Making Migrants Illegal Means Putting their Health at RiskPRECARIOUS LIVING CONDITIONS AND BARRIERS TO MEDICAL TREATMENT MAKE THE LIVES OF IRREGULAR IMMIGRANTS UNSAFE. THEY DON'T POSE A THREAT TO THE HEALTH OF ITALIANS. RATHER IT'S ITALY'S NEW APPROACH TO IMMIGRATION THAT IS MAKING THEM UNHEALTHY
A quick Internet search for the term "sicurezza e immigrati irregolari" [security and irregular immigrants] yields 875,000 results (retrieved on December 20, 2018), showing the frequency with which the terms are combined in the public mind. In social science, it is a well-known that in people’s minds immigration has been progressively linked to rising crime and economic insecurity, as well as to a perceived existential threat to Italy’s cultural identity.
In a recent research study carried out in collaboration with Tommaso Frattini and Francesco Fasani, I have tried to reverse the perspective by looking instead at how the condition of irregularity affects the security, health and safety of immigrants themselves. The research makes use of data on nearly 8,000 irregular immigrants who the medical clinic of NAGA (a volunteer association helping migrants in Milan) between 2014 and 2017 (www.naga.it). We have built one largest databases on irregular immigration worldwide, which since 2000 has enabled us to track the socio-demographic characteristics of a population that, by its nature, moves under the radar of official statistics.
With respect to ther early 2000s, some new elements have emerged. First of all, there was a clear inversion of the trend in the number of medical visits. It had been in constant reduction since 2007 and reached a minimum 2015, before starting to rise in the following two-year period (2,155 visits in 2017). This increase is accompanied by a sharp reduction in migratory seniority: in 2015, those visited were in 39% of cases people who had been in Italy for less than two years; in 2017, the percentage had risen to 52%. This shows an increase in undocumented migrants living in Italy, largely caused by the closure of legal ways to emerge out of the condition of illegal migrant.
Secondly, we are witnessing a worsening of an already difficult housing situation. Since the 2008 crisis, there has been a steady increase in homeless patients, who were less than 10% of the sample in 2009 and had risen to almost 25% by 2016 (with a slight turnaround in 2017, when the share decreased to 22.4%). The problem is particularly acute for male migrants (about 31% were homeless in 2017). The percentage of people who rent has consequently fallen, although it still represents over three quarters of the sample. The percentage of individuals living with their employer (maids, butlers, care workers, nurses etc.), which had fallen from 2009 to 2013, in now again on the increase, rising from 1.1% in 2014 to 2.1% in 2017 (4.2% for women). This suggests a recovery in employment.
In fact, the third novelty is an increase in employment starting in 2014, after the dramatic collapse of the early 2010s following the 2008 crisis. In 2017, over a third of the sample was employed. This meant that about 37% of individuals who have been in Italy for less than a year have yet to find a job, while 20% do have a job. The latter percentage reaches 50% for migrants after three years of stay.
Finally, for the first time we were able to analyze clinical information relating to the over 2,000 immigrant patients visited in 2017. The results contradict many clichés on the subject: the sample does not show a significantly different health profile of immigrants with respect to the general Italian population. Thus women visit NAGA’s medical center mainly for problems related to genital infections, contraception and pregnancy (24.8%), while the most common pathologies among males are those related to the respiratory system (14.14%) and the musculoskeletal system (13.73%). The extreme rarity of infectious diseases (0.014% in the NAGA sample) and in particular of tuberculosis (only three cases) also emerges. In fact, illegal immigration is rather detrimental to the health of immigrants themselves. Not only the illegal status creates barriers to access medical treatment, evidenced by the fact that at least 10% of patients need hospitalization to complete the diagnostic and therapeutic process, something which would be difficult to do were it not for NAGA’s. Furthermore, irregularity is associated with socio-economic conditions that are harmful to health. For example, the fragility of homeless people emerges from the data: they suffer from a higher frequency of traumatic injuries, respiratory pathologies and skin problems. Also the kind of employment is associated with a varying frequency of pathologies: diseases of the respiratory system are much more common among street sellers (22.2%) than among who are in either temporary (11.1%) or permanent (5.5%) employment. Similar differences are observed for traumatisms.
In conclusion, the study shows a section of people who have health problems that are not dissimilar from those of the Italian population, but whose precarious living and working conditions make it hard for them to be treated by the National Health Service, thus leading to a major failure in the protection of the fundamental right to health. In this sense, the health, safety and security of migrants should be put at the top of the political agenda.
by Carlo Devillanova
Translated by Alex Foti