Actively changing ‘healthography': Gender, transnational migration and reproductive health of Chuukese women

Significance: Migrant health studies often focus on health care access, the ‘healthy migrant’ effect, and primarily, men due to the historically larger proportion of migrating males. However, women are increasingly seeking work, education and healthcare abroad. More research is needed focusing on women’s health challenges living transnationally.

Objectives/Purpose: Chuukese women migrate to alter their ‘healthography,’ as Chuuk is an island state characterized by poverty and a deteriorating healthcare system.  Yet, this choice to pursue a better life still leaves Chuukese women with the worst reproductive health outcomes in Guam, a U.S. Territory and receiving island for many regional migrants. This presentation describes how migration, gender and discrimination impact Chuukese migrant women’s reproductive health in Guam.

Methods:  Ethnographic methods of participant observation and in-depth life history interviews were conducted with 20 Chuukese migrant women in Guam to explore how social, structural and economic factors inhibit or promote their improved reproductive health.

Results: Chuukese women described gendered, economic, and structural constraints impacting their reproductive health. Male partner authority and infidelity, childcare priorities, and lack of income were primary inhibitors to women’s ability to maintain health and seek care, despite having health insurance through a ‘Medically Indigent’ Program. Further, women found the public health system confusing, abrasive and intimidating, further preventing ease of access.

Discussion/Conclusion:  Chuukese migrant women represent one example of a growing number of women impacted by migration differently than men. More attention is needed to the intersection of gender, migration and health to understand and improve their health and lives.