Anales de la RANM

12 A N A L E S R A N M R E V I S T A F U N D A D A E N 1 8 7 9 MIGRATION AND HEALTH INEQUITY Aagaard-Hansen J, et al. An RANM. 2025;142(01): 11 - 20 1. INTRODUCTION This article brings together two topical themes – migration and health inequity. Both topics are highly complex in their own right, and the combination of the two adds even further to the complexity. The global trend in involuntarily displaced populations has continued to increase (1), though it is essential to remember, that there are many other sorts of population movement such as education, labor, and family unification (2). Although the importance of social determinants of health have been recognized for a long time, the more recent contribution of the Commission of the Social Determinants of Health (CSDH) provided further evidence as well as political attention (3). Recent reviews have provided updated overviews of the complexity of the field globally as well as in the European region (4-8). This article will juxtapose two conceptual frameworks from the fields of migration and health inequity respectively to guide public health planning and research. 2. METHODOLOGY This study is based on a narrative review, aimed at providing a comprehensive overview of the intersection between conceptual frameworks of migration and health inequity, allowing for a broader and more flexible exploration of available information, and facilitating the integration of multiple theoretical and contextual perspectives. To identify relevant literature, a search was conducted in academic databases using the following key terms: Conceptual framework, health inequity, migration, tuberculosis, visceral leishmaniasis, diabetes mellitus. Studies addressing the relationship between migration patterns and health inequities were reviewed, with a particular focus on the three diseases considered exemplary cases in this analysis. The reviewed literature was assessed according to its relevance to the study's conceptual framework, prioritizing research that contributed empirical evidence, theoretical models, or public health policy analyses. This approach allowed for the identification of connections between the various mechanisms through which migration influences health inequity and the development of an integrated perspective to guide public health planning and research. 3. PATTERNS OF MIGRATION The United Nation’s International Organiza- tion for Migration (IOM) (2022) (1,4) defines a “migrant with an umbrella term, not defined under international law, reflecting the common lay understanding of a person who moves away from his or her place of usual residence, whether within a country or across an international border, temporarily or permanently, and for a variety of reasons”. This is not a globally recognized term, but it guides the work of the organization. The IOM (2022) estimates that the “number of interna- tional migrants has increased over the past five decades. The total estimated 281 million people living in a country other than their countries of birth in 2020 was 128 million more than in 1990, and over three times the estimated number in 1970” (1,4,5). Recent years’ large waves of population movement (e.g. from Ukraine and Palestine to neighboring countries due to the recent wars, from Africa and the Middle East to Europe, and from Latin America to Central and North America and other countries) are conspicuous examples of migration with detrimental health effects and other negative consequences - either driven by forced and rapid refuge from immediate danger, or more protracted flows of migrants converging towards regions with presumed better economic potential. Notwithstanding the importance of these tragic events, it should be borne in mind that there are many other sorts of population movements (1,4,5). A comprehensive framework of population movements has been suggested based on work by previous scholars ( Table 1 ) (2). This concep- tual framework displayed the multitude of forms in which population movement takes place according to the variables of ‘onset’ (slow or rapid), ‘cause’ (human/political or natural), ‘direction’ (unidirectional or circular) and ‘motivation’ (voluntary or forced). Overall, the table displays the many different sorts of popula- tion movemen t. Despite its complexity, this framework is still an over-simplification, and the individual catego- ries are not absolutely distinct. For instance, labor migration may be intended to be temporary, but turns out to be permanent or vice versa. Further- more, recent developments have shown that the distinction between human/political and natural may not always be clear (9), and refuge due to natural causes has also been caused by rising sea levels (10-11). The concept of ‘mixed migration flows’ has also drawn the attention to the issue (12). In short, this typology illustrates that population movements are multi-faceted and very complex (13). Furthermore, it should be pointed out that migration patterns should be analyzed in the local contexts. Thus, the degree of similarity between migrants and the host population in terms of language, ethnicity, traditions, or religion as well as previous historical ties or animosity play major roles.