Migration and health care utilization in the European context

Abstract

Throughout the second half of the twentieth century, many traditional emigration countries in Western Europe gradually became receiving countries for significant numbers of immigrants, leading to an increasing ethnic diversification of their populations. Although at first a “healthy migrant effect” could be noted, in time, migrant groups were shown to generally develop a poorer health status and face important barriers in accessing health services compared to the native population. Since current evidence in the European context is inconsistent in illustrating trends in health care utilization among migrants, the present chapter aims at gaining a better understanding of this phenomenon through an in-depth analysis of selected original articles. Following a systematic literature search and evaluation process, eight publications from European countries were selected and analyzed based on Andersen’s model of health care utilization. Even in this small sample, a great diversity of migrant definitions, study designs, and target groups was noted, which arguably precludes the identification of generalizable trends on a European level. Against the background of a generally high objective need for health services among migrants, residence status, region of origin, duration of stay in the receiving country, migrant generation, local language proficiency, level of acculturation, and reason for migration were identified as explanatory variables for health services utilization in our review. Despite efforts to increase equity in health care utilization within the European Union and in individual countries, persistent barriers to health care access among migrants call for further action in health services research and delivery.