1. Future Trends in Migration and Health in Canada Seminar on Migration and Health Guatemala City, Oct. 19 & 20, 2004

2. 2 Migration health trends in Canada are influenced by three main events: 1.Changes in the nature of immigration to Canada 2.Changes in the speed, scope and availability of international travel 3.New infectious diseases emerge and old ones re-emerge

3. 3 Canadian Immigrant Source Regions Past 40 Years (MacDonald BS Transatlantic Economic Issues and their Security Implications Atlantic Council Members Paper 03/02)

4. 4 Top 10 Source Countries: China India Philippines Pakistan U.S. Iran Romania U.K. Sri Lanka Colombia

5. 5 What are the health implications of this change in source countries? Over the long term – changes in chronic disease epidemiology Effects on the health care system Current “medical inadmissibility” provisions do not guarantee a healthy incoming population

6. 6 Trend #1 Increasing awareness of the need to focus more on post-arrival health issues. “Immigrant Health and Health Care Utilization in Canada” – HC and CIC

7. 7 Trend #2 Recognition that population mobility is the issue, not just “immigrant health”

8. 8 The term “migrants” can include... Immigrants Refugees Asylum seekers VFR travellers Tourists Students Temporary workers Smuggled and trafficked persons Business travellers Returning Canadians

9. 9 Trend #3 Realization that focussing our efforts at excluding ill persons at the border has diminished utility in the 21 st century. Health Canada is currently amending the Quarantine Act

10. 10 Trend #4 Increasing recognition of the need to involve all health stakeholders Advisory committee for immigrant health study Advisory committee for Interim Federal Health Program

11. 11 In 2002, the Canadian Government established…

12. 12

13. 13 Migration Health Task Force Joint HC/CIC initiative 2 year timeframe Mandate: To examine the larger migration health issues and make recommendations to both depts.

14. 14 Moving a bit beyond my mandate…

15. 15 Important International Trends Increasing awareness that health issues must be taken into consideration whenever international migration is being examined. Example: The Global Commission on International Migration And the RCM too !

16. 16 International Trends Continued… Increasing recognition of the connection between health, security, trade and globalization.

17. 17 “ While globalization has been extensively studied and debated since the 1970s in a number of fields…it has only begun to be explored by health researchers and policy makers in the mid-1990s.” Kelly Lee “Globalisation and Health Policy” 2000

18. 18 Some recent articles: Globalization, Communicable Disease and Equity Globalisation and the Challenges to Health Systems Globalization and Health at the United States-Mexico Border (AJPH, Dec. 2003) Globalisation and Public Health The Global Threat of New and Reemerging Infectious Diseases: Reconciling U.S. National Security and Public Health Policy

19. 19 A Closing Thought…

20. 20 “It really boils down to this: that all life is interrelated. We are all caught in an inescapable network of mutuality… Whatever affects one directly, affects all directly.” Martin Luther King, Jr. 1968

21. Muchas gracias. Thank you for your kind attention. Linda.Williams@cic.gc.ca