Health status and access to care among migrant market workers in Kazakhstan

In 2010, Kazakhstan, one of the fastest growing economies, was hosting over three million labor migrants, representing 19.5% of the population. Poor working conditions, limited legal rights, and changing social contexts may expose migrant workers to health risks and hinder their access to health care services. This paper examines self-rated physical and mental health status as well as utilization of health services among migrant market workers in Kazakhstan. The sample includes 422 randomly selected migrant market workers in Almaty, Kazakhstan. On average, respondents were 27 years of age and 50% were females. Of those interviewed, 32% were internal migrants (legal residents of other regions of Kazakhstan) and 68% were external migrants (predominately citizens of Kyrgyzstan, Uzbekistan and Tajikistan). Logistic regression analysis demonstrated that external migrant status (aOR=1.65, 95% CI=1.00,2.74) and high mobility (aOR=1.83, 95%CI=1.11,3.03) were associated with poor utilization of health care services. High mobility (frequent travels) was also associated with higher odds of depression (aOR=3.08). Length of stay in home countries was associated with lower risk of not seeing a doctor when needed (aOR=0.58, 95%CI=0.36,0.94). Female migrant workers reported greater health concerns than males (aOR=3.88 for depression and aOR=1.67 for poor physical health) and were at higher risk of not utilizing the health care when needed (aOR=4.25). Married migrants and migrants with greater level of family support were less likely to rate their health status as poor. This study demonstrates the urgent need to address health risks and improve access to health care among labor migrants in Central Asia.