Migrant health – data and resources Mia Moilanen – Principal Knowledge Transfer Facilitator Thanks to East Midlands LKIS, PHE and Travel and Migrant Health Section (TMHS), NIS, PHE

Data on migrant health Difficulty in gathering information on health and defined migrant populations But some proxy measures available e.g. English as a second language, country of birth outside UK GP registrations can indicate less effective use of healthcare e.g. GP registrations versus National Insurance Number (NINO) applications Census in 2011, migrants status v long term limiting illness Births to mothers who were born outside of the UK HIV diagnosis to migrant populations, country of birth Tuberculosis cases in people born outside of the UK Migrant health - data and resources

Long term international migration in the UK from 1991-2015 Round 600 thousand a year Migrant health - data and resources

The percentage of the population living in each LA area born abroad, by world regions of birth Clustered in certain areas Migrant health - data and resources

Migrant statistics: South West Per 1000 resident population - ONS Population Turnover: Figures presented show the volume of long-term international or internal movement in the UK, and are calculated as the sum of in and out-migration (in the year to June) per 1,000 resident population Short-Term Migration Inflows: Figures presented show the estimate of short-term international migrants who stayed in England and Wales (in the year to June) per 1,000 resident population Non-UK Born Population: Figures presented show the estimated non-UK born population living in the UK per 1,000 (APS) resident population by calendar year Non-British Population: Figures presented show the estimated non-British population living in the UK per 1,000 (APS) resident population by calendar year Migrant GP Registrations: Figures presented show the number of new migrant GP registrations in England, Wales and Northern Ireland per 1,000 resident population by mid-year www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/migrationwithintheuk/datasets/localareamigrationindicatorsunitedkingdom Migrant health - data and resources

Non British nationals and GP registrations Per 1000 resident population - ONS www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/migrationwithintheuk/datasets/localareamigrationindicatorsunitedkingdom Migrant health - data and resources

Estimates of non-British nationals Per 1000 resident population - ONS Put into context www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/migrationwithintheuk/datasets/localareamigrationindicatorsunitedkingdom Migrant health - data and resources

Migrant health Many international migrants are relatively healthy Unlikely to impose a disproportionate burden on health services Studies indicate that migrants, in general, make less use of the health service than the UK population and for several types of migration there is significantly lower use of NHS services (George A et al 2011) Particular determinants of health associated with working migrants: poorer living conditions higher risk of injury due to predominately working with heavy machinery or manual labour in agriculture. (Cooper et al, 2014) George, A et al (2011) Impact of migration on the consumption of education and children’s services and the consumption of health services, social care and social services, London: National Institute of Economic and Social Research. Cooper J, Campbell S, Patel D, Simmons J. The reasons for migration and labour market characteristics of UK residents born abroad, Home Office Sept 2014 Migrant health - data and resources

Self reported health – short term migrants Census 2011, South West South West, all ages, all persons QS801EWYear of arrival in the UK2.230/01/2013-QS802EWAge of arrival in the UK2.230/01/2013-QS803EWlength of residence in the UK Reflect the age of the population Since they rely on the subjective views of respondents, self-reported health status may reflect cultural biases or other influences www.nomisweb.co.uk/census/2011/uk_migration Migrant health - data and resources

Maternal deaths by country of birth “Women born outside the UK were significantly more likely to die than those born in the UK (RR 1.77, 95% CI 1.39-2.24). Women born in Nigeria had the highest maternal mortality rate (34.2 per 100,000 maternities, 95% CI 16.4- 62.9). Three of the ten women from Nigeria who died, died from cardiac disease (30%). Most (70%) were long-term migrants (>5 years of residence). Nine of the ten women received antenatal care, but only one of them received the NICE recommended level of care (booking at less than 10 weeks and no antenatal appointments missed).” Saving Lives, Improving Mothers’ Care Lessons learned to inform future maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2009-2012, Page 19 https://www.npeu.ox.ac.uk/downloads/files/mbrrace-uk/reports/Saving%20Lives%20Improving%20Mothers%20Care%20report%202014%20Full.pdf Source: CMACE, MBRRACE-UK www.npeu.ox.ac.uk/downloads/files/mbrrace-uk/reports/Saving%20Lives%20Improving%20Mothers%20Care%20report%202014%20Full.pdf Infant mortality and ethnicity

Major limitations on infectious disease in migrants Goes some way to explains why not about to give detailed description of migrant population and health in your local area Migrant health - data and resources

Estimates of people living with HIV https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/477702/HIV_in_the_UK_2015_report.pdf From: HIV in the UK – Situation Report 2015 Incidence, prevalence and prevention : The second of two complementary reports about HIV in the UK in 2015. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/477702/HIV_in_the_UK_2015_report.pdf Migrant health - data and resources

Percentage of newly diagnosed persons with HIV born abroad 2002-2004 Migrant health - data and resources

TB case notifications and rates by place of birth England 2000-2014 Migrant health - data and resources

Migrants continue to be at risk of disease after arrival Migrant health - data and resources

Why do so many cases of disease occur in some non-UK born? Migrant health - data and resources

Key sources

Key sources Office for National Statistics Home Office WHO Global Health Atlas Enhanced disease surveillance Medical literature Migrant health - data and resources

Availability of data by source Office for National Statistics (ONS): Local area Migration Indicators Suite Census 2011 Country of birth and Country of birth by sex by age Proficiency in English, local authorities in England and Wales. Non-UK born short-term residents by country of Birth 2011 extracted from the NOMIS website Office for National Statistics (ONS) Births to non-UK born mothers (2010- 2014) Parent’s Country of Birth England and Wales Home Office: Immigration Statistics Cooper J, Campbell S, Patel D, Simmons J. The reasons for migration and labour market characteristics of UK residents born abroad, Home Office Sept 2014 Migrant health - data and resources

Availability of data by source Department for Work and Pensions (DWP) National statistics: National Insurance number allocations to adult overseas nationals entering the UK Department of Education. Schools, pupils and their characteristics: Local authority and regional tables HSCIC (Now NHS Digital). The Female Genital Mutilation Enhanced Dataset 'Female Genital Mutilation (FGM) – October to December 2015' - Accessed May 2016 URL: http://www.hscic.gov.uk/fgm Chappel, D et al. Including migrant populations in Joint Strategic Needs Assessment: A Guide. 2011 Jayaweera H. Health of Migrants in the UK: what do we know? Migration observatory briefing. 2014. Oxford: COMPAS Migrant health - data and resources

HIV and TB reports Migrant health - data and resources

Thank you. mia.moilanen@phe.gov.uk

Appendix – PHE knowledge and intelligence resources

Where to go? Available from: www.gov.uk/guidance/phe-data-and-analysis-tools Migrant health - data and resources

Fingertips Public Health Profiles Use search function for specific indicators Available from: fingertips.phe.org.uk Migrant health - data and resources

Fingertips profiles Sexual and Reproductive Health Health Protection Learning Disability Cancer Services Cardiovascular Disease Diabetes Liver Disease Alcohol Profiles Tobacco Control NHS Health Checks National child measurement programme local authority indicators Older People’s Health and Wellbeing End of Life Care Adult Social Care …and others Public Health Outcomes Framework (PHOF) Longer Lives National GP profiles Children and young people’s health profiles Mental Health Dementia and Neurology profiles Segment Tool AMR (Antimicrobial resistance) local indicators Available from: fingertips.phe.org.uk Migrant health - data and resources

Census 2011 www.nomisweb.co.uk/census/2011/uk_migration Migrant health - data and resources

Migrant health - data and resources

Migrant health - data and resources

Migrant health - data and resources

Migrant health - data and resources