Kapilashrami Anuj, John Ekatha A
Professor in Global Health Policy & Equity, School of Health & Social Care, University of Essex, Wivenhoe Park, Colchester, UK.
Independent Researcher & Co-Coordinator, Migration Health South Asia Network, Mullai Nagar, Kovilpathagai, Avadi, Chennai, Tamil Nadu, India.
J Migr Health. 2023 Mar 20;7:100180. doi: 10.1016/j.jmh.2023.100180. eCollection 2023.
Mobility patterns in South Asia are complex, defined by temporary and circular migration of low waged labourers within and across national borders. They move, live and work in conditions that expose them to numerous hazards and health risks that result in chronic ailments and physical and mental health problems. Yet, public policies and discourses either ignore migrants' health needs or tend to pathologise them, framing them as carriers of diseases. Their structural neglect was exposed by the ongoing pandemic crisis. In this paper, we take stock of the evidence on the health of low-wage migrants in South Asia and examine how their health is linked to their social, political and work lives. The paper derives from a larger body of work on migration and health in South Asia and draws specifically on content analysis and scoping review of literature retrieved through Scopus from 2000 to 2021 on health of low-income migrants. Utilising the lens of precarity and building on previous applications, we identify four dimensions of precarity and examine how these influence health: i) , concerned with hazardous and disempowering work conditions, ii) pertaining to the social stratification and intersecting oppressions faced by migrants, iii) , derived from vulnerabilities arising from the mobile and transient nature of their lives and livelihoods, and iv) -based, relating to the formal policies and informal procedures of governance that disenfranchise migrants. We illustrate how these collectively produce distinct yet interrelated and interlocking oppressive states of insecurity, disempowerment, dispossession, exclusion, and disposability that define health outcomes, health-seeking pathways, and lock migrants in a continuing cycle of precarity, impoverishment and ill-health.
南亚的流动模式十分复杂，其特点是低薪劳工在国界内外进行临时和循环迁移。他们在流动、生活和工作过程中面临众多危害和健康风险，从而导致慢性病以及身心健康问题。然而，公共政策和相关论述要么忽视移民的健康需求，要么倾向于将他们病态化，将他们视为疾病携带者。当前的疫情危机暴露了对他们的结构性忽视。在本文中，我们评估了有关南亚低薪移民健康状况的证据，并研究他们的健康状况如何与其社会、政治和工作生活相关联。本文源自关于南亚移民与健康的大量研究工作，具体借鉴了对2000年至2021年通过Scopus检索到的关于低收入移民健康状况的文献进行的内容分析和范围综述。我们运用不稳定状态这一视角，并在以往研究的基础上，确定了不稳定状态的四个维度，并研究它们如何影响健康：i）与危险且使人丧失权能的工作条件有关；ii）涉及移民所面临的社会分层和交叉压迫；iii）源自其流动和短暂的生活及生计所带来的脆弱性；iv）基于治理的正式政策和非正式程序，这些政策和程序剥夺了移民的权利。我们阐述了这些因素如何共同产生独特但相互关联且相互交织的压迫性不安全、丧失权能、被剥夺财产、被排斥和可处置状态，这些状态决定了健康结果、寻求健康的途径，并使移民陷入不稳定、贫困和健康不佳的持续循环之中。
