01.07.2010 Education and migration as health determinants
Equality of opportunities. Studies show that young immigrants do not enjoy the same opportunities as their Swiss peers in Switzerland’s educational system. This poorer access to education can ultimately have negative effects on health.
As has been documented in the 2008 National Health Report, the migrant community is in poorer health than the indigenous population. Lower socio-economic status and other factors associated with a migration background can impact unfavourably on health. Education, too, is a health determinant. It influences our health-related behaviour at the health skills and health literacy level, on the one hand. On the other, it influences our health indirectly through specific lifestyles, as well as directly. The focus here is on the social situation of young migrants in Switzerland’s educational system.
As the National Health Report points out, access to education and training has a decisive influence on health. Particular efforts are required for young people who are experiencing educational problems. This problem must be viewed in the light of the fact that staying on longer in school both improves job prospects, promotes health literacy and a health-conscious lifestyle.
Many migrant children are in special classes
Kronig, Haeberlin and Eckhart have published a study on migrant children and school selection. In an analysis of educational statistics for the 1980–1998 period, they demonstrate a highly significant increase in the number of migrant children assigned to special classes, compared with Swiss children. The authors speak of a tendency for migrant children to occupy the lowest stratum of the educational pyramid at primary-school level. According to a report by Christian Imdorf, the same process can be seen at junior-secondary level. Current data from the Swiss Federal Statistical Office confirm this development for the period up to 2005. No data for more recent years are as yet available. Schools with special classes and junior-secondary schools providing a basic curriculum account for the largest proportion of pupils with a non-Swiss native language. This proportion has increased by at least 30% since 1980, while that of junior-secondary schools providing an extended curriculum has been stable for a long period. The proportion of foreign children in special classes has risen from a quarter to over half since 1980. According to the Swiss Federal Statistical Office, close to every tenth migrant child was attending a special class in 2005, compared with every 40th Swiss child. It should be noted that this high proportion of migrants is not due to educational programmes introduced explicitly for foreign children and adolescents. This finding would be of no significance if the children had been referred primarily to a foreign language class for a short spell in order to learn the local language.
Connection between the educational system and health
The National Health Report reveals a trend towards higher levels of educational attainment in Switzerland. This development is referred to as educational expansion. According to the Report, this trend is primarily benefiting those who have grown up in Switzerland. To explain the connection between a selective educational system and the health of pupils with a migration background, an understanding of the basic determinants of health is required. Social status should be included as a co-determining factor. Children and adolescents of foreign origin who grow up in Switzerland do not appear to enjoy the same opportunities in the educational system as Swiss children. The complexity of the situation in this context also needs to be emphasised. The reasons why migrant children occupy the lowest levels of the educational system are found not only in the school system itself but also in processes involving society as a whole.
Access barriers to health promotion and prevention services also often co-determine health-related behaviour in the migration context. Conversely, professionals may have difficulty accessing migrant communities. As education is a relevant health resource, it is also worthwhile focusing attention on the school system, which reaches almost all children and adolescents living in Switzerland.
Importance of the school setting
With the programme education + health Network Switzerland (e + h), the Federal Office of Public Health (FOPH) recognises the importance of the school setting and supports its use in health promotion and prevention and the development of health literacy. In line with policy on integration and the promotion of equality of health opportunities, it is also recommended that the selection mechanisms that put certain population groups at a disproportionate disadvantage should be addressed on a basis of multisectoral cooperation.
Priyani Ferdinando, Public Health Directorate, firstname.lastname@example.org