Acculturation and healthcare access among labour migrants: A systematic review

Abstract

Acculturation plays a significant role in migrant health. However, there has been little synthesis of the relationship between migrants’ acculturation and healthcare access. This systematic review examines how acculturation is measured and its relationship with healthcare access among labour migrants. A systematic search of primary research studies (January 2000-July 2024) was conducted in PubMed, ScienceDirect, Scopus, and Web of Science using predefined MeSH terms and keywords. Records were screened by two independent reviewers and data were extracted on study characteristics, the measures of acculturation, healthcare access outcomes, and covariates. Assessment of study quality was done using the Newcastle-Ottawa quality assessment scale. Results were reported following PRISMA 2020 guidelines. The protocol was registered in PROSPERO (registration number CRD42024532204). Twenty-four studies met the inclusion criteria for final analysis. Four main acculturation proxies influencing labour migrants’ access to healthcare were identified: length of stay, proficiency in local languages, country of origin, and immigration status. Longer residency and higher local languages proficiency were associated with better healthcare access. The influence of the origin country varied by migrant group. Irregular immigration status negatively affected healthcare access, with undocumented migrants having the poorest access. The identification of key acculturation proxies suggests targets for inclusive policies that improve specific areas of acculturation to increase equitable healthcare access for labour migrants. Future research is needed in low-and middle-income destination countries, incorporating validated instruments of acculturation, longitudinal studies, and the exploration of other contributing factors for a greater understanding of the acculturation process