Social and Structural Determinants of Chronic Pain Among Migrant Workers: A Scoping Review Using an Intersectionality Framework.

Background: Due to structural inequities, many migrant workers face adverse health outcomes potentially exposing them to long-term pain issues. However, the extent of current knowledge on chronic pain (>3  months) in this population is unclear. As labor migration policies evolve toward less protective measures, it is essential to gain insights into the experiences and drivers of chronic pain among migrant workers. Aims: Drawing on the theoretical framework of intersectionality, this scoping review aimed to synthesize existing knowledge on chronic pain among migrant workers in Canada and the United States. More precisely, we examined evidence related to epidemiology, treatments, lived experiences, and the role of social and structural determinants. Methods: This review followed the Joanna Briggs Institute methodology for scoping reviews. A search of four databases was followed by a screening and extraction procedure involving four researchers. Relevant findings were reported through quantified and narrative syntheses. Results: This scoping review highlights a major gap in understanding pain chronicity among migrant workers. Nine studies met the eligibility criteria. Most studies have focused on occupational health outcomes. Definitions of chronic pain are inconsistent. Only one qualitative study examined migrant workers' pain trajectories beyond workplace settings. Social and structural determinants were underscored in all studies, including poor working conditions, socioeconomic precarity, unfavorable labor market structure, restrictive immigration policies, racism and discrimination, and gendered inequities. Conclusions: This review invites researchers and policymakers to move beyond occupational health approaches to fully appraise and tackle the intersecting structural and political drivers exposing migrant workers to lifelong experiences of chronic pain.