pcc eastern european economic migrants jsna and ccc migrant populations jsna stakeholder scoping...

Meeting health needs – are migrant populations disproportionately affected by infectious diseases?

Lynsey Emmett, Epidemiological Scientist14th October 2015

2 Meeting health needs – are migrant populations disproportionately affected by infectious diseases?

Background• Valuable contribution of migrant populations• Number of people migrating to the UK has been greater

than the number emigrating since 1994 (by more than 100,000 since 1998)

• East of England scoping exercise in 2008• integration dependent upon equitable access to health

care and positive health outcomes alongside employment, education and housing

• Unmet health needs

• Reports – increased burden of infection in some UK born populations


What is a migrant?

Complex – effect on data and analyses

Person who changes their usual country of residence

- Country of birth different to country of residence- Nationality is different to country of residence- Changes country of residence for a period of at least a year

Strengths and weaknesses

Understanding migration statistics

4

ONS International Passenger

Survey

ONS UK Census

DWP Migrant Workers Scan

ONS GP registrations

Home Office Asylum seekers, worker

registration scheme

Gangmaster registrations

ONS Annual Population

Survey

ONS Labour Force

Survey

DWP National

Insurance Number

registrations


Understanding migration statisticsKey points

• Before 1964No systematic attempt to measure extent of

international migration (census data – diff births/deaths)

• 1964 to 1990International Passenger Survey (IPS)

• 1991 onwardsLong term international migration series

IPS + other data sources


Migration in the UK 1991-2014• ONS long term

international migration

• Changes residence for at least a year

• Net migration:• 1991-5 –

av. 37,000• 2010-14 –

av. 234,000Source: House of Commons, Migration Statistics Briefing Paper


Migration in the UK 1964-2014

Source: House of Commons, Migration Statistics Briefing Paper


From where do people migrate to the UK?

2013 –

• 14% British nationals

• 38% nationals of other EU

• 47% nationals of non-EU countries

Nationality, country of birth, country of last residence



Why do people migrate to the UK?

WORK

STUDY



Migration in the East of England

• Region with 4th highest proportion of population born abroad (11%, 37% in London)

• 101% increased between 1995 (308,707) to 2013 (621,145)

• Luton highest number (62,872) as well as highest population share (31%) of non-UK born residents in the region

• Residents born in Poland represent the most numerous non-UK born group in the East of England (62,100) followed by residents born in India, Ireland, United States and Pakistan

• Cambridge had the highest number (3187) and proportion (21%) of short term residents

Source: Migration Observatory, Oxford




• 48% male, 52% female

• 43% aged 20-39 years

• Most common 25-29 years and 30-34 years



Fenland – 211% (2641 to 8209)

Peterborough – 148%(15,268 to 37,892)


Health needs of migrant populations

13


Health needsTB 73% of cases were born abroad Majority born in South Asian (57%), sub-Saharan Africa

(27%) 77% of non-UK born cases in 2010 were diagnosed two or

more years after arrival in the UK Higher proportion of non-UK born cases present with extra-

pulmonary cases (54% to 31%) Highest rates of TB in the UK are in ethnic minority groups


Health needsHIV 65% new HIV diagnoses between 2001 and 2010 were

among those born abroad Majority from Africa (87%) 80% acquired their infection heterosexually 22-30% of MSM diagnosed 2001-2010 were born abroad

(majority Europe excluding UK) Heterosexuals who were born outside of the UK were more

likely to be diagnosed late than those born in the UK (63% vs. 50%)

Project aims

16

- Background information on migration trends in and characteristics within the region

1. To map the migrant population within the EoE and how this has changed over time

2. To describe the characteristics of the migrant population within the EoE

Project aims

17

3. To estimate the burden of infection (HIV, TB, STI(?)) within the migration population within the

East of England

4. To undertake a comparison of the burden of infectious diseases in the migrant population versus

UK born residents

- Provide a resource on burden of infectious diseases in migrant populations in the East of England

What is the rate of TB in migrants in the East of England?

18 Migrant health - TB

Average rate of TB in Migrants = 53.3 per 100,000

Average rate of TB in Anglia and Essex: 6.7 per 100,000

Average rate of TB in South Midlands and Hertfordshire:13.0 per 100,000

England rate of TB :14.1 per 100,000

Age and gender of migrants with TB in the East of England in 2013


0-19

20-39

40-59

60-79

80-99

120 70 20 30 80

Female Male

Count

Age

gro

up

Country of birth of migrants with TB in the East of England


2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 20130%

10%

20%

30%

40%

50%

60%

Pakistan, Bangladesh and India

Year

Per

cent

age

of n

on-U

K b

orn

peop

le

(%)

2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 20130%

1%

2%

3%

4%

5%

6%

7%

8%

9%

North-Eastern Eu-ropean countries

Year

Per

cent

age

of n

on-U

K b

orn

peop

le

(%)

Estonia, Latvia and Lithuania joined the

EU in 2004

HIV and STIs

21

0

50

100

150

200

250

2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Num

ber o

f new

HIV

dia

gnos

es

UK

Africa

All other countries

New HIV diagnoses by world region of birth

HIV and STIs

22

Gonorrhoea diagnoses by world region of birth

0

20

40

60

80

100

120

140

2010 2011 2012 2013 2014

Europe (excluding UK)CaribbeanSub-saharan Africaother world regionUnknown


Thank you….

pcc eastern european economic migrants jsna and ccc migrant populations jsna stakeholder scoping...

Health & Medicine