Challenges in researching migration status, health and health service use: an intersectional analysis of a South London community

Ethn Health. 2015;20(6):564-93. doi: 10.1080/13557858.2014.961410. Epub 2014 Oct 1.

Abstract

Objectives: This study aimed to investigate the associations between migration status and health-related outcomes and to examine whether and how the effect of migration status changes when it is disaggregated by length of residence, first language, reason for migration and combined with ethnicity.

Design: A total of 1698 adults were interviewed from 1076 randomly selected households in two South London boroughs. We described the socio-demographic and socio-economic differences between migrants and non-migrants and compared the prevalence of health-related outcomes by migration status, length of residence, first language, reason for migration and migration status within ethnic groups. Unadjusted models and models adjusted for socio-demographic and socio-economic indicators are presented.

Results: Migrants were disadvantaged in terms of socio-economic status but few differences were found between migrant and non-migrants regarding health or health service use indicators; migration status was associated with decreased hazardous alcohol use, functional limitations due to poor mental health and not being registered with a general practitioner. Important differences emerged when migration status was disaggregated by length of residence in the UK, first language, reason for migration and intersected with ethnicity. The association between migration status and functional limitations due to poor mental health was only seen in White migrants, migrants whose first language was not English and migrants who had moved to the UK for work or a better life or for asylum or political reasons. There was no association between migration status and self-rated health overall, but Black African migrants had decreased odds for reporting poor health compared to their non-migrant counterparts [odds ratio = 0.15 (0.05-0.48), p < 0.01].

Conclusions: Disaggregating migration status by length of residence, first language and reason for migration as well as intersecting it with ethnicity leads to better understanding of the effect migration status has on health and health service use.

Keywords: UK; ethnicity; health; health service use; language use; migrant.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Alcohol Drinking
  • Ethnicity*
  • Female
  • Health Services / statistics & numerical data*
  • Health Services Accessibility*
  • Health Status Indicators
  • Health Status*
  • Humans
  • Language
  • London
  • Male
  • Mental Health
  • Middle Aged
  • Prevalence
  • Social Class*
  • Transients and Migrants*

Grants and funding

Funding: B. Gazard receives an Economic and Social Research Council Studentship. B. Gazard, S.L. Hatch, S. Frissa and M. Hotopf receive salary support from the National Institute for Health Research (NIHR), Biomedical Research Centre and Dementia Unit at South London and Maudsley NHS Foundation Trust and King's College London. L. Nellums received an NIHR Biomedical Research Centre and Dementia Unit at South London and Maudsley NHS Foundation Trust and King's College London PhD Studentship. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. The funders did not have a role in the study design; collection, analysis or interpretation of data; the writing of the manuscript; or in the decision to submit the manuscript for publication.