Evagora-Campbell Mireille, Zahidie Aysha, Buse Kent, Rabbani Fauziah, Hawkes Sarah
Research Coordinator, Institute for Global Health, University College London, 30 Guilford Street, London, WC1N, UK.
Research Consultant, Aga Khan University, PO Box 3500, Stadium Road, Karachi, Pakistan.
J Migr Health. 2022 Feb 1;5:100082. doi: 10.1016/j.jmh.2022.100082. eCollection 2022.
Labour migrants, who represent over sixty per cent of international migrants globally, frequently have poorer health status than the population of host countries. These health inequities are determined in a large part by structural drivers including political, commercial, economic, normative and social factors, including living and working conditions. Achieving health equity for migrant workers requires structural-level interventions to address these determinants.
We undertook a systematic review of peer-reviewed literature designed to answer the question "what is the evidence for the effectiveness of interventions to address the structural determinants of health for labour migrants?" using the Ovid Medline electronic database.
We found only two papers that evaluated structural interventions to improve the health of labour migrants. Both papers evaluated the impact of insurance - health or social. In contrast, we found 19 evaluations of more proximal, small-scale interventions focused on changing the knowledge, attitudes and behaviours of labour migrants.
Despite the rise in international migration, including for work, and evidence that labour migrants have some higher health risks, there is a paucity of research addressing the structural determinants of health inequities in labour migrants. The research community (including funders and academic institutions) needs to pay greater attention to the structural determinants of health - which generally requires working across disciplines and sectors and thinking more politically about health and health inequities.
Wellcome Trust (208712/Z/17/Z).
劳务移民占全球国际移民的60%以上，其健康状况往往比东道国人口差。这些健康不平等在很大程度上由包括政治、商业、经济、规范和社会因素（包括生活和工作条件）在内的结构性驱动因素所决定。实现移民工人的健康公平需要在结构层面进行干预，以解决这些决定因素。
我们对同行评议文献进行了系统综述，旨在回答“有哪些证据表明干预措施对解决劳务移民健康的结构性决定因素有效？”这一问题，使用的是Ovid Medline电子数据库。
我们仅发现两篇评估改善劳务移民健康的结构性干预措施的论文。这两篇论文均评估了保险——健康保险或社会保险的影响。相比之下，我们发现有19项评估关注更直接、小规模的干预措施，重点是改变劳务移民的知识、态度和行为。
尽管包括因工作目的在内的国际移民有所增加，且有证据表明劳务移民存在一些更高的健康风险，但针对劳务移民健康不平等的结构性决定因素的研究却很匮乏。研究界（包括资助者和学术机构）需要更加关注健康的结构性决定因素——这通常需要跨学科和跨部门合作，并从政治角度更多地思考健康及健康不平等问题。
惠康信托基金会（208712/Z/17/Z）。
