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Understanding Migration

Understanding Migration

Migration: A Complex System

MCN Migration

The picture of migration, in the US and worldwide, is vastly more complicated than at first glance. Improved technology, rapid and accessible new forms of communication, increasing social inequality, a changing climate, a growing world economy, and greater ease of movement across the globe promise even greater complexity in the future. 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 for many years 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 and safety 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 strong effects on the health, health risks, and health management of mobile populations. 


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. 



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 2020, the figure stretched 281 million. In 1990, there were 23 million people living in the US who were born elsewhere; in 2020, over 51 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. Nonetheless, the US-Mexico border is one of the biggest migration hotspots in the world, with a record 2.1 million border encounters between October 2021 and August 2022. Migration at that border isn’t just increasing; it is also shifting demographically. Over the last decade, immigrants from Central Africa and Haiti previously employed in Brazil for the construction of world cup sites and Venezuelans facing the political and financial downfall are frequently seen at immigrant shelters along the southern border.  

Within the US, people frequently move between states, influencing the United States’ economy, politics, and culture. Over 26 million people moved within the US in 2021, yet health care systems are by their nature stationary. 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.”