Children and young people at the intersection of chronic illness and migration: a scoping review

Background

Chronic illnesses (CIs) are increasingly prevalent among children/young people (CYP) globally. For migrant CYP with CIs, achieving a stable life in a new country can be particularly challenging due to additional barriers such as cultural and language differences, unsafe living conditions, and discrimination. While migration can sometimes improve healthcare access by introducing new models of care and ways of understanding health, these advantages are often outweighed by obstacles that hinder access to essential services. This review aimed to map the global evidence on post-migration experiences and outcomes of CYP with CIs and to identify priorities for research, policy, and practice to improve their care.

Methods

A scoping review was conducted following JBI guidelines. We searched seven online databases, including MEDLINE, Embase, PsycINFO, Cochrane Library, CINAHL, Social Science Collection, and Web of Science, up to February 2024. Data were synthesised using a socio-ecological model, and four young migrants living with sickle cell disease in the UK contributed to the review through a Patient and Public Involvement Advisory Group.

Results

Of the 58 included papers, most focused on migration to high-income countries, particularly the USA, and used institutional records or case studies. Few studies provided detailed information about migration status or reason for migration, often using proxies like parental country of birth or language spoken. The socio-ecological model revealed disparities in health status, treatment access, and health outcomes for migrant CYP with CIs. Key challenges were language, communication, costs, bureaucracy, family dynamics, coordination issues, resource constraints, and socio-political influences. Significant gaps included a lack of intersectional analyses (e.g. accounting for ‘race’ and citizenship) and limited qualitative research capturing the lived experiences of migrant CYP with CIs.

Conclusions

Migrant CYP with CIs face significant health disparities shaped by individual, social, and systemic factors. Addressing these challenges requires intersectional and qualitative research, alongside collaboration with policymakers, practitioners, and communities, to inform more equitable healthcare policies and practices.