Migrant Health Policies in the European Union: a Comparative Policy Analysis

There is an undeniable relationship between migration and health. Despite the fact that the concept of health as a fundamental human right has been enshrined in numerous international and supranational policy instruments, health disparities between migrants and host nation populations persist. Inequities in health are perpetuated by several factors that include, but are not limited to, immigration status, lack of knowledge of health system access points, appropriateness of health care services, language barriers, and unique health profiles of migrants. The literature firmly positions migrants as a vulnerable population due to their collective risk of poor health outcomes in multiple areas. Between 1998 and 2007, 10 European Union (EU) member states, plus Switzerland in a special partnership with the EU through the European Economic Area, adopted a migrant health policy to improve the health of migrants through targeted strategies. These national level migrant health policies go beyond statutory requirements outlined in international and supranational charters and treaties to protect the health migrants and address factors that contribute to health inequity between migrants and European host nation populations. Listed in alphabetical order, European nations with migrant health policies include: Austria, England, France, Germany, Ireland, Italy, the Netherlands, Portugal, Spain, Sweden, and Switzerland. While barriers encountered by migrants in accessing health care services in host nations and inequities in health between migrants and host nation populations have been well- documented in the literature, scholarly research on comparative analysis of the content of European-based migrant health policies is relatively limited and migrant health policy process or outcome analyses are virtually non-existent. Comparative analysis of eleven migrant health policies that broadly share the same objective to improve the health status of migrant populations provides insight into how a group of nations responded to addressing the health of migrant populations through a policy instrument. This study identified how the policies are similar and different through a two- phased analytic process that included content analysis followed by typological analysis. The coding scheme that emerged from content analysis was mapped onto a typology matrix. The result was the emergence of four themes that are a type of orientation toward the health of migrant populations. The theme-based typology goes beyond description and classification of the policy cases by offering a higher level of understanding of variation across the themes and cases. This is a new framework from which to compare concepts, explore dimensionality, and identify hierarchical relationships at macro and micro levels. The macro level occurs across and within emergent themes, while the micro level is the policy case. This study aims to inform future policy making processes concerning all areas of immigration and provide context for future migrant health policy process and outcomes research