US migrant health, compensation for night-shift work, and the Pope

March 26, 2009

The three Editorials in this week's Lancet focus on US migrant health, compensation for breast cancer sufferers who have done night shift work, and the Pope's recent announcement on AIDS and condom use.

The US migrant health Editorial discusses the inadequate conditions many immigration detainees find themselves in, with a particular focus on women, who now make up some 10% of those detained. It says that failure to provide migrant health is seriously undermining President Obama's commitment to global health.

The Editorial says: "One of the major barriers to adequate health care for migrants to the USA is a lack of understanding of their specific health needs. Data for disease prevalence are rarely disaggregated by country of birth or length of residence in the USA, so American-born ethnic minorities are not distinguished from foreign-born migrants. This knowledge is crucial for targeting vulnerable communities with tailored disease-prevention programmes and treatment strategies."

It concludes: "The Lancet has previously praised the USA on its contribution to global health. The country's efforts to improve the health of vulnerable people in resource-poor countries around the world is immensely important, but the fact that the USA largely ignores the needs of migrants on its own doorstep is shameful. All migrants held in Immigration and Customs Enforcement Agency detention facilities should be able to access adequate health care to meet their needs. Issuing guidelines is not enough--they must be enforced through data transparency, staff training, and continuous monitoring of standards. Migrants in US communities must have their specific health needs assessed to ensure access to care is equitable. America's failure to provide adequate health care for its migrant population risks seriously undermining President Obama's commitment to improve global health."

The second Editorial analyses the recent decision by the Danish Government to award compensation to breast cancer sufferers who have worked many night shifts in the past. The decision was based on a 2007 announcement by the International Agency for Research on Cancer (IARC) that night shift work was a risk factor for cancer.

It concludes: "The ramifications of the Danish decision for occupational health are huge. Every fifth employee in Europe and North America works night shifts. The move could increase legal pressure on employers to reduce risks associated with shift work and might create sexual discrimination in some jobs. Most importantly, it establishes a desperate need for more rigorous scientific research into cancer that might be attributable to shift work. In the meantime, the emphasis should be on prevention of cancer by concentrating on established and controllable risk factors, such as maintaining a healthy weight, drinking moderately, and exercising regularly."

The final Editorial says that Pope Benedict XVI should retract the recent remarks he made during his Africa visit regarding the AIDS epidemic. The Pope said that the problem "cannot be overcome by the distribution of condoms: on the contrary, they increase it".

The Editorial condemns the remarks, saying: "By saying that condoms exacerbate the problem of HIV/AIDS, the Pope has publicly distorted scientific evidence to promote Catholic doctrine on this issue."

It concludes: "Whether the Pope's error was due to ignorance or a deliberate attempt to manipulate science to support Catholic ideology is unclear. But the comment still stands and the Vatican's attempts to tweak the Pope's words, further tampering with the truth, is not the way forward. When any influential person, be it a religious or political leader, makes a false scientific statement that could be devastating to the health of millions of people, they should retract or correct the public record. Anything less from Pope Benedict would be an immense disservice to the public and health advocates, including many thousands of Catholics, who work tirelessly to try and prevent the spread of HIV/AIDS worldwide."
Lancet Press Office T) +44 (0) 20 7424 4949 E)

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