Anales de la RANM

16 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 6. INTEGRATING MIGRATION AND HEALTH INEQUIT Y PERSPECTIVES VL and TB are both communicable diseases requiring relatively long-term treatment regimens, though VL has a more acute progression. In contrast, DM is a non-communicable, chronic condition requiring life-long health care. Table 2 summarizes how the three disease cases exemplify the ways in which various sorts of migration patterns may aggravate the health inequities based on various mechanisms. Table 2. Representation of the three exemplary cases (visceral leishmaniasis, diabetes mellitus and tuberculosis) by mechanisms of health inequity and elements of migration. Visceral leishmaniasis Diabetes mellitus Tuberculosis Mechanism Migration Mechanism Migration Mechanism Migration Socio- economic context and position - User fees for health care services in place of arrival - Health care services only for original popula- tion - Populations migrating into places where they are not entitled to health care - User fees for health care services in place of arrival - Health care services only for original popula- tion - Populations migrating into places where they are not entitled to health care - User fees for health care services in place of arrival - Health care services only for original popula- tion - Populations migrating into places where they are not entitled to health care Differential exposure - Exposure to infectious agent - Migrants moving into endemic areas - Migrants introducing infection in new area - Obesogenic environment (high-fat diet and more sedentary lifestyle) - Migrants changing their nutrition and lifestyle - Exposure to infectious agent - Migrants moving into endemic areas - Migrants introducing infection in new area Differential vulnerability - Lack of immunity - Co-morbidity - Naïve popula- tions migrating into endemic area - Infected population introducing VL into new areas - Susceptibility to an increased risk of different conditions - Adaptation to new conditions, nutrition, and lifestyle - Lack of immunity - Co-morbidity - Naïve popula- tions migrating into endemic area - Infected population could introduce TB and DR-TB into new areas Differential outcome - Inadequate benefit from health care services in new environment - Populations migrating into places where they are not entitled to health care - Inadequate benefit from health care services in new environment - Populations migrating into places where they are not entitled to health care - Inadequate access to and benefit from health care services in new environment - Populations migrating into places where they are not entitled to health care Differential consequences - Catastrophic health expendi- tures - Loss of income - Migrants required to pay excessively for health care in new environment - Catastrophic health expendi- tures - Loss of income - Migrants required to pay excessively for health care in new environment - Catastrophic health expendi- tures - Loss of income - Migrants required to pay excessively for health care in new environment