In This Article Expand or collapse the "in this article" section Vulnerability, Intersectionality and Health in Migration

  • Introduction
  • General Overviews
  • Assessment Tools
  • Journals

Public Health Vulnerability, Intersectionality and Health in Migration
by
Souad Osseiran
  • LAST REVIEWED: 21 March 2024
  • LAST MODIFIED: 21 March 2024
  • DOI: 10.1093/obo/9780199756797-0218

Introduction

Vulnerability and intersectionality are two lenses that have been relied on to explore specific themes relating to health in migration. Intersectionality, originally emerging in feminist and race studies, is relied on in scholarship on migration and migrant health due to the complex and overlapping factors influencing migrant experiences overall and health outcomes. Beyond philosophical discussions of vulnerability as situational or universal, vulnerability has been relied on in studies on the health of specific segments of society such as migrants or refugees. Vulnerability has been analyzed as increased risk of poor health due to migration, work conditions, and barriers to healthcare access among other factors. In much of the literature, vulnerability in migrant health is approached as arising due to work and living or other conditions, and it is understood as a heterogenous experience rather than it being a singular or uniform experience. Vulnerability in relation to migrant health has been explored as situational, structural, and group specific. While discussions on vulnerability may account for the intersecting dimensions of race, gender, and class and the impact of oppressive and exploitative relations, in many cases intersectionality theory specifically is not mentioned. Similarly, for research employing an intersectionality lens, vulnerability is mentioned in terms of increased likelihood of experiencing poor health or health inequities rather than as a theorizing of vulnerability. Vulnerability or intersectionality are then both used in research on health in migration, but with few resources engaging with both concepts simultaneously—highlighting possible avenues for further research. This entry will provide general overviews concerning vulnerability and intersectionality in migrant health and then focus on works utilizing either concept in the analysis of migrant health. In the following, the terms “migration” and “migrant” will be favored as encompassing terms that refer to multiple and diverse movements and legal statuses; based on the resource being annotated, “refugee” or “asylum seeker” may be used as relevant.

General Overviews

Literature examining migrant health has highlighted the structures and relations that produce migrants’ vulnerability to poor(er) health outcomes. Casteňeda, et al. 2015 argues for expanding the framework of social determinants to include migration as a determinant. The review article highlights the ways migration influences health and the impact of migrant experiences on health as well as discussing the different ways migrant health has been studied. While not focusing on vulnerability and intersectionality directly, the review contributes to debates around these themes. Reilly, et al. 2022 focuses on the concepts of intersectionality, vulnerability, and precarity with respect to gender-based violence in migration but the overview can offer guidance on how to incorporate these concepts in studies on health in migration. With a focus more broadly on vulnerability to poor health among different disadvantaged categories of people, Allotey, et al. 2012 provides a brief overview of how vulnerability has been used conceptually. Continuing with vulnerability, Siriwardhana, et al. 2017 examines the impact of multiple factors on migrant health while Tangcharoensathien, et al. 2018 demonstrates the need for universal health for migrants and other vulnerable groups. Kapilashrami and Hankivsky 2018 argues for adopting an intersectionality approach to studying migrant health. Spitzer 2016 and Spitzer 2022 provide an overview of intersectionality and how to incorporate it into studies on migration and health. Discussing another possible research frame, Spini, et al. 2017 highlights the possibilities of a lifecourse framework for studying intersectional dimensions influencing health among migrants and other vulnerable groups.

  • Allotey, Pascale, Sharuna Verghis, Fatima Alvarez-Castillo, and Daniel D. Reidpath. 2012. Vulnerability, equity and universal coverage: A concept note. BMC Public Health 12.supp 1: S2.

    DOI: 10.1186/1471-2458-12-S1-S2

    The commentary presents an overview of the ways vulnerability has been conceptualized with respect to health for a diverse range of groups including migrants. It highlights the situational nature of vulnerability, and the ways intersectional factors influence the production of vulnerability among people.

  • Casteňeda, Heidi, Seth M. Holmes, Daniel S. Madrigal, Maria-Elena De Trinidad Young, Naomi Beyeler, and James Quesada. 2015. Immigration as a social determinant of health. Annual Review of Public Health 36:375–392.

    DOI: 10.1146/annurev-publhealth-032013-182419

    The article argues for expanding the social determinants of health framework to include migration since existing research highlights how migration and experiences as a migrant influence health. Includes a comprehensive review of the literature on migrant health, social determinants of health, and an overview of frameworks (e.g., behavioral, cultural, and structural) used to study health in migration. Identifies gaps in how health in migration has been studied, thereby outlining the need to include migration as a social determinant of health.

  • Kapilashrami, Anuj, and Olena Hankivsky. 2018. Intersectionality and why it matters to global health. The Lancet 391.10140: 2589–2591.

    DOI: 10.1016/S0140-6736(18)31431-4

    A commentary discussing the benefit of adopting an intersectionality approach to the analysis of structures resulting in health inequities for vulnerable groups including migrants and refugees. It highlights the advantages of relying on an intersectionality lens, given its emphasis on the social and political position of individuals, thereby exploring the structural relations affecting their health outcomes.

  • Reilly, Niamh, Margunn Bjornholt, and Evangelia Tastsoglou. 2022. Vulnerability, precarity, and intersectionality: A critical review of three key concepts for understanding gender-based violence in migration contexts. In Gender-based violence in migration: Interdisciplinary, feminist, and intersectional approaches. Edited by Jane Freedman, Nina Sahraoui and Evangelia Tastsoglou, 29–56. Cham, Switzerland: Palgrave Macmillan.

    DOI: 10.1007/978-3-031-07929-0_2

    The chapter provides an overview of discussions of vulnerability, precarity, and intersectionality to then focus on gender-based violence with respect to migration. While not focusing on health, the overview of the three concepts supports understanding of the ways that vulnerability and intersectionality may apply to studies of health in migration.

  • Siriwardhana, Chesmal, Bayard Roberts, and Martin McKee. 2017. Vulnerability and resilience. Thematic discussion paper, 2nd Global Consultation On Migrant Health: Resetting the agenda. Brussels: International Organization for Migration.

    Presents an overview of literature on migrant health to propose a conceptual approach to studying migrant vulnerability and resilience in health. Relying on the social determinants of health, the approach seeks to account for intersecting and multilevel factors affecting health outcomes. Vulnerability is understood as resulting from actions or events negatively affecting individuals and their ability to cope—including persecution, discrimination, rights violations, unemployment, and living conditions.

  • Spini, Dario, Laura Bernardi, and Michel Oris. 2017. Toward a life course framework for studying vulnerability. Research in Human Development 14.1: 5–25.

    DOI: 10.1080/15427609.2016.1268892

    The article argues for adopting a lifecourse framework for studying vulnerability in different disciplines and research fields. It explains vulnerability as relating to stress factors and the availability or lack of resources at individuals’ disposal over time. While indirectly focusing on migration, their approach explores vulnerability as resulting from multiple intersecting factors and stressors impacting individuals at different levels over such time periods.

  • Spitzer, Denise L., 2016. Migration and health through an intersectional lens. In Handbook of migration and health. Edited by Felicity Thomas, 75–92. London: Elgar.

    The chapter presents the ways migration and the neoliberal economic order align to then explore the concept of intersectionality and how it can be applied in studies of health in migration.

  • Spitzer, Denise L. 2022. Intersectionality: From migrant health care to migrant health equity. In Migration and health. Edited by Sandro Galea, Catherine Ettman, and Muhammed Zaman, 186–193. Chicago: Univ. of Chicago Press.

    DOI: 10.7208/chicago/9780226822495.003.0020

    The book chapter provides an overview of the concept of intersectionality and how it can be applied to studies of migrant health, highlighting key challenges faced by migrants with respect to healthcare, policy gaps concerning migrant health, and possibilities for achieving equity in healthcare.

  • Tangcharoensathien, Viroj, Anne Mills, Maitreyi Bordia Das, Walaiporn Patcharanarumol, Monthian Buntan, and Jeffery Johns. 2018. Addressing the health of vulnerable populations: Social inclusion and universal health coverage. Journal of Global Health 8.2: 020304.

    DOI: 10.7189/jogh.08.020304

    The article focuses on the health of vulnerable populations including but not limited to refugees and migrants. Building on a recognition of intersectionality, the authors argue that the implementation of universal healthcare and social inclusion are key to addressing vulnerable groups’ health. The authors identify the (possible) role different actors (e.g., local, government, or international) may play in processes to reduce vulnerability to low health outcomes.

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