Although there is no international definition for the term human migration, it generally is considered to be the act of leaving an established residence for another country or across borders. International migrants are considered immigrants if they enter a new country with legal documents obtained from the embassy of the receiving country. Migrants are considered refugees when they are forced to leave their home country and cannot return for fear of persecution because of their ethnicity, religion, nationality, social group, or political opinion. Refugees have non-resident country status until taken in by an accepting nation. Otherwise, international migrants are persons seeking to leave a homeland and enter another country without legal documents.

As the new year has opened, migration of undocumented persons and families to other nations in Europe, the Western Hemisphere, Africa, and the Middle East is occurring on a large scale. Migration has been dramatic into the European Union with 1.9 million migrants entering in 2020 and 23.7 million migrants living in the European Union as of January 2021.¹ At the United States-Mexico border, 1.7 million migrants were encountered by the US Border Patrol in 2021.² This US-Mexico statistic is a significant under-estimate, as many migrants cross the border undetected. In most cases, the current migration patterns represent major movements of people with marginal means of survival and lack of government and social protections. While global leaders focus on the Ukrainian War and on-going outbreaks and controversies surrounding COVID-19, massive human migration and the humanitarian crisis it forms gains less informed and sporadic government and political attention.

Both the United States and Italy have received recent criticism for closure of ports and borders to migrants seeking to enter those countries. In addition, the on-going process of the United Kingdom withdrawal from the European Union has roots in limiting migration into England.^{Reference McAndrew3} The effects of mass migration on receiving nations that are usually considered economically developed are dramatic. As developed world economies cope with inflation, skilled worker shortages, civil unrest, and rapid changes in the consumerism that supports those economies and governments, the influx of migrants who often have skills not needed in the receiving nation and speak different languages as well as having limited understanding of the recipient nation social structure and norms presents challenges to political and social support systems (including health care systems).

International migrants face many documented risks, including those listed in Table 1. Beyond the recognized risks noted in Table 1 are subtle challenges such as being misled by those who transport migrants into believing they will be welcomed at border crossings, be safe during the migration travel period, and that jobs, shelter, and food are plentiful in the countries of destination. Migrants are most often not aware that receiving countries discriminate against undocumented migrants by refusing basic medical services and housing and social support programs for non-documented residents. Further, migrants are an easy target for condemnation and blame for social ills by political leaders simply because migrants do not have the privilege to vote in elections.

Table 1.

Documented Risks Facing Migrants During Travel and at Border Detention Points

An important factor in understanding and addressing current migration patterns is recognizing the push and pull factors that convince people and families to migrate. Push factors for migration include: (1) political instability and threats to personal safety in the home country, (2) poor or no working opportunities, (3) environmental hazards and losses, (4) government seizure of property, (5) social oppression, and (6) the potential for being labeled criminal due to social or political affiliation in the home country. Pull factors for migration to a receiving country include: (1) economic opportunity, (2) education opportunity, (3) family unification, and (4) cultural and religious freedom. In addition, political and economic stability in a receiving country is a pull factor.^{Reference Agren4}

Current mass migration is most often associated with threats of personal violence to families, and particularly younger males and females, by organized crime gangs and cartels in home countries. In addition, corruption of government officials who often confiscate private land and levy high taxes in forms of extortion are reasons for leaving one’s homeland. Central American migration has also been associated with destruction of agricultural and industrial resources due to environmental disruption such as hurricanes and flooding. Another factor is likely over-population causing struggle for basic resources such as food and shelter.

For national governments, global organizations, and local governments to address the issue of migration, the push and pull factors need attention in an organized and factor-inclusive manner. Stopping migration at a national border by refusing entry, as is current government policy in many circumstances, is futile and worsens the health and safety of migrants. For example, addressing migration push issues in Central America by international coordination of methods to limit or contain gang or cartel violence in migrant home countries, stabilizing home governments, and addressing environmental destruction of agricultural lands in home countries would likely help address migration challenges. As with Central America, migration in the European region is also driven by similar factors as those found in Central America.

Important to recognize is the current migration crisis is complex in origin. Environmental degradation of agricultural and habitat land, social violence for control of limited resources by gangs and cartels, corrupt governments, and cultural discrimination, as well as a rapidly changing world economy are inter-related push factors for migration. Migrants and receiving nations both face challenges due to the current global mass migration patterns. In addition, over-population and poverty are becoming common in much of the world, particularly in nations from which migrants flee. The current on-going COVID-19 pandemic and regional wars are important global concerns, but to ignore the complex disasters causing mass migration and the humanitarian crisis represented by mass migration is short sighted on the parts of international organizations and world governments.