The Tradeoff of Temporariness: Economic and Social Impacts of H-2A Status on Mexican Migrant Men

As the H-2A visa program expands to become a core component of contemporary Mexican migration to the United States, questions emerge about the tradeoffs migrants face between temporary and undocumented statuses. This article employs propensity score matching of participants in the Mexican Migration Project—an extensive binational survey of Mexican migrants and their families—to compare economic and social outcomes of H-2A visa recipients vis-à-vis undocumented migrants. Findings indicate that although H-2A visas offer benefits like a lower cost of living while abroad, they do not produce a discernible effect on wages relative to wages earned by undocumented migrants. While H-2A migrants are more likely to work in the formal economy, they are also less likely to build social capital or language proficiency in the United States than undocumented migrants, indicating a degree of social isolation that can be exploited by employers. This comparison contributes to a growing literature on the proliferation of temporary migratory statuses and the marginality experienced by migrants within these statuses.

Paperittomien maahanmuuttajien muuttoliike Suomeen, Suomessa ja Suomesta

Irregular migration to, in and from Finland is the focus of this study. The empirical material consists of a survey among undocumented migrants (n=100) in Finland in 2019 and earlier surveys among all Finnish municipalities about undocumented migrants. In 2019, about 4,000–5,000 undocumented migrants were in Finland. Most current undocumented migrants came to Finland in 2015 legally as asylum seekers (who later failed to obtain asylum or other residence permit), fewer entered Finland without legal right to do so and some remained in Finland after their resident permit on other than asylum seeking grounds expired. War, insecurity, and economic challenges in the country of origin influenced people’s decision to leave. Perceived safety and economic opportunities in Finland influenced their choice of it as the destination country. For some, Finland was rather a choice influenced by rumours and misinformation, also in the social media. Many undocumented migrants live in Helsinki and the capital region. This area attracts undocumented migrants from other parts of Finland due to better everyday opportunities. Very few if any lives in rural areas and small towns. Of responded undocumented migrants, 2–11 percent considered outmigration from Finland and 22 percent could perhaps return to their country of origin. Many will remain in Finland for years if not permanently despite legal, economic and social hardships.

Right to health for undocumented migrants in Mexico: from theory to practice in the context of the health system reform

Purpose Undocumented Central American migrants in Mexico are legally eligible for free access to the public health system through the new Instituto para la Salud y el Bienestar (INSABI) health program, but many experience structural vulnerability and stigmatization that prevent them from accessing health-care facilities. The purpose of this study is to investigate the discrepancy between the migrants’ Human Right to health, proclaimed by the Mexican Government and supposedly guaranteed by law, and the reality of the migration process. Design/methodology/approach This study reviewed relevant literature on the health risk factors, social and structural vulnerability, stigmatization and structural violence experienced by undocumented migrants as obstacles to their Human Right to health. It also reviews the current legal framework in Mexico and internationally. Findings This review demonstrates the lack of implementation of the current legal framework in Mexico and identifies a set of complex obstacles to effective access to health for undocumented migrants. Although the migration process itself was not found to be directly associated with major health issues, the social conditions of the migratory journey expose the migrants to serious threats, especially sexually transmitted diseases and tuberculosis. Practical implications This paper makes 10 practical recommendations for interventions collectively involving the state, international and civil organizations and the migrant community. These are especially relevant since the implementation of the INSABI health program in 2020. Social implications The paper lays the basis for influencing Mexican health system stakeholders to improve the health of migrants. Originality/value The sociological barriers to health access for undocumented populations in Mexico have not been fully explored. In addition, this paper provides a unique reflection on opportunities and challenges linked to the 2020 health system reform.

Including undocumented migrants in universal health coverage: a maternal health case study from the Thailand-Myanmar border

Background Many countries aspiring to achieve universal health coverage struggle with how to ensure health coverage for undocumented migrants. Using a case study of maternal health care in a Thailand-Myanmar border region this article explores coverage for migrants, service provision challenges and the contribution of a voluntary health insurance program. Methods In 2018 we interviewed 18 key informants who provided, oversaw or contributed to maternal healthcare services for migrant women in the border region of Tak province, Thailand. Results In this region, we found that public and non-profit providers helped increase healthcare coverage beyond undocumented migrants’ official entitlements. Interview participants explained that Free and low-cost antenatal care (ANC) is provided to undocumented migrants through migrant specific clinics, outreach programs and health posts. Hospitals offer emergency birth care, although uninsured migrant patients are subsequently billed for the services. Care providers identified sustainability, institutional debt from unpaid obstetric hospital bills, cross border logistical difficulties and the late arrival of patients requiring emergency lifesaving interventions as challenges when providing care to undocumented migrants. An insurance fund was developed to provide coverage for costly emergency interventions at Thai government hospitals. The insurance fund, along with existing free and low-cost services, helped increase population coverage, range of services and financial protection for undocumented migrants. Conclusions This case study offers considerations for extending health coverage to undocumented populations. Non-profit insurance funds can help to improve healthcare entitlements, provide financial protection and reduce service providers’ debt. However, there are limits to programs that offer voluntary coverage for undocumented migrants. High costs associated with emergency interventions along with gaps in insurance coverage challenge the sustainability for NGO, non-profit and government health providers and may be financially disastrous for patients. Finally, in international border regions with high mobility, it may be valuable to implement and strengthen cross border referrals and health insurance for migrants.

Beyond biopolitics: the importance of the later work of Foucault to understand care practices of healthcare workers caring for undocumented migrants

Background Undocumented migrants experience multiple institutional and legal barriers when trying to access healthcare services. Due to such limitations, healthcare workers often experience ethical dilemmas when caring for undocumented migrants. This article aims to understand how individual healthcare workers who regularly take care of undocumented migrants deal with these dilemmas in practice. So far, the role of healthcare workers in this context has mainly been theorized through the lens of biopolitics, conceiving of healthcare workers as merely obedient instruments of humanitarian government or gatekeeping. Methods Based on semi-structured, in-depth interviews and ethnographic observations with healthcare workers in Belgium, we explore how they ascribe meaning, reflect upon and give shape to care practices in relation to undocumented migrants. We use Foucault’s later work on care of the self to interpret the accounts given by the healthcare workers. Results Healthcare workers in clinical roles exercise a certain degree of freedom in relation to the existing limitations to healthcare access of undocumented migrants. They developed techniques such as purposefully being inattentive to the undocumented status of the migrants. They also try to master their affective responses and transform their bodily attitude towards undocumented patients. They perform practical mental exercises to remind themselves of their role or position in the wider healthcare system and about their commitment to treat all patients equally. These techniques and exercises are inspired by colleagues who function as role models, inspiring them to relate in an ethical way to limitations in healthcare access. The developed care practices sometimes reproduce, sometimes transform the legal and institutional limitations to care for undocumented migrants. Conclusions The findings nuance the biopolitical analysis regarding the role of healthcare workers in healthcare delivery to undocumented migrants that has been dominant so far. Theoretically this article provides a reconceptualization of healthcare ethics as care of the self, an ethical practice that is somewhat independent of the traditional professional ethics. Trial Registration Medical ethics committee UZ Jette, Brussels, Belgium – Registration date: 18/05/2016 – Registration number: B.U.N. 143201628279.

Inclusion of Migrants with Irregular Status

<div>Sarah Spencer explains why cities in Europe, like their North American counterparts, are increasingly exploring ways to enable irregular (‘undocumented’) migrants to have access to essential services, and tells us some of the creative ways that they have found to do so. She draws on the work of the City Initiative on Migrants with Irregular Status in Europe, a two-year learning-exchange project involving 11 European cities, chaired by the City of Utrecht, which she facilitates with her Oxford colleague, Nicola Delvino. </div>

Inclusion of Migrants with Irregular Status

<div>Sarah Spencer explains why cities in Europe, like their North American counterparts, are increasingly exploring ways to enable irregular (‘undocumented’) migrants to have access to essential services, and tells us some of the creative ways that they have found to do so. She draws on the work of the City Initiative on Migrants with Irregular Status in Europe, a two-year learning-exchange project involving 11 European cities, chaired by the City of Utrecht, which she facilitates with her Oxford colleague, Nicola Delvino. </div>