The health of Britain's Polish migrants: a suitable case for history taking and examination.

In 2004 eight new countries (the A8) were admitted into the European Union (EU), allowing their citizens full rights of settlement and employment in the UK. Initial estimates by the Labour government were that between 5000 and 13 000 people would migrate to the UK, which proved a gross underestimate. Although exact population data is difficult to obtain precisely because of free movement, it is estimated that at least 2 million have actually done so, around half this number from Poland alone. 1 This migration has had a significant impact on both the UK and the migrants themselves, including their health. Little has been published about health issues affecting the Polish community, which begs the question: what does the piecemeal evidence so far suggest? In short, it is cause for concern. Polish organisations are reporting high levels of suicide, depression, and poverty amongst migrant workers. 2 Most worrying are unreleased figures from the Polish embassy indicating that a fifth of the 250 Poles who died in Britain in 2007 took their own lives. 2 The emerging data has prompted MP Daniel Kawczynski, who is of Polish descent, to call upon the Polish government to improve support services for this population. 2 The causes of these health outcomes are necessarily multifactorial and inter-linked, although key determinants deserve particular consideration, mainly those relevant to psychological health. Bashir Qureshi has noted, anecdotally, that Eastern Europeans appear to have high rates of depression and somatisation disorder. 3 A study from Sweden comparing rates of attempted suicide in immigrants from selected countries showed the risks in Polish men and women to be 42% and 95% higher respectively than in indigenous Swedes. 4 A likely contributory factor in the Polish community is heavy alcohol intake, 5 which may be both a cause and consequence of depression. Polish migrants also fare badly where smoking, the major preventable cause of illness, is concerned. A survey of Ireland's Polish population indicated that 61% of men and 47% of women smoke, compared with a 35% prevalence in 'home' Poles and 31% of indigenous Irish; 6 the picture in the UK is likely to be similar. Given the well-known association between deprivation and ill health, 7 a significant factor with a negative impact on the health of migrants is relative deprivation. Poles are over-represented in occupations such as catering and construction, where poorly paid, hard physical work is the norm. 2 …