Addressing migration-related inequities in health: an expert narrative review of emerging patterns, myths and realities in a rapidly transforming world

Abstract

Purpose This expert narrative review uses an integrated framework to examine interactions between infectious diseases and non-communicable diseases (NCDs), while challenging prevailing assumptions shaping migrant health narratives and policy. Design/methodology/approach This expert narrative review draws on the author’s professional experience and a targeted literature appraisal. It prioritises conceptual and practice-based insights over exhaustive synthesis, integrating evidence on infectious-NCD interactions, health patterns and myths driving inequities. Policy implications are derived from empirical and theoretical framing. Findings For NCDs, migrants often show higher morbidity, lower health-care utilisation and lower mortality, except for blood and immune disorders, where genetic predisposition may contribute to higher disease burden with comparable mortality. For external causes and infectious diseases, migrants generally experience higher morbidity, lower service use and higher mortality. For maternal and child health, migrants experience higher adverse perinatal outcomes and lower antenatal and postnatal care use, with mixed mortality patterns by contexts. Across domains, there are important variations by country of origin, receiving country and migration pathways, yet narratives often overemphasise behavioural explanations whilst understating structural determinants. Originality/value The “healthy migrant” trajectory is often reduced to lifestyle acculturation. This is incomplete. NCD risk is also shaped by long-term metabolic and inflammatory sequelae of infections and disrupted continuity of care. Completion of infectious disease treatment should not mark clinical disengagement. Health systems that discharge migrant patients after infectious treatment completion, without longitudinal NCD surveillance, fail their patients at a predictable and preventable point in the disease trajectory.