41%), and obesity (2 to 15%). The host country also exhibited similar burden of risk factors: hypertension (13 to 38%), diabetes (8 to 17%), overweight (33 to 77%) and obesity (35 to 41%). Only Nepal, Bangladesh and Sri Lanka have some provisions related to screening of CMDs before labor migration. Further, analysis of policy papers showed that none of the reviewed documents had requirements for screening of any specific CMDs, but chronic diseases were used generically, failing to specify specific screening target. Given the high burden of risk factors, migrants’ health should become an urgent priority. The lack of specific focus on screening during different stages of labor migration should receive attention. The International Labour Organization and the International Office for Migration, through their country coordination teams should engage local stakeholders to create policies and plans to address this concern. Similarly, there is a need for the host country to become an equal partner in these efforts, as migrant’s better cardiometabolic health is in the benefit of both host and home countries.
Highlights
The Middle East, a region with countries centred on Western Asia and Northern Africa, hosted 32 million migrants in 2015, which is about 80% of their population [1]
Risk factors of cardiovascular and metabolic disease (CMD) among migrant populations varied according to the country
We found that HTN was the most reported condition among the migrants followed by diabetes mellitus (DM)
Summary
The Middle East, a region with countries centred on Western Asia and Northern Africa, hosted 32 million migrants in 2015, which is about 80% of their population [1]. South Asia contributes a significant proportion of this workforce [2]. South Asian migrants’ health has been neglected by both the host and home governments [3]. Sexually transmitted infections (STIs) and Human Immunodeficiency Virus (HIV) is routinely screened pre-departure [3], because of the threat to populations in the host nations [4]. Other emerging global health threats including non-communicable diseases (NCDs) are ignored [3]. The migrant population usually adopts a sedentary lifestyle, including the use of car instead of walk for commuting, increase in screen time, jobs that require more sitting, and unhealthy eating habits [5, 6]. Migrants in all occupational categories have unfavorable changes in risk factor profiles leading to hypertension (HTN), diabetes mellitus (DM), and obesity
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