Health service use and health outcomes among international migrant workers compared with non-migrant workers: A systematic review and meta-analysis

PLoS One. 2021 Jun 9;16(6):e0252651. doi: 10.1371/journal.pone.0252651. eCollection 2021.

Abstract

Objectives: The review aimed to synthesise recent evidence on health service use and health outcomes among international migrant workers, compared with non-migrant workers.

Methods: A search was carried out in MEDLINE, PubMed, Embase, and CINAHL for studies published between Jan 1, 2010, and Feb 29, 2020. Included outcomes were: occupational health service use, fatal occupational injury, HIV, and depression. Two authors independently screened records, extracted data, assessed risk of bias and judged quality of evidence. We meta-analysed estimates and conducted subgroup analyses by sex, geographical origin, geographical destination, and regularity of migration.

Results: Twenty-one studies were included comprising >17 million participants in 16 countries. Most studies investigated regular migrant workers in high-income destination countries. Compared with non-migrant workers, migrant workers were less likely to use health services (relative risk 0·55, 95% confidence interval 0·41 to 0·73, 4 studies, 3,804,131 participants, I2 100%, low quality of evidence). They more commonly had occupational injuries (1·27, 95% confidence interval 1·11 to 1·45, 7 studies, 17,100,626 participants, I2 96%, low quality of evidence). Relative risks differed by geographical origin and/or destination. There is uncertainty (very low quality of evidence) about occupational health service use (0 studies), fatal occupational injuries (5 studies, N = 14,210,820), HIV (3 studies, N = 13,775), and depression (2 studies, N = 7,512).

Conclusions: Migrant workers may be less likely than non-migrant workers to use health services and more likely to have occupational injuries. More research is required on migrant workers from and in low- and middle-income countries, across migration stages, migrating irregularly, and in the informal economy.

Publication types

  • Comparative Study
  • Meta-Analysis
  • Research Support, U.S. Gov't, P.H.S.
  • Systematic Review

MeSH terms

  • Cost of Illness
  • Humans
  • Internationality
  • Occupational Diseases / therapy*
  • Occupational Health / economics
  • Occupational Health / statistics & numerical data*
  • Occupational Health Services / methods
  • Occupational Health Services / statistics & numerical data*
  • Occupational Injuries / prevention & control*
  • Outcome Assessment, Health Care / economics
  • Outcome Assessment, Health Care / methods
  • Outcome Assessment, Health Care / statistics & numerical data
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Transients and Migrants / statistics & numerical data*