We live in an increasingly globalized world, where the overall number of international migrants and refugees is rapidly growing. Around 75 million international migrants are estimated to be living in the European Region alone, accounting for one third of all international migrants worldwide. Above and beyond this long-term phenomenon, which has been intensified by growing global inequalities, the number of people fleeing conflict and war has also increased dramatically in recent years. Europe has experienced this acutely: over 1 million refugees and migrants arrived in European countries in 2015 alone, and over the course of the first 5 months of 2016 there have been over 200 000 new arrivals on European shores and at borders.
On World Refugee Day, UN Secretary-General Ban Ki-moon reminds us: “Refugees are people like anyone else, like you and me. They led ordinary lives before becoming displaced, and their biggest dream is to be able to live normally again. … Let us recall our common humanity, celebrate tolerance and diversity and open our hearts to refugees everywhere.” On this day, WHO/Europe reaffirms that it stands with refugees, both those within the Region and around the world.
While migration has multiple positive societal effects, including economic and employment benefits, the recent large-scale population movement from countries of the Eastern Mediterranean and African Regions has given rise to a number of challenges to which public health and health systems must adapt.
At the request of European Member States, WHO/Europe is drawing on the experience of the Migration and Health programme to develop a European strategy and action plan on refugee and migrant health. It aims to chart a path toward a coherent regional response to the influx of refugees and migrants, focusing on strategic areas and priority actions to address the public health and health system challenges related to migration. The document is based on the principles and values of the European health policy framework Health 2020; the World Health Assembly resolution WHA61.17 on the health of migrants; and the more recently adopted 2030 Agenda for Sustainable Development. The strategy and action plan will be submitted for approval, along with a resolution, to the WHO Regional Committee for Europe in September 2016.
The European Region lacks reliable, comparable data on migration patterns and trends across Europe. In order to build and strengthen the evidence on migration and health, WHO/Europe is publishing a series of Health Evidence Network (HEN) reports, in collaboration with several universities across the Region, aimed at collecting and synthesizing the existing evidence on public health and migration. These reports are being used as an evidence base for the development of the European strategy and action plan on refugee and migrant health.
Statistics, where available, generally indicate that refugees, asylum seekers and migrants may be at risk of worse health outcomes and, in some cases, increased rates of infant mortality. Migrants account for a high percentage of the working-age population in low-paid jobs and are more likely to be employed on insecure, temporary contracts. This can contribute to social exclusion, depression and the early onset of cardiovascular disease. Gender differences in health status also manifest: women are more exposed to sexual violence, abuse and trafficking, as well as risks related to pregnancy and childbirth, particularly when these occur without medical assistance. Men are more exposed to accidents, physical stress and other work-related health hazards. Evidence also suggests higher rates of mental distress among refugee and migrant populations, with increased risk for women, older people and those who have experienced trauma.
The HEN reports contain reviews of policies and interventions designed to help reduce inequalities in access to and quality of health care for refugees and migrants. Links for the 3 published reports can be found below.