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Migration and Health: The Challenge of Causality and Implications for Action

Migration and Health: The Challenge of Causality and Implications for Action

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Published by Randall Kuhn
My opening plenary presentation at 4th annual Global Health Symposium, University of Colorado Health Sciences Center.

Official continuing medical education goals:
a) Explore specific pathways by which migration affects the health of migrants and the left-behind
b) Understand the powerful role of migrant self-selection in confounding the migration-health relationship
c) Synthesize implications for medical and programmatic intervention
My opening plenary presentation at 4th annual Global Health Symposium, University of Colorado Health Sciences Center.

Official continuing medical education goals:
a) Explore specific pathways by which migration affects the health of migrants and the left-behind
b) Understand the powerful role of migrant self-selection in confounding the migration-health relationship
c) Synthesize implications for medical and programmatic intervention

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Published by: Randall Kuhn on Dec 18, 2010
Copyright:Attribution Non-commercial

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02/11/2013

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Just as a bit of background, I am a Demographer and Sociologist by training,though my tenure as Director of the Global Health Affairs Program has allowedme to delve into the epidemiologic side of health AND the broader politicaleconomy of health: the narrative frames, biases, and power dynamics throughwhich we view health and disease.And now a caveat. I have conducted a great deal of research on patterns of
migration and migration’s impact on health, particularly for populations left
behind by migration.I have also studied HIV/AIDS. I have studied the vicious cycle linkinghomelessness and HIV/AIDS in the US. And I now study the impact ofHIV/AIDS on the health and welfare of affected families in South Africa.But you may have noticed that I have never actually looked at migration andHIV/AIDS together. With good reason. The migration to HIV/AIDS link is atremendously challenging subject that raises deep moral and politicalconcerns. The United States and South Africa share, moresothan mostcountries, a near obsession with blaming public health problems on vulnerablecommunities, migrants among them. I thus come to this symposium with sometrepidation about the thin line between the humanitarian approach to infectiousdisease and the securitization of migrant health.1
 
Here is my official financial disclosure slide. I have absolutely nothing to report.I am not a clinician but I hopethat my perspective will prove enlightening asyou all embark on an impressive two-day program.2
 
As a social scientist, the best way I know to help is to try and highlight thespecific pathways linking migration to health, which is the primary goal of mytalk. Is migration bad for your health? (Pause)This question does not lend itself to a clinical trial.2) The answer is highly dependent on processes of self-selection intomigration.
Who 
migrates often ends up being just as important as the actualeffect of migration.3) I will conclude by setting out some
Hippocratic 
principles for addressingmigrant health in a clinical or social context.4) And just to set the stage for an exploration of migrationand health, CalWilson asked me to include a bit of background on migration levels, countriesof origin, and areas of destination. Fortunately some of my amazing studentsat DU had just prepared a presentation on the US migration system, and so Ihave appropriated their slides and give special thanks to Megan Banick,ShreeshBhattarai, and Erica Rosenfield.3

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