Human health is affected by social, economic and environmental factors as well as biological factors. These factors are called determinants of health. Age-gender and structural factors, individual lifestyle factors, social and communal networks, agriculture and food production, education, working area, living and working conditions, unemployment, water and sanitation, health services, housing, general socio-economic, cultural and environmental conditions could be considered the determinants of health. A situation could directly affect health negatively or positively, or it affected indirectly by the determinants of health.
Fig.1 Determinants of Health
When it comes to the phenomenon of war and migration, we see that determinants of health and many factors that seem unrelated to health significantly affect human health. During the migration process; Human rights violations, psychosocial risks, physical-chemical-biological factors (chemical biological radiological nuclear threats-CBRN weapons), insufficient care, accidents and injuries, gender discrimination and other difficulties increase the picture of death and diseases.
Events experienced before, during and after migration accelerate the deterioration of chronic diseases. In the pre-migration period; The health system of the country where they live has already collapsed. There has been an increase in the frequency of the diseases and the follow-up of the disease has started to be delayed. Non-communicable diseases (NCD) are on the rise with the rapid increase of causes (such as war, epidemic) and traumatic events. Physical injuries, secondary infections, failure or insufficient glycemic control resulting from the effect of sudden migration on those with chronic diseases make acute trauma control difficult. Forced displacement also causes the drugs and medical supplies used, previous prescriptions and medical files to be lost.
Deterioration of living conditions; bring along troubles with shelter, not having regular access to water and food, inability to do physical exercise. Destroying health centres, insufficient health service providers, not having electricity and not enough clean water are the main reasons which can not reach to health services, can be life-threatening especially for patients with chronic kidney failure who need dialysis.
These masses, who have entered the immigration period for saving their lives; face smuggling, human trafficking, length and difficulty of the process and not only NCD but all health is rapidly deteriorating. Extreme cold and heat, extreme effort, exposure to chemicals, can not reach drugs or medical supplies and stress also affect these people.
Photo 2. Child with a broken bread
Difficulties in accessing services and legal situation directly affect health in the country of destination and residence. Poverty and exclusion worsen the situation regarding NCD. These vulnerable groups remain more inactive in new settlements, adopt an unhealthy lifestyle in poor housing and sanitation environment, and are fed unhealthy. Working conditions can also be stressful. They are faced with long working hours, risky jobs requiring physical strength, low wages and bad shift conditions. There is an increase in smoking, alcohol and substance addiction problems. In addition, chronic side effects caused by inability to access NCD control programs implemented in the country and conditions and complications related to sexually transmitted diseases occur.
In our next article, we will focus on the NCD of Syrians Under Temporary Protection in our country. Please do not hesitate to ask questions about the health of immigrants. You can also comment, what is your opinion? Do you see any migrants in need of healthcare? What do you think about your country’s migrant health policies? Your comments will guide us in writing new articles. You can send your comments via firstname.lastname@example.org or our social media accounts. Thank you for reading.
- 1: Mark Exworthy, Policy to tackle the social determinants of health: using conceptual models to understand the policy process, Health Policy and Planning, Volume 23, Issue 5, September 2008, Pages 318–327, https://doi.org/10.1093/heapol/czn022
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