MIGRATION AT THE
INTERSECTION OF IDENTITIES
Sana Loue, J.D., Ph.D., M.P.H., M.S.S.A.
Case Western Reserve University
Annual Research Meeting
June 29, 2009
GLOBAL MIGRATION STATISTICS
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200 million people now living outside of their homeland; represents
3% of global population and 1 out of every 40 individuals
In >70 countries, >10% of population comprised of immigrants, e.g.,
Greece, Ireland, once traditionally sending countries
In >50 countries, immigrants comprise >=15% of population
In U.S., approx. 11% of population foreign-born
Proportion of migrants worldwide by sex: 49% women
2000, compared with 46% in 1960
Number of refugees worldwide at highest on record
Illegal/irregular immigration growing, but downturn due to economic
climate
Migration related to sex and economics:
– Polish male construction workers earned over 3x as much in Germany as in
Poland
– Indonesian laborers in Malaysia earned almost 8x as much in Malaysia as
Indonesia
– Mass migration often related to unstable economics, e.g. Colombia and
deterioration of sustainable resources, e.g. Sahel region of Africa
A FRAMEWORK FOR MIGRATION
• Three phases of migration process:
– Pre-migration
– Peri-migration
– Post-migration
• Vulnerabilities from one phase carry into
next; possibly cumulative effect
PRE-MIGRATION
• Socioeconomic status
– Together with sex, determines who in family receives what
education
– Together with sex, determines who migrates and for what
purpose
– Out-migration of males, e.g. for economic opportunities, may
result in delayed marriage or no marriage for females
– Level of income may determine mechanism of migration and
extent to which resources will be allocated to migration
– Availability of assets, together with sex and other factors,
determines pre-migration access to health care, form of health
care, and health status
PRE-MIGRATION (2)
• Sex may determine educational possibilities
– Education may determine employment possibilities
– Employment relates to socioeconomic status
• Sex and gender role related to migration:
– May relate to decisionmaking process in family:
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who holds power to decide whether to migrate
what resources will be allocated to migration
what remittances the remaining family can expect to receive
whether migration is temporary or permanent
– In past, women often migrated to join/establish families or after
abandonment by family; tend to migrate permanently
– Men migrated primarily for economic reasons; more likely to be
temporary migrants
INTERSECTING SES, SEX, AND
ETHNICITY: IRISH MIGRATION, 1840s
• “Push” conditions similar to other areas of Europe:
poverty, landlessness, social and economic dislocations
during transition from agrarian feudal society to
industrial, capitalist society
• Conditions exacerbated by famine
• Irish system of single inheritance and single dowry; land
scarcity increased practice of arranged marriage and
dowry
• Few realistic marriage prospects for women
• Only realistic options for women were emigration and
entry into religious order
• >50% Irish migrants to US were women
PERI-MIGRATION
• Issues of vulnerability
– Heightened differing health risks associated with sex and SES
• Women: if trafficked, often for sex work
• Men: trafficked for construction, agriculture, factory work
• Nature of smuggling may vary with SES: business deal vs. less
benign smuggling
• Mechanism of immigration
– Mechanism of payment: through existing assets vs. working off
debt
• Smuggling across single border from $500; complex journeys from
$70K; as fees increase, migrants more likely to be sold into slavery
– Mechanism of transport: e.g. corporate executive vs.
unemployed
– Channel of migration: legal vs. illegal entry
• Heightened health risks related to illegal entry
POST-MIGRATION
• Employment prospects related to sex, ethnicity and preexisting factors (SES, education)
– Discrimination related to race/ethnicity
– Health vulnerabilities often determined by nature of employment,
e.g. pesticide exposure vs. engineer vs. work as “domestic”
– Cuban female immigrants: often worked in garment industry on
transitory basis to help husband establish own business;
Mexican women worked in garment industry due to financial
need (abandonment by husband, husband’s inadequate
earnings)
– Fifth World Survey on the Role of Women in Development
(2005) found:
• Migration may benefit women through increased economic
empowerment BUT gendered division of labor perpetuated after
migration
• Women remaining in country of origin following partner’s migration
often burdened by increased tasks
POST-MIGRATION (2)
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Nature of employment may affect both ability to legalize and ability
to obtain health care (SES, employment-based insurance)
• Cumulative health effects may positively or negatively affect ability
to obtain legal status
– Middle class, upper SES individuals more likely to have had
access to appropriate care, may be less likely to have
disqualifying medical conditions; more likely to afford care
needed for existing conditions
– Trafficked individuals may or may not obtain legal status
• Sex and SES combine post-migration to affect relationships and
related health issues
– Battered immigrant women: issues of financial dependency
– Remittances to home country dependent on employment/income
in new country; relevant to health care for family members
remaining in country of origin