4. Some migrants have poorer health than people born in the UK
African Caribbean Migrants
Twice as likely to suffer from Asthma (Netuveli et al., 2005)
2.4 - 14.6 times higher Incidence of Schizophrenia (Bhugra and Jones, 2001)
Three times as likely to die from liver cancer (Haworth et al., 1999)
5. Some migrants have poorer health than people born in the UK
African Caribbean Migrants
Twice as likely to suffer from Asthma (Netuveli et al., 2005)
2.4 - 14.6 times higher Incidence of Schizophrenia (Bhugra and Jones, 2001)
Three times as likely to die from liver cancer (Haworth et al., 1999)
East African Migrants have a tenfold excess of deaths from liver
cancer (SMR 1014) (Landman and Cruickshank, 2001)
7. Infant Mortality
11.000
10.1
7.333
5.8
3.667
0
UK Born Mothers Pakistan Born Mothers
Rate per 100,000
Davey-Smith et al., 2000, Critical Public Health, 10, 375-408
8. Standardised Mortality Ratios (SMR) for Male and Female African-Caribbean Migrants,
20-64 years (England and Wales 1991-1993)
Males Females
Source: Davey-Smith et al., 2000, Critical Public Health, 10, 375-408
9. Standardised Mortality Ratios (SMR) for Male and Female African-Caribbean Migrants,
20-64 years (England and Wales 1991-1993)
Males Females
200
178
169
150
121
104 100 103
100 89
60 59 59
49
50
32
0
All Causes IHD Stroke Lung Cancer Accident Suicide
Source: Davey-Smith et al., 2000, Critical Public Health, 10, 375-408
10. Standardised Mortality Ratios (SMR) for Indian Born
Males, 20-64 years (England and Wales 1991-1993)
Source: Davey-Smith et al., 2000, Critical Public Health, 10, 375-408
11. Standardised Mortality Ratios (SMR) for Indian Born
Males, 20-64 years (England and Wales 1991-1993)
148
150
140
125
106 109
100 97
75
50 43
25
0
All Causes IHD Stroke Lung Cancer Accident Suicide
Source: Davey-Smith et al., 2000, Critical Public Health, 10, 375-408
13. Poor health may be a consequence of migration
Migrants have been found to
develop higher rates of mental
illness than those who remain at
home (Louden, 1995)
14. Poor health may be a consequence of migration
Migrants have been found to
develop higher rates of mental
illness than those who remain at
home (Louden, 1995)
Despite originating from areas of
the world with low rates of
asthma South Asians are three
times as likely to be admitted to
hospital for Asthma (Netuveli et al., 2005)
15. Poor health may be a consequence of migration
Migrants have been found to
develop higher rates of mental
illness than those who remain at
home (Louden, 1995)
Despite originating from areas of
the world with low rates of
asthma South Asians are three
times as likely to be admitted to
hospital for Asthma (Netuveli et al., 2005)
16. Poor health may be a consequence of migration
Migrants have been found to
develop higher rates of mental
illness than those who remain at
home (Louden, 1995)
Despite originating from areas of
the world with low rates of
asthma South Asians are three
times as likely to be admitted to
hospital for Asthma (Netuveli et al., 2005)
17. TB Infection in the UK: Rate per 100,000 pop.
UK All Born Abroad Recent Entrant +3yr Entrant
Source: Rose, A. et al. 2001 Thorax, 56, 173-179
18. TB Infection in the UK: Rate per 100,000 pop.
UK All Born Abroad Recent Entrant +3yr Entrant
150
118.0
120
90
73.6
60
40.9
30
4.8
0
TB Infection
Source: Rose, A. et al. 2001 Thorax, 56, 173-179
19. Standardised Mortality Ratios (SMR) for Irish Migrants
by Sex, aged 20-64 years (England and Wales 1991-1993)
Males Females
Source: Davey-Smith et al., 2000, Critical Public Health, 10, 375-408
20. Standardised Mortality Ratios (SMR) for Irish Migrants
by Sex, aged 20-64 years (England and Wales 1991-1993)
Males Females
189
190.0
157 160
143 144
142.5 135 135
129 130
121 118
115
95.0
47.5
0
All Causes IHD Stroke Lung Cancer Accident Suicide
Source: Davey-Smith et al., 2000, Critical Public Health, 10, 375-408
21. Standardised Mortality Ratios (SMR) for Scottish Migrants
by Sex, aged 20-64 years (England and Wales 1991-1993)
Males Females
Source: Davey-Smith et al., 2000, Critical Public Health, 10, 375-408
22. Standardised Mortality Ratios (SMR) for Scottish Migrants
by Sex, aged 20-64 years (England and Wales 1991-1993)
Males Females
210 201
177
168 164
146 149 153
129 127 127 131
126 117
111
84
42
0
All Causes IHD Stroke Lung Cancer Accident Suicide
Source: Davey-Smith et al., 2000, Critical Public Health, 10, 375-408
24. Personal
Factors
Migration and Vulnerability Relational
Factors
Age
Gender
Reason Economic
Preparation Social
Personality Pre Migration Educational
Separation
The process Education
Support Migration Expectations
Alone/Group Language
Social Support networks Achievement
Cultural identity Racism
Self esteem Post Migration Ethnic Density
Self concept Social isolation
Unemployment
Source: Bhugra, D. & Jones, P. 2001, Adv. in Psych. Treatment, 7, 216-223.
27. Psychological Distress
Refugees may be more likely than other migrant
groups to suffer psychological stress. (Leavey et al.,
2004)
Older migrants and refugees more likely to suffer
post migration stress (Silveira and Allebeck, 2001)
28. Psychological Distress
Refugees may be more likely than other migrant
groups to suffer psychological stress. (Leavey et al.,
2004)
Older migrants and refugees more likely to suffer
post migration stress (Silveira and Allebeck, 2001)
Migrant children are more likely to have
psychological support needs than UK born
children (Leavey et al., 2004)
29. Psychological Distress
Refugees may be more likely than other migrant
groups to suffer psychological stress. (Leavey et al.,
2004)
Older migrants and refugees more likely to suffer
post migration stress (Silveira and Allebeck, 2001)
Migrant children are more likely to have
psychological support needs than UK born
children (Leavey et al., 2004)
Most common psychological problems for refugee
children:
Post Traumatic Stress Disorder
Anxiety
Depression
(Fazel and Stein, 2005)
30. Culture Shock
Osberg 1960 cited in Bhugra and Oyedeji 2004
31. Culture Shock
A stress reaction arising from
uncertainty of important physical and
psychological rewards
Osberg 1960 cited in Bhugra and Oyedeji 2004
32. Culture Shock
A stress reaction arising from
A transitional experience essential
uncertainty of important physical and Social Strain
for self development and growth
psychological rewards
Feelings of Impotence
Role Expectation Confusion
Rejection by Host Culture
Sense of Loss or Deprivation
Surprise, Anxiety, Indignation
Osberg 1960 cited in Bhugra and Oyedeji 2004
33. Experiencing Culture Shock
Language is a significant barrier
to psychological well being for
migrant children (Leavey et al., 2004)
My New Home Channel 4 TV, 15 June 2006
35. Cultural Conflict
Children and Subsequent
Generations
Expectations v Achievements
Alienation and Isolation From
Majority and Minority Culture
Sense of Cultural Tension
(Bhugra and Oyedeji, 2004)
37. Post Migration Experiences
Ethnic density is significant in the genesis and maintenance of
some types of psychological distress (Bhugra and Jones, 2001)
38. Post Migration Experiences
Ethnic density is significant in the genesis and maintenance of
some types of psychological distress (Bhugra and Jones, 2001)
Second generation Irish more likely to die before reaching 44
(SMR 147 males 153 Females) (Davey-Smith et al., 2000)
39. Post Migration Experiences
Ethnic density is significant in the genesis and maintenance of
some types of psychological distress (Bhugra and Jones, 2001)
Second generation Irish more likely to die before reaching 44
(SMR 147 males 153 Females) (Davey-Smith et al., 2000)
Mortality in men of patrileneal Irish descent in Scotland (19th
century migrants) is elevated for overall mortality, CHD
accidental and violent death. (Abbotts et al., 2001)
40. Post Migration Experiences
Ethnic density is significant in the genesis and maintenance of
some types of psychological distress (Bhugra and Jones, 2001)
Second generation Irish more likely to die before reaching 44
(SMR 147 males 153 Females) (Davey-Smith et al., 2000)
Mortality in men of patrileneal Irish descent in Scotland (19th
century migrants) is elevated for overall mortality, CHD
accidental and violent death. (Abbotts et al., 2001)
UK Born African Carribean men have higher smoking rates than
UK born White males (Abbotts et al., 2004)
41. Purpose of the Research
To enrich understanding of the impact of migration on health
and well being in the North West
To facilitate the empowerment of individuals, groups and the
migrant community
To help participants (and services) deal with factors that
influence their health and that of their community
42. Research Methods
Participatory ethnographic case study using documentary analysis,
interviews, narrative workshops- e.g. construction of visual narratives,
photo elicitation, story telling.
17
43. Research Methods
Participatory ethnographic case study using documentary analysis,
interviews, narrative workshops- e.g. construction of visual narratives,
photo elicitation, story telling.
17
47. Knowledge and Capacity Building
Make positive use of knowledge & community resources
Allows for learning about research methods
48. Knowledge and Capacity Building
Make positive use of knowledge & community resources
Allows for learning about research methods
Allows for flexibility and change in methods and focus
49. Knowledge and Capacity Building
Make positive use of knowledge & community resources
Allows for learning about research methods
Allows for flexibility and change in methods and focus
Enable expression and valuing of personal and collective
experiences
53. Participatory Research
Services
Research
Research
Education
Action
Education
Communities
54. Participatory Research
Services
Research
Perceived Needs
Research
Education
Action
Education
Communities
55. Participatory Research
Services
Research
Perceived Needs
Actual Needs
Research
Education
Action
Education
Communities
56. Participatory Research
Services
Research
Align Knowledge and Resources
Perceived Needs
Actual Needs
Research
Education
Action
Education
Communities
Notas do Editor
Abbotts, J., Williams, R. & Ford, G. (2001) Morbidity and Irish Catholic descent in Britain. Relating health disadvantage to socio-economic position. Soc Sci Med, 52, 999-1005.
Bhugra, D. & Jones, P. (2001) Migration and Mental Illness. Advances in Psychiatric Treatment, 7, 216-223.
Bhugra, D. & Oyedeji, A. (2004) Depression in Migrants and Ethnic Minorities. Advances in Psychiatric Treatment, 7, 216-223.
Davey-Smith, G. et al. (2000) Ethnic inequalities in health: a review of UK epidemiological evidence. Critical Public Health, 10, 375-408.
Fazel, M. & Stein, A. (2005) The Mental Health of Refugee Children. Archives of Disease in Childhood, 878, 366-370.
Haworth, E.A., Soni Raleigh, V. & Balarajan, R. (1999) Cirrhosis and primary liver cancer amongst first generation migrants in England and Wales. Ethn Health, 4, 93-99.
Landman, J. & Cruickshank, J.K. (2001) A review of ethnicity, health and nutrition-related diseases in relation to migration in the United Kingdom. Public Health Nutr, 4, 647-657.
Leavey, G. et al. (2004) Psychological disorder amongst refugee and migrant schoolchildren in London. Social Psychiatry and Psychiatric Epidemiology, 39, 191-195.
Netuveli, G., Hurwitz, B. & Sheikh, A. (2005) Ethnic variations in incidence of asthma episodes in England & Wales: national study of 502,482 patients in primary care. Respir Res, 6, 120.
Rose, A. et al. (2001) Tuberculosis at the end of the 20th century in England and Wales: results of a national survey in 1998. Thorax, 56, 173-179.
Silveira, E. & Allebeck, P. (2001) Migration, ageing and mental health: an ethnographic study on perceptions of life satisfaction, anxiety and depression in older Somali men in east London. International Journal of Social Welfare, 10, 309-320.
Abbotts, J., Williams, R. & Ford, G. (2001) Morbidity and Irish Catholic descent in Britain. Relating health disadvantage to socio-economic position. Soc Sci Med, 52, 999-1005.
Bhugra, D. & Jones, P. (2001) Migration and Mental Illness. Advances in Psychiatric Treatment, 7, 216-223.
Bhugra, D. & Oyedeji, A. (2004) Depression in Migrants and Ethnic Minorities. Advances in Psychiatric Treatment, 7, 216-223.
Davey-Smith, G. et al. (2000) Ethnic inequalities in health: a review of UK epidemiological evidence. Critical Public Health, 10, 375-408.
Fazel, M. & Stein, A. (2005) The Mental Health of Refugee Children. Archives of Disease in Childhood, 878, 366-370.
Haworth, E.A., Soni Raleigh, V. & Balarajan, R. (1999) Cirrhosis and primary liver cancer amongst first generation migrants in England and Wales. Ethn Health, 4, 93-99.
Landman, J. & Cruickshank, J.K. (2001) A review of ethnicity, health and nutrition-related diseases in relation to migration in the United Kingdom. Public Health Nutr, 4, 647-657.
Leavey, G. et al. (2004) Psychological disorder amongst refugee and migrant schoolchildren in London. Social Psychiatry and Psychiatric Epidemiology, 39, 191-195.
Netuveli, G., Hurwitz, B. & Sheikh, A. (2005) Ethnic variations in incidence of asthma episodes in England & Wales: national study of 502,482 patients in primary care. Respir Res, 6, 120.
Rose, A. et al. (2001) Tuberculosis at the end of the 20th century in England and Wales: results of a national survey in 1998. Thorax, 56, 173-179.
Silveira, E. & Allebeck, P. (2001) Migration, ageing and mental health: an ethnographic study on perceptions of life satisfaction, anxiety and depression in older Somali men in east London. International Journal of Social Welfare, 10, 309-320.
Abbotts, J., Williams, R. & Ford, G. (2001) Morbidity and Irish Catholic descent in Britain. Relating health disadvantage to socio-economic position. Soc Sci Med, 52, 999-1005.
Bhugra, D. & Jones, P. (2001) Migration and Mental Illness. Advances in Psychiatric Treatment, 7, 216-223.
Bhugra, D. & Oyedeji, A. (2004) Depression in Migrants and Ethnic Minorities. Advances in Psychiatric Treatment, 7, 216-223.
Davey-Smith, G. et al. (2000) Ethnic inequalities in health: a review of UK epidemiological evidence. Critical Public Health, 10, 375-408.
Fazel, M. & Stein, A. (2005) The Mental Health of Refugee Children. Archives of Disease in Childhood, 878, 366-370.
Haworth, E.A., Soni Raleigh, V. & Balarajan, R. (1999) Cirrhosis and primary liver cancer amongst first generation migrants in England and Wales. Ethn Health, 4, 93-99.
Landman, J. & Cruickshank, J.K. (2001) A review of ethnicity, health and nutrition-related diseases in relation to migration in the United Kingdom. Public Health Nutr, 4, 647-657.
Leavey, G. et al. (2004) Psychological disorder amongst refugee and migrant schoolchildren in London. Social Psychiatry and Psychiatric Epidemiology, 39, 191-195.
Netuveli, G., Hurwitz, B. & Sheikh, A. (2005) Ethnic variations in incidence of asthma episodes in England & Wales: national study of 502,482 patients in primary care. Respir Res, 6, 120.
Rose, A. et al. (2001) Tuberculosis at the end of the 20th century in England and Wales: results of a national survey in 1998. Thorax, 56, 173-179.
Silveira, E. & Allebeck, P. (2001) Migration, ageing and mental health: an ethnographic study on perceptions of life satisfaction, anxiety and depression in older Somali men in east London. International Journal of Social Welfare, 10, 309-320.
Abbotts, J., Williams, R. & Ford, G. (2001) Morbidity and Irish Catholic descent in Britain. Relating health disadvantage to socio-economic position. Soc Sci Med, 52, 999-1005.
Bhugra, D. & Jones, P. (2001) Migration and Mental Illness. Advances in Psychiatric Treatment, 7, 216-223.
Bhugra, D. & Oyedeji, A. (2004) Depression in Migrants and Ethnic Minorities. Advances in Psychiatric Treatment, 7, 216-223.
Davey-Smith, G. et al. (2000) Ethnic inequalities in health: a review of UK epidemiological evidence. Critical Public Health, 10, 375-408.
Fazel, M. & Stein, A. (2005) The Mental Health of Refugee Children. Archives of Disease in Childhood, 878, 366-370.
Haworth, E.A., Soni Raleigh, V. & Balarajan, R. (1999) Cirrhosis and primary liver cancer amongst first generation migrants in England and Wales. Ethn Health, 4, 93-99.
Landman, J. & Cruickshank, J.K. (2001) A review of ethnicity, health and nutrition-related diseases in relation to migration in the United Kingdom. Public Health Nutr, 4, 647-657.
Leavey, G. et al. (2004) Psychological disorder amongst refugee and migrant schoolchildren in London. Social Psychiatry and Psychiatric Epidemiology, 39, 191-195.
Netuveli, G., Hurwitz, B. & Sheikh, A. (2005) Ethnic variations in incidence of asthma episodes in England & Wales: national study of 502,482 patients in primary care. Respir Res, 6, 120.
Rose, A. et al. (2001) Tuberculosis at the end of the 20th century in England and Wales: results of a national survey in 1998. Thorax, 56, 173-179.
Silveira, E. & Allebeck, P. (2001) Migration, ageing and mental health: an ethnographic study on perceptions of life satisfaction, anxiety and depression in older Somali men in east London. International Journal of Social Welfare, 10, 309-320.