In Scotland as a whole, around 2% of the population are from minority ethnic backgrounds, although the distribution of people from such backgrounds is uneven across the country. In Aberdeenshire, out of a total population of 232,850, 1,165 people come from ethnic minority backgrounds, around 0.5 % of the total population. According to the 2001 Census, there are nine main ethnic minority groups in Aberdeenshire, the largest of which is Chinese, comprising around a quarter of the total ethnic minority population of the area (n=277, 24%). The remaining groups are made up of Indians, Pakistanis, other South Asians, Africans, Black Scottish and people from the Caribbean. However, around 29% come from ‘other minority ethnic groups’. With respect to the latter, there has been a noticeable influx of people from Eastern Europe, particularly Poland, Lithuania and Latvia following the accession of ten new member states to the European Union on the 1st April 2004. It has been estimated that around 800 migrant workers and their families are now coming to Grampian each month (400 of whom are Polish), if levels of applications for National Insurance numbers are indicative in this respect (NHS Grampian, 2005). The health needs of migrants is becoming increasingly recognised. As such, the International Organization for Migration’s most recent World Migration Report (2005) argued that, ‘the social and economic costs of neglecting migration health, also as a public health issue, can be immeasurable’. The experience of migration can lead to increased vulnerability to ill health as well as ill health, which arises after arrival. Poorer migrants are often lowly paid, living in damp conditions, badly nourished and exposed to higher risks in working environments yet under-utilise health services. In addition, the stigma generated from wider perceptions of poor migrant health can contribute to an undermining of the benefits of migration. In short, migration is a public health issue, which seems likely to endure in an emerging age of migration (Castles and Miller 2003). Finally communication is considered fundamentally important to the health of migrants due to ‘language barriers having adverse effects on the accessibility of care, the quality of care received, patient satisfaction and patient health outcomes’ (Bischoff 2003). To help in-migrants settle into Scotland generally and Aberdeenshire in particular the Scottish Executive and a range of national and regional bodies have introduced a range of policies. Within healthcare, NHS Grampian (2005) aims "to make genuine and lasting improvements in the quality of services provided to the local ethnic communities and to make NHS Grampian the leader, for other Health Boards to follow". To this end a range of policies are being implemented. These include, interpretation and translation services, training for NHS Grampian staff to better understand the needs of the local ethnic communities, access and service delivery, racial equality within NHS Grampian, appointments procedures, training procedures, actively promoting health within the ethnic communities and meeting the healthcare needs of recently arrived migrant workers and their families and asylum seekers
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