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      Migration and health: a global public health research priority

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          Abstract

          Background

          With 244 million international migrants, and significantly more people moving within their country of birth, there is an urgent need to engage with migration at all levels in order to support progress towards global health and development targets. In response to this, the 2nd Global Consultation on Migration and Health– held in Colombo, Sri Lanka in February 2017 – facilitated discussions concerning the role of research in supporting evidence-informed health responses that engage with migration.

          Conclusions

          Drawing on discussions with policy makers, research scholars, civil society, and United Nations agencies held in Colombo, we emphasize the urgent need for quality research on international and domestic (in-country) migration and health to support efforts to achieve the Sustainable Development Goals (SDGs). The SDGs aim to ‘leave no-one behind’ irrespective of their legal status. An ethically sound human rights approach to research that involves engagement across multiple disciplines is required. Researchers need to be sensitive when designing and disseminating research findings as data on migration and health may be misused, both at an individual and population level. We emphasize the importance of creating an ‘enabling environment’ for migration and health research at national, regional and global levels, and call for the development of meaningful linkages – such as through research reference groups – to support evidence-informed inter-sectoral policy and priority setting processes.

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          Most cited references14

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          Pathways to “Evidence-Informed” Policy and Practice: A Framework for Action

          Bowen and Zwi propose a new framework that can help researchers and policy makers to navigate the use of evidence.
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            Our health and theirs: forced migration, othering, and public health.

            This paper uses 'othering' theory to explore how forced migrants are received in developed countries and considers the implications of this for public health. It identifies a variety of mechanisms by which refugees, asylum seekers and irregular migrants are positioned as 'the other' and are defined and treated as separate, distant and disconnected from the host communities in receiving countries. The paper examines how this process has the potential to affect health outcomes both for individuals and communities and concludes that public health must engage with and challenge this othering discourse. It argues that public health practitioners have a critical role to play in reframing thinking about health services and health policies for forced migrants, by promoting inclusion and by helping shape a narrative which integrates and values the experiences of this population.
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              Syndemic vulnerability and the right to health.

              Investigators working both in syndemics, a field of applied health research with roots in medical anthropology, and in the field of health and human rights recognise that upstream social, political, and structural determinants contribute more to health inequities than do biological factors or personal choices. Syndemics investigates synergistic, often deleterious interactions among comorbid health conditions, especially under circumstances of structural and political adversity. Health and human rights research draws on international law to argue that all people deserve access not only to health care, but also to the underlying determinants of good health. Taking the urgent matter of migrant health as an empirical focus, we juxtapose the fields of syndemics and health and human rights, identify their complementarities, and advocate for a combined approach. By melding insights from these fields, the combined syndemics/health and human rights approach advanced here can provide clinicians and other key stakeholders with concrete insights, tools, and strategies to tackle the health inequities that affect migrants and other vulnerable groups by: (1) mapping the effect of social, political, and structural determinants on health; (2) identifying opportunities for upstream intervention; and (3) working collaboratively to tackle the structures, institutions, and processes that cause and exacerbate health inequities. Undergirding this approach is an egalitarian interpretation of the right to health that differs from narrow legalistic and individual interpretations by insisting that all people are equal in worth and, as a result, equally deserving of protection from syndemic vulnerability.
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                Author and article information

                Contributors
                kwickramage@iom.int
                jovearey@gmail.com
                a.zwi@unsw.edu.au
                court.robinson@jhu.edu
                Michael.Knipper@histor.med.uni-giessen.de
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                8 August 2018
                8 August 2018
                2018
                : 18
                : 987
                Affiliations
                [1 ]ISNI 0000 0004 0522 5946, GRID grid.435307.6, Migration Health Division, International Organization for Migration, United Nations Migration Agency, ; Geneva, Switzerland
                [2 ]African Centre for Migration & Society, University of the Witwatersrand and Centre of African Studies, University of Edinburgh, PO Box 76, Wits, 2050 South Africa
                [3 ]ISNI 0000 0004 4902 0432, GRID grid.1005.4, Health, Rights and Development (HEARD@UNSW), School of Social Science, , The University of New South Wales, ; Sydney, NSW 2052 Australia
                [4 ]ISNI 0000 0001 2171 9311, GRID grid.21107.35, Center for Humanitarian Health, Johns Hopkins Bloomberg School of Public Health, ; Baltimore, MD USA
                [5 ]Institute of the History of Medicine, University Justus Liebig Giessen, Iheringstr. 6, 35392 Giessen, Germany
                Article
                5932
                10.1186/s12889-018-5932-5
                6083569
                30089475
                24945a2a-22a0-45dc-a7b7-2f0ce2a1e571
                © The Author(s). 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 14 March 2018
                : 2 August 2018
                Categories
                Debate
                Custom metadata
                © The Author(s) 2018

                Public health
                migration,health,global health,research
                Public health
                migration, health, global health, research

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