Transnational migration, state policy and local clinician treatment of asylum seekers and resettled migrants: Comparative perspectives on reception center and community health care practice in Finland

Based on interviews conducted at five Finnish reception centers and in two municipal communes during summer 2002 with 93 migrants, mainly from a variety of Southern and Eastern countries of origin, and their ethnoculturally discordant clinicians, the article compares asylum seekers and foreign-born residents in terms of health care treatment and outcome perspectives. Comparative analysis suggests that context makes a difference in post-migration medical encounters. The legally admitted foreign nationals consulted at community facilities were considerably more likely than were asylum seekers assisted at reception centers to be satisfied with the health care they had received and to be confident that the attending physician's recommendations would serve them well in the future. Policy implications related to the study's findings are explored. In Finland and elsewhere, the education of general practitioners for transnational medical encounters needs to be enhanced. International and national efforts to promote health also need to encompass political asylum and third country resettlement policies. In Finland and other migrantreceiving states, prolonged insecure immigration status can be debilitating for both asylum seeker and host society. Expedited admission to legal residence and expanded choice of physician are likely to result in improved health outcomes. Global Social Policy