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      Health and legal literacy for migrants: twinned strands woven in the cloth of social justice and the human right to health care

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          Abstract

          Background

          Based on an analysis of published literature, this paper provides an over-view of the challenges associated with delivering on the right to access quality health care for international migrants to industrialized countries, and asks which group of professionals is best equipped to provide services that increase health and legal literacy. Both rights and challenges are approached from a social justice perspective with the aim of identifying opportunities to promote greater health equity. That is, to go beyond the legal dictates enshrined in principles of equality, and target as an ethical imperative a situation where all migrants receive the particular assistance they need to overcome the barriers that inhibit their equitable access to health care. This assistance is especially important for migrant groups that are further disadvantaged by differing cultural constructions of gender. Viewing the topic from this perspective makes evident a gap in both research literature and policy. The review has found that while health literacy is debated and enshrined as a policy objective, and consideration is given to improving legal literacy as a means of challenging social injustice in developing nations, however, no discussion has been identified that considers assisting migrants to gain legal literacy as a step toward achieving not only health literacy and improved health outcomes, but critical participation as members of their adoptive society.

          Conclusion

          Increasing migrant health literacy, amalgamated with legal literacy, aids migrants to better access their human right to appropriate care, which in turn demonstrably assists in increasing social engagement, citizenship and productivity. However what is not evident in the literature, is which bureaucratic or societal group holds responsibility for assisting migrants to develop critical citizenship literacy skills. This paper proposes that a debate is required to determine both who is best placed to provide services that increase health and legal literacy, and how they should be resourced, trained and equipped.

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          Most cited references 59

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          Gender: An Intersectionality Perspective

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            Applying an equity lens to interventions: using PROGRESS ensures consideration of socially stratifying factors to illuminate inequities in health.

            To assess the utility of an acronym, place of residence, race/ethnicity/culture/language, occupation, gender/sex, religion, education, socioeconomic status, and social capital ("PROGRESS"), in identifying factors that stratify health opportunities and outcomes. We explored the value of PROGRESS as an equity lens to assess effects of interventions on health equity.
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              Health disparities and health equity: the issue is justice.

              Eliminating health disparities is a Healthy People goal. Given the diverse and sometimes broad definitions of health disparities commonly used, a subcommittee convened by the Secretary's Advisory Committee for Healthy People 2020 proposed an operational definition for use in developing objectives and targets, determining resource allocation priorities, and assessing progress. Based on that subcommittee's work, we propose that health disparities are systematic, plausibly avoidable health differences adversely affecting socially disadvantaged groups; they may reflect social disadvantage, but causality need not be established. This definition, grounded in ethical and human rights principles, focuses on the subset of health differences reflecting social injustice, distinguishing health disparities from other health differences also warranting concerted attention, and from health differences in general. We explain the definition, its underlying concepts, the challenges it addresses, and the rationale for applying it to United States public health policy.
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                Author and article information

                Contributors
                bilkis.vissandjee@umontreal.ca
                wendy.short@uqconnect.edu.au
                karine.bates@umontreal.ca
                Journal
                BMC Int Health Hum Rights
                BMC Int Health Hum Rights
                BMC International Health and Human Rights
                BioMed Central (London )
                1472-698X
                13 April 2017
                13 April 2017
                2017
                : 17
                Affiliations
                [1 ]GRID grid.14848.31, , Faculty of Nursing, Université de Montréal, ; PO Box 6128 Station Centre-Ville, Montréal, QC H3C 3J7 Canada
                [2 ]GRID grid.14848.31, Université de Montréal, , Faculty of Nursing, Université de Montréal, ; PO Box 6128 Station Centre-Ville, Montréal, QC H3C 3J7 Canada
                [3 ]University of Queensland, Faculty of Humanities and Social Sciences, St. Lucia, Queensland 4072 Australia
                [4 ]GRID grid.14848.31, , Department of Anthropology, Université de Montréal, ; PO Box 6128 Station Centre-Ville, Montréal, QC H3C 3J7 Canada
                Article
                117
                10.1186/s12914-017-0117-3
                5390456
                © The Author(s). 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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