ABSTRACT
Immigrants to European countries experience health risks and develop health needs that may differ from the risks and needs of the majority population of country receiving the immigrants. Additionally, immigrants may face specific barriers to accessing health care. These barriers apply both to migrants seeking protection and asylum (here called refugees) and to those seeking work and economic opportunities (here called immigrants with legally ‘regular’ residence status). We show in Part 1 of this chapter (Section 1.2) that a life course perspective can help to better understand the resulting health-related diversity, or heterogeneity, of today’s societies in Europe. In Part 2 (Sections 1.3–1.5), we illustrate how health services address this heterogeneity using the example of migrants and refugees in Germany, with a particular emphasis on entitlement restrictions and access barriers to health care. Based on the insights from the life course approach and on empirical data, we demonstrate that public health research and practice are not ‘neutral’. In other words, public health is not free of underlying normative agendas (‘mind frames’ that define what ought to be). We present such normative agendas that often constrain public health research work or practice in immigrant health and that researchers and practitioners are often not aware of. A life course approach can serve as a tool to expose such hidden normative agendas in immigrant health, such as by demonstrating the need to consider health needs arising beyond national borders.
