Beyond the Headlines: Real Migration, Real Diversity, Real Health

Beyond the headlines, a global health perspective on real migration, everyday diversity, and the impact of structural racism on health.

This year, I have been able to experience and share the daily life of a Romanian teenager through a social mentoring programme. Week after week, over many months, I shared his difficulties, achievements and setbacks. During the same year, I also accompanied a second-year Peruvian medical resident through the exhausting process of renewing her residence permit, with all its associated frustrations. Supporting people both socially and personally has given me a perspective that helps me reflect and apply these learnings in my daily practice as a family physician and as a researcher in the field of migrant health. In both cases, despite their very different socioeconomic backgrounds, situations of structural racism appeared far too often.

A diverse society that does not always recognise itself as such

With these realities so close at hand, I am struck by the recurring headlines that describe our “new” society as multiracial and ageing. I am struck because it stopped being new a long time ago: it is a society diverse in its identity. More than 36% of the population living in Spain under the age of 20 has at least one parent born abroad.

Despite this, media narratives do not always reflect this everyday reality. Migrants feature prominently in headlines, but real coexistence rarely does, nor do second generations (generally identifying with the Spanish society in which they have grown up), or the fact that opportunities for social mobility remain strongly shaped by families’ educational and socioeconomic conditions.

Real migration, beyond the headlines

Every year, on 18 December, we mark International Migrants Day. The International Organization for Migration (IOM) defines migration as the movement of people from their usual place of residence to a new one, either across an international border or within the same country.

Contrary to what major headlines often suggest, most migration takes place within the same country or to neighbouring countries. The majority of movements are orderly and driven by family, work or study reasons. They do not generate major problems nor fit the crisis narratives that often dominate media discourse, although none of them is free from challenges.

Forced migration, or when migrating is not a choice

Difficulties arise especially in economic or forced migration, which often occurs under extreme conditions and, in many cases, outside the legal frameworks that facilitate privileged forms of migration while complicating or preventing less advantaged ones.

This includes people who move due to economic hardship, climate crises, armed conflicts or deprivation of freedoms. Many had no prior intention of migrating, but circumstances force them to do so.

Over the past year, international responses to forced migration have hardened, both in the United States and across several European countries, as well as at the European Union level.

Migrant health: barriers and opportunities

At ISGlobal’s multidisciplinary and multinational Migrant Health group, our main goal is to improve both access to and the quality of healthcare for migrant populations.

Research into access and the management of specific needs has identified barriers and facilitators for the detection of female genital mutilation. Community health work has also been carried out through participatory processes aimed at promoting mental health among migrant women.

Innovation for safer and more effective care

In clinical practice, we are developing an innovative multiple screening tool to detect migrants who are inadequately immunised against vaccine-preventable diseases. At the same time, we continue to implement ISMiHealth, a multiple disease screening tool that supports primary care professionals in addressing migrant health.

Working conditions and health: an urgent challenge

Another line of research focuses on working conditions and their impact on health among certain migrant groups, such as the heat stress experienced by many agricultural workers. Studying these realities allows us to design interventions to mitigate their effects and improve wellbeing.

Towards a truly equitable health system

Improving migrants’ access to the health system and providing care better suited to their needs, through jointly generated and shared knowledge, is both an achievable and necessary goal.

Only in this way can we build a health system that is equitable and aligned with the diverse society in which we live: a society that is no longer “new”, but simply real.