Initiative for U.S.-China Dialogue on Global Issues

As a social epidemiologist, I am particularly interested in behavioral and social determinants of health among migrants and immigrants. Rapid urban growth in many developing countries is accompanied by the spontaneous emergence of migrant and immigrant settlements at the cities’ peripheries and by a disorganization of these settlements in terms of infrastructure (e.g., crowded and poorly planned housing, limited access to education and health facilities, and clandestine relationships with local law enforcement agencies).  The great danger is that these floating populations also exhibit high risks for illness and disease because of very low access to sanitary facilities and preventive care, as well as the high exposure to often hazardous working environments.  Health needs of migrants and immigrants are often poorly understood by the public health system, communication between health care providers and migrant clients remains difficult with or without linguistic barriers, and health systems are not prepared to respond adequately. 

In theory, migrant and immigrant health service utilization would be predicted by various predisposing and enabling factors and the effects of perceived needs, including health and mental health indicators, personal and social resources, and a range of post-migration living difficulties. A recent Delphi consensus has highlighted that “as worldwide migration increases, the media, decision makers and stakeholders are recognizing the importance of building responsive health and other social systems. . . If policies and programs for a responsive health system can be developed, crises may be averted in the future.”  Global health scholars are calling for actions to engage migrant communities, provide culturally sensitive health care, and prioritize data collection on demographic movement, health surveillance, and health services studies in order to build a responsive health system.  Our health studies on African migrants in China and Chinese migrant workers in Africa aim to highlight the unique needs of these floating populations and help engage these communities and local governments in building responsive health systems.