chapter  4
Migrant health in Northern reception countries
WithPeter H. Koehn
Pages 44

Chapter 4 Migrant health in Northern reception countries. Chapter 4 addresses the impact of unequal mobilities, principally reflected in immigration status, on pre-migration health checks, host-population receptivity, employment opportunities, workplace health, and physical- and mental-health-care prospects. The ironic situation of migrant farmworkers and their unhealthy families in Salinas Valley, California, who tend to healthy crops but cannot afford to buy them is given space. Disabilities, occupational (worker) health, and the mental health of migrants with diverse immigration status are treated. Communicable and non-communicable (often chronic) illnesses as well as the healthy-immigrant paradox and migrant contributions to healthy host practices receive attention. Enabling receiving-country benefits from immigrant-health professionals requires addressing issues surrounding deskilling, requalification, and reskilling. In light of practical barriers to patient-practitioner match and the absence of trained staff, migrant-practitioner medical and public-health interactions become particularly challenging in detention and holding centers as well as in host-community contexts. The value of treating the experience of illness from the migrant’s perspective through Arthur Kleinman’s explanatory model and with the benefit of transnationally competent (TC) health-care interactions on the part of all parties is demonstrated. Promising individual health approaches that negotiate migrant and provider explanatory models of disease causation and prevention receive scrutiny within the context of the five dimensions of the TC framework. The role of transnational ties (“migrant transnationality”), including distant and proximate sending-country consultations and E-health links, is considered in connection with migrant agency and health care in Northern settings. Prospects for future health invasions from the South are explored. In multiple ways, Chapter 4 shows how unequal mobility exerts a powerful and diverse influence on health access and outcomes in Northern reception places. The chapter concludes with calls for a fresh, proactive, and mobility-relevant redirection of medical education and the activation of new approaches to global governance at the intersections of health and migration policy.