Illegality as risk factor: A survey of unauthorized migrant patients in a Berlin clinic
Illegality as risk factor: A survey of unauthorized migrant patients in a Berlin clinic
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DOI：
10.1016/j.socscimed.2009.01.024
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发表时间：
2009-04-01
影响因子：
5.4
通讯作者：
Castaneda, Heide
中科院分区：
文献类型：
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作者：
Castaneda, Heide
未经许可的移徙者在许多接受国面临健康方面的不利因素。然而，很少有研究准确地探讨了“非法”的条件如何影响疾病的经验，医疗和康复。本文介绍了一个案例研究，从德国（2004-2006年和2008年），未经授权的移民面临有限的医疗保健和驱逐出境的威胁，避免服务和治疗延误的结果。这是混淆了独特的法律，基本上刑事定罪的医疗保健工作者帮助移民。这篇文章提供了一个快照的183名患者谁参加了柏林诊所，作为单一的最大来源的医疗援助的未经授权的人在德国的功能。人口统计信息描绘了一幅劳动力移民的图景，平均年龄约为29岁。在该诊所就诊的妇女多于男子，这是由于该诊所能够成功安排产前护理和分娩，也反映了当地劳动力市场的情况。原籍国的多样性（n = 55）令人惊讶，这突出表明使用非法身份作为统一变量来突出移民在全球经济中的共同地位以及由此产生的基本医疗服务障碍的效用。患者表现出一系列其年龄组的典型疾病。然而，非法身份的影响导致了四个方面的不平等：（1）母婴护理的总体质量和数量受到限制;（2）慢性病患者就诊延迟，难以获得正常供应的药物;（3）难以获得对不可预测的伤害和其他急性健康问题的立即医疗护理;以及4）缺乏对影响健康的广泛压力和焦虑的心理健康护理选择。在德国，不一致的政策环境导致服务不足和治疗延误。解决方案必须解决这些法律的模糊性，这是一个在其他方面实现全民健康覆盖的国家实现公平的主要障碍。(C)2009爱思唯尔有限公司保留所有权利。
Unauthorized migrants face health disadvantages in many receiving nations. However, few studies have explored precisely how the condition of "illegality" influences illness experiences, medical treatment, and convalescence. This article presents a case study from Germany (2004-2006 and 2008), where unauthorized migrants face limited access to health care and the threat of deportation results in avoidance of services and treatment delays. This is confounded by unique laws which essentially criminalize health care workers for aiding migrants. This article provides a snapshot of 183 patients who attended a Berlin clinic that functions as the single largest source of medical assistance for unauthorized persons in Germany. The demographic information sketches a picture of labor migrants with a mean age of approximately 29 years. More women than men presented at this clinic, a result of its ability to successfully arrange prenatal care and delivery as well as a reflection of local labor markets. The diversity of countries of origin (n = 55) is surprising, underscoring the utility of using illegal status as a unifying variable to highlight migrants' shared position in the global economy and the resulting barriers to basic medical services. Patients presented with a range of illnesses typical for their age group. However, the effects of illegal status resulted in four areas of disparities: 1) limits to the overall quality and quantity of care for mothers and infants: 2) delayed presentation and difficulties accessing a regular supply of medication for patients with chronic illnesses; 3) difficulties in accessing immediate medical attention for unpredictable injuries and other acute health concerns;, and 4) a lack of mental health care options for generalized stress and anxiety affecting health. In Germany, an incoherent policy environment contributes to inadequate services and treatment delays. Solutions must address these legal ambiguities, which represent a primary barrier to equity in a nation with otherwise universal health coverage. (C) 2009 Elsevier Ltd. All rights reserved.