Re-examining the perspectives of health and mobility

Mobility and health: Strongly connected, but rarely analysed together

Before coming to Eurac Research in March 2020, I spent at least six hours almost every week on trains and buses, commuting between my workplace in Munich, Germany and my hometown Sterzing in South Tyrol, Italy. Crossing two nation-state borders on a bi-weekly basis was completely normal, and many of my colleagues in Munich led similar lives, regularly leaving the city for their weekend destinations in Austria, Italy, Switzerland, or even France. Mobility and flexibility have come to be prerequisites in many sectors and companies, and especially so for academics, who often not only spend their time commuting between the centers of their working and private lives, but also frequently cross borders for international conferences, research collaborations, or fieldwork. In times of Covid-19, the level of mobility we had once considered to be established and secured by the European Integration process has now eroded completely. In Italy, people are no longer allowed to leave their municipality of residence – traveling to another country seems like a prospect from an altogether different life. Health considerations have thus had a dramatic impact on mobility, demonstrating the interplay between two fields that are usually not studied through a common lens. Covid-19 therefore provides a valuable opportunity to take a closer look at the interconnectedness of health and mobility.

Migration and health: an endangered human right

There are many meeting points between health and mobility. One of the most obvious, and one of the few where a shared approach has been adopted, is the connection between health and migration as a specific form of human mobility. The WHO (World Health Organization) has defined health as a human right, which must be granted regardless of legal status or citizenship .

Covid-19 accentuates the need for public health policies that take on a global perspective, and that also specifically include vulnerable groups, such as migrants. Before the Corona pandemic, health for migrants and refugees was mostly discussed in terms of restricted access to local health care systems, allowing only the most necessary procedures. Now, precarious health conditions of migrants are no longer just a community-related problem, but are also seen as an influential factor for general public health. Dangerous developments like the lack of hygiene standards and distancing measures in Greek refugee camps could now impact the whole population.

However, the response to the realisation of how related migration and health policy are does not necessarily need to be one of trying to outlaw migration through restrictive border closures. Portugal has taken a different road, and opened its social system to all persons present in the country, despite their legal status , calling this act the duty of a solidary society in times of crisis.

Mobility in and for health as an indispensable part of European Integration

Besides international migratory movements, mobility and health are also connected in inter-European mobility. The four freedoms, one of the main achievements of the European Integration process, mean that goods, services, capital and persons can move without restriction in the EU. These provisions make it possible for EU citizens to work and live in EU member-states other than their homelands, without any disadvantages in regard to nationals of said states. This kind of mobility can be observed throughout Europe, and across different sectors, with the health care industry being one of the prime examples. Demographic change makes for an increased need for health care professionals, i.e. in Germany there is a lack of caretakers, doctors and nurses, and personnel recruitment from other parts of Europe is regarded as part of the solution.Corona also highlights the interdependency of mobility and health in this sector: many caretakers have now left for their homelands in order to return to their families, while other workers are not able to enter the countries they were supposed to work in due to border closures. This could lead to an emergency in elderly care Not only health care workers but also patient mobility has fallen victim to the virus; treatments abroad are only possible if they are vital for survival and cannot be carried out in the patient’s region of residence, leaving many people, especially in border regions, without the care of their usual trusted physicians during this difficult time.

Well-Being requires more than just being virus-free

Finally, as the WHO notes, “health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. Lockdowns and mobility restrictions are necessary to help reduce the spread of Covid-19, and thus can be defined as measures to ensure the absence of disease. But if we look at the desirable state of complete well-being, and especially at the mental and social dimensions, said measures may be more detrimental than beneficial. According to the US Centers for Disease Control and Prevention (CDC), “well-being includes the presence of positive emotions and moods (e.g., contentment, happiness), the absence of negative emotions (e.g., depression, anxiety), satisfaction with life, fulfillment and positive functioning”. The prerequisites for well-being might therefore be different ones than those for health, if health is viewed merely as the absence of disease. While stopping mobility altogether may be the safest bet for preventing the virus from being mobile, it is not a long-term solution, due to the effect it has on other aspects that are fundamental for our well-being (e.g. the possibility to travel to see loved ones).

We have gone from open borders to closed ones, from traveling for work and leisure and from working freely all over Europe to being confined to our homes, from a mobility radius spanning thousands of kilometers to one of 200-400 meters from our residences – these developments are bound to have a significant impact on individual well-being. In Italy, the end of the lockdown is now scheduled for May 3, 2020.

One of the biggest challenges of a post-Covid-19 world will be to reconcile the need for virus containment with the necessities of human mobility. Initially, work-related travel will have to be allowed again, as shops and production lines re-open and workers must get to their workplaces. Following this first step, a slow and gradual expansion of mobility possibilities, in check with both the epidemiological but also the social and psychological factors for health and well-being, will be the only feasible way forward.

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Katharina Crepaz is a political scientist and Senior Researcher at the Institute for Minority Rights. Her research focuses on national minorities, mobility and migration policies, political participation and inclusion of marginalised groups, as well as health care systems and societal diversity.