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Understanding Migration

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Migration: A Complex System

MCN MigrationThe picture of migration, in the US and worldwide, is vastly more complicated than at first glance -- and modern technology, economic and ecological factors, and ease of movement promise greater complexity in the future. While much of the focus is given to the influx of immigrants into the richer Northern countries like the US from the developing nations of the global South, the true picture of migration shows a dense web of movement: migrants moving back and forth between their home country and their adopted country; agricultural workers moving within one country, sometimes several times a year to follow the seasonal changes in work opportunities; new immigrants who are willing and able to keep pressing on to new locations in search of better opportunity or more stable conditions elsewhere.

This complex picture of modern human migration is a result of improved transportation and communication, increasing social inequality, a changing climate, a growing world economy, and greater ease of movement across the globe. Rapid dissemination of information, updating far-off communities on the opportunities of a different community, has fueled population movement further. As these factors have accelerated and reached more corners of the globe, migration in the US and globally has changed. Migrants have begun working in industries and communities that until recently did not largely rely on migrant workers, like salmon fisheries in Alaska, or industrial dairy farms in Wisconsin. The new migrants often do not have experience in the field where they have found work; the employers in these communities are often not equipped to communicate the health risks associated with the work they are offering, in a linguistically and culturally appropriate way.  The changes and increases in migration patterns, the arrival of migrants into new communities, and the participation in new and often dangerous forms of employment have therefore strong effects on the health, health risks, and health management of mobile populations.



While the Department of Health and Human Services and others define a migrant within the scope of agricultural work, we at Migrant Clinicians Network prefer to define migrants with this complex global reality in mind. A migrant is defined as one who:

  1. Crosses a prescribed geographic boundary by chance, instinct, or plan;
  2. Stays away from his/her normal residence;
  3. Seeks or engages in remunerated activity.
Population figures

Population figures

Worldwide, migration has increased. In 1990, there were 155 million people living outside of the country of their birth.  By 2013, the figure stretched 232 million. In 1990, there were 23 million people living in the US who were born elsewhere; in 2013, almost 46 million people in the US were born out of the country. The overall figures do not adequately present the complexity of the picture, however. For example, although migration from Mexico to the US increased dramatically in the 1990s, by the 2010s, migration had evened out -- roughly the same number of people were moving to (or returning to) Mexico as were moving to (or returning to) the US. In 2011, there was a net negative migration from Mexico. And the makeup of immigrants continues to shift; in 2013, new migration flows from Mexico fell below those of China and India.

Within the US, people frequently move between states, influencing the United States’ economy, politics, and culture, as is noted in this New York Times article on state-to-state migration. When immigrants cross state lines, they encounter new barriers: different requirements in each state for health care access, varying rules and regulations on safety and health, a different local perspective on the role of immigrants, and more. These additional barriers may be magnified by language and cultural differences, and fears due to documentation status. 

Addressing migrant health issues

Addressing migrant health issues: Underserved or undeserved?

The national conversation on migration often sticks narrowly to the question of how the immigrant arrived. This focus on immigration status sidetracks progress on public health for all US residents, by moving the focus away from addressing the health needs of individuals within our borders. It also stalls needed adjustments of our rigid health care systems that are largely unequipped to care for patients who may become migratory but still need care.  Please see our Migrant Health Overview for more information on the health needs of migrants. 

For further information, we recommend our archived webinar series, entitled, “Clinician Orientation to Migrant Health.”