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Helena Legido-Quigley and Martin McKee

There is a growing interest in European pensioners moving to other European Union Member States. Questions include how they adapt to their new country of residence, what are their motivations for migrating, what factors influence international retirement migration, and how can the various forms that this type of mobility takes be conceptualised? Yet there has been little research to inform these questions and, specifically, how pensioners access health care in their new country of residence. This chapter presents the European legal framework within which this group obtains health care. It then presents the findings of a qualitative study that explored the access to health care of British pensioners migrating to Spain. In this way it provides an understanding of the different pathways followed when accessing health care and how these chosen options were negotiated, including the factors that influenced the group’s decisions to choose either the public or private system. The chapter then presents a typology according to the type of care that this group decided to access. Following on from the findings of the study, the chapter concludes with policy recommendations that can help Europeans pensioners moving to another Member State.

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Gemma A. Williams, Anna Odone, Taavi Tillmann, Anastasia Pharris, Dina Oksen, Bernd Rechel, Philipa Mladovsky, Sabrina Bacci, Rebecca Shadwick, Teymur Noori, Andreas Sandgren Erika Duffell, Jonathan E. Suk, David Ingleby and Martin McKee

This chapter explores the burden of infectious diseases in migrant populations in the European Union and the European Economic Area (EU/EEA) by means of a comprehensive literature review and analysis of data from the European Surveillance System (TESSy). The available evidence indicates that migrants in the EU/EEA have a higher burden of some infectious diseases, including HIV, TB and chronic hepatitis B, than the native-born population, but are less affected by others, such as measles and rubella. The extent to which different migrant populations are affected by infectious diseases depends on the disease in question, the country of destination and the region or country of origin. For example, Chagas disease disproportionately affects irregular migrants from Latin America, the majority of migrant HIV cases in the EU/EEA are from sub-Saharan Africa and migrants with TB or chronic hepatitis B are mainly from Asia, Africa and other parts of the European region. However, it should be noted that it is challenging to reach strong conclusions on the burden of infectious diseases in migrants, as few surveillance systems capture reliable and complete data that identify migrants and their specific characteristics. Measures of migrant status that are collected also vary among studies and contexts, adding to the challenge of obtaining a clear picture of infectious diseases in the migrant population in Europe. Strengthening of European surveillance systems must be a priority to enable meaningful comparisons across migrant populations in different Member States and to inform the provision of appropriately targeted health services.