Abstract
BackgroundLabour migrants, who represent over sixty per cent of international migrants globally, frequently have poorer health status than the population of host countries. These health inequities are determined in a large part by structural drivers including political, commercial, economic, normative and social factors, including living and working conditions. Achieving health equity for migrant workers requires structural-level interventions to address these determinants. MethodsWe undertook a systematic review of peer-reviewed literature designed to answer the question “what is the evidence for the effectiveness of interventions to address the structural determinants of health for labour migrants?” using the Ovid Medline electronic database. FindingsWe found only two papers that evaluated structural interventions to improve the health of labour migrants. Both papers evaluated the impact of insurance – health or social. In contrast, we found 19 evaluations of more proximal, small-scale interventions focused on changing the knowledge, attitudes and behaviours of labour migrants. InterpretationDespite the rise in international migration, including for work, and evidence that labour migrants have some higher health risks, there is a paucity of research addressing the structural determinants of health inequities in labour migrants. The research community (including funders and academic institutions) needs to pay greater attention to the structural determinants of health – which generally requires working across disciplines and sectors and thinking more politically about health and health inequities. FundingWellcome Trust (208712/Z/17/Z).
Highlights
Labour migrants represent over 60% of the 277 million international migrants globally6 whose lives are shaped by a range of structural and social factors that can lead to substantial health inequities compared with non-migrant populations
We identified two studies evaluating interventions to address structural determinants both focused on financial interventions: health insurance and social insurance
Our review of peer-reviewed literature on the effectiveness – i.e. health impact – of interventions addressing the structural determinants of the health of labour migrants has found little (2 papers) in the way of public health research
Summary
Labour migrants represent over 60% of the 277 million international migrants globally whose lives are shaped by a range of structural and social factors that can lead to substantial health inequities compared with non-migrant populations. The international import and export of labour on a mass scale, underpinned by the forces of globalisation and neoliberalism, and the absence of employment opportunities in home (often called ‘sending’) countries, reinforce a system of structural discrimination that leads to social inequalities and health inequities [11]. Labour migrants, who represent over sixty per cent of international migrants globally, frequently have poorer health status than the population of host countries. These health inequities are determined in a large part by structural drivers including political, commercial, economic, normative and social factors, including living and working conditions.
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