08 SES 14, Learning for Change: Health, ESD and Citizenship
Parallel Paper Session
One of the most noble challenges affected by migration relates to the provision of universal and equitable health care, central accessibility and quality of services, regardless of gender, ethnicity or country of origin - health as a universal right. Health and accessibility to health care are keystones for social inclusion of immigrants, consisting one of the primary routes of access to citizenship and civil rights.
Portugal has shown strong commitment on improving the migrants’ integration through a series of inclusive policies, favoring legalization and family reunification, presenting a framework of free access to health care. Nevertheless there are undeniable weaknesses in investigating these areas, as development of national research, comparative health indicators and strategies for concerted action in this area are needed.
The most recent waves of immigration unanimously show the feminization of migration and increasing participation of migrant women in European demography. However, scientific evidence shows that immigrant populations have a higher risk of contracting diseases, such as cardiovascular disease, showing higher rates of diabetes prevalence and mortality associated to cancer, compared with native populations; migrants are also at higher risk of contracting infectious diseases such as tuberculosis, HIV / AIDS and hepatitis. They also exhibit a greater risk of suffering from mental illness, including depression, schizophrenia and post traumatic stress, as a result of specific psychosocial determinants. These factors induce and cause an ascending vulnerability during pregnancy (psychopathological complications after delivery - postpartum blues, psychosis and depression - exacerbated by stressors associated with the migration process), so maternal and child health care should be handled with particular attention.
European lines of research indicate that the morbidity associated with pregnancy, as well as some sexual and reproductive complications tend to be higher among immigrants. There is also evidence that the outcomes of pregnancy tend to be impoverished (losses shown in general state of health, with significant weight to public health), particularly the greater incidence of preterm and low birth weight babies. This population also has the worst health indicators associated with higher maternal, neonatal and infant mortality, spontaneous abortion, increased incidence of postpartum depression, negligible gynecological follow-up and poor prenatal education.
It can be pointed out that a key aspect of integration and acceptance lies, above all, on supplying accessibility to make informed decisions (that implies the availability of multilingual information in different contexts, and ideally providing multicultural mediators, trained to be sensitive and attentive to diversity and cultural specificity), to allow constructed knowledge of legislation and civil rights, and especially access to education as the core of developing a full autonomy.
Bunevicius, R., Kusminskas, L., Bunevicius, A., Nadisauskiene, R., Jureniene, K., & Pop, V. (2009). Psychosocial risk factors for depression during pregnancy. Acta Obstetricia et Gynecologica, 88, 599-605. Carballo, M. (2009a). Non-communicable Diseases. In A. Fernandes & J. Miguel (Eds.), Health and Migration in the European Union: Better Health for All in an Inclusive Society (pp. 73-82). Lisboa: Instituto Nacional de Saúde Doutor Ricardo Jorge. Carballo, M. (2009b). Communicable Diseases. In A. Fernandes & J. Miguel (Eds.), Health and Migration in the European Union: Better Health for All in an Inclusive Society (pp. 53-70). Lisboa: Instituto Nacional de Saúde Doutor Ricardo Jorge. Creswell, J. (2003). Research Design: qualitative, quantitative and mixed methodes approaches (Second Edition ed.). California: SAGE Publications. Dias, S., A. Gama, & Rocha, C. (2010). Immigrant women's perceptions and experiences of health care services: insights from a focus group study. . Journal of Public Health, 18, 489-496. Dias, S., Gama, A., Cortes, M., & Sousa, B. (2011). Healthcare-seeking patterns among immigrants in Portugal. Health and Social Care in the Community, 19(5), 514-521. Fernandes, A., & Miguel, J. (2009). Health and Migration in the European Union: Better Health for All in an Inclusive Society. Lisboa: Instituto Nacional de Saúde Doutor Ricardo Jorge. Ingleby, D., Chimienti, M., Hatziprokopiou, P., & Freitas, C. (2005). The role of health in integration. In M. Fonseca & J. Malheiros (Eds.), Social integration and mobility: education, housing and health (pp. 88-119). Lisbon: Centro de Estudos Geográficos. Padilla, B., Portugal, R., Ingleby, D., Freitas, C., & Lebas, J. (2009). Health and migration in the European Union: Good Practices. In A. F. J. P. Miguel (Ed.), Health and Migration in the European Union: Better Health for All in an Inclusive Society. Lisboa: Instituto Nacional de Saúde Doutor Ricardo Jorge.
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