Migrant and Refugee Health

Migrant and refugee health concerns the health needs and care of people who move across borders — including labour migrants, refugees fleeing persecution or conflict, asylum seekers, and other displaced persons — and the way migration itself shapes health and access to services. For community and public health nursing it spans the pre-migration, journey, and post-migration phases that influence well-being.

Definition

Migrants are people who move from their place of usual residence across an international border or within a country; refugees are people who have fled their country owing to a well-founded fear of persecution, and asylum seekers are those whose refugee claim is undetermined. Migrant and refugee health is the field concerned with the health and care of these populations.

Scope

This entry covers definitions of the main migrant categories, the health profile and mental-health burden of refugees and migrants, the determinants and barriers shaped by legal status, language, and entitlement, and the framing of migration as a determinant of health. It is reference-educational and population-level, not clinical guidance for individuals.

Core questions

• How are migrants, refugees, and asylum seekers defined, and why do the distinctions matter for health entitlement and care?
• How do the phases of migration — pre-departure, journey, and resettlement — shape physical and mental health?
• What is the burden of mental disorder and of communicable and non-communicable disease in refugee and migrant populations?
• What barriers of legal status, language, and entitlement limit access to care, and how can services respond?

Key concepts

• Migrant, refugee, and asylum-seeker categories
• Migration as a social determinant of health
• Pre-migration, journey, and post-migration phases
• Healthy migrant effect
• Post-traumatic stress and resettlement stress
• Entitlement and access barriers
• Culturally and linguistically appropriate care

Mechanisms

Health in migrant and refugee populations is shaped across the migration trajectory: conditions in the country of origin, exposures and trauma during transit, and the legal, social, and economic circumstances of resettlement. Pre-departure conflict and persecution, hazardous journeys, detention, insecure status, language barriers, and restricted entitlement can all elevate risk and impede care. Some arriving migrants are initially healthier than the host population (the healthy migrant effect), an advantage that may erode with time and adverse post-migration conditions.

Clinical relevance

For community and public health nurses, this topic explains why migrant and refugee populations have distinctive and sometimes unmet health needs, and why entitlement, language, and trust shape whether care is reached. It is descriptive orientation to a population and the systemic factors affecting it, not a protocol for any individual's diagnosis or treatment.

Epidemiology

Refugees resettled in Western countries have elevated rates of serious mental disorder, including post-traumatic stress disorder and depression, relative to general populations, as shown in systematic review (Fazel, Wheeler, & Danesh, 2005). The broader migrant population is heterogeneous: the UCL-Lancet Commission on Migration and Health (Abubakar et al., 2018) found that migrants often contribute positively to host economies and are not, in aggregate, a major source of imported infection, while specific subgroups face concentrated risk shaped by the conditions of their migration.

Evidence & guidelines

The UCL-Lancet Commission on Migration and Health (Abubakar et al., 2018) is a landmark synthesis framing migration as a determinant of health and challenging common misconceptions. The systematic review by Fazel and colleagues (2005) documents the mental-health burden among resettled refugees. WHO regional reports provide policy framing for refugee and migrant health systems (WHO, 2018).

History

Concern with the health of migrants accompanied the great population movements of the nineteenth and twentieth centuries, but the contemporary field took shape as international displacement rose and as the social-determinants framework matured. The 2018 UCL-Lancet Commission marked a turning point in synthesising evidence and reframing the public and policy narrative around migration and health.

Debates

Does migration import disease and burden host health systems?

A persistent public narrative frames migrants as a source of infection or cost, but the Commission's synthesis found this largely unsupported in aggregate and emphasised that restricting migrants' access to care can itself harm public health; the framing of migrants as risk versus as contributors remains contested in policy.

Key figures

• Ibrahim Abubakar
• Mina Fazel
• Robert Aldridge

Seminal works

• abubakar-2018
• fazel-2005

Frequently asked questions

What is the difference between a refugee, an asylum seeker, and a migrant?

A migrant is anyone who moves from their usual place of residence; a refugee has fled their country because of a well-founded fear of persecution and has been recognised as such; an asylum seeker has applied for that recognition but is awaiting a decision. The distinctions carry different legal rights and entitlements to care.

Are migrants generally less healthy than host populations?

Not uniformly. Some migrant groups arrive healthier than the host population, an effect that can fade over time, while specific groups such as refugees and asylum seekers carry a higher burden of trauma-related mental illness shaped by the conditions of their migration.