The main aim of the research was to map the influence of selected social determinants on health of target immigrant groups. The method was based on the concept of ten social determinants of health as introduced by Wilkinson and Marmot (2003). The quantitative method used were interviews. The survey was carried out in the period from January 2010 to December 2012. Data collection was carried out in two stages. In the first stage, the influence of two social determinants of health (nutrition and addiction) on the respondents' state of health was investigated. The second stage of the survey focused on working conditions and on how respondents can use health care. 246 immigrants were interviewed in the first stage of the survey. They were from the following regions: South Bohemian Region, the capital Prague and Vysočina Region. 236 immigrants from two regions (South Bohemian Region and the capital Prague) were addressed in the second stage of the survey. They were legally settled immigrants in the age group 18 65, of Vietnamese, Mongolian and Ukrainian nationality. The results of the survey clearly show that the target immigrant groups are more exposed to unfavorable working conditions than majority population. Compared to the Czech population the target immigrant groups show statistically significant differences especially in the area of excessive workload and discrimination in the workplace. Increasing incidence of unfavorable working conditions resulted in significant increase in occupational diseases. The factors influencing use of healthcare by immigrants are the type of health insurance, length of residence, sex and knowledge of Czech language. Immigrants who had entered the system of public health insurance used healthcare much more frequently than immigrants with commercial health insurance. Male immigrants smoke and drink alcohol much more heavily than female immigrants. The young generation of immigrants (aged 18 to 29) smoke statistically more significantly than the middle-aged and older generation of immigrants. Middle-aged immigrants (aged 30 to 50) consume more wine and spirits. Their health was perceived subjectively as "worse" by those respondents who at the same time mentioned chronic pain and psychic stress in the workplace. The following measures could lead to elimination of social inequality and to improvement of immigrants' situation in the Czech Republic: equal working conditions for immigrants and Czech employees, improvement of immigrants' knowledge of Czech, shortening of the overall time for obtaining permanent residence, simplification of the terms for gaining citizenship, guarantee of access to public healthcare to all legally settled immigrants.

The aim of this thesis is to argue what it means to embody clinical competence for treating im/migrant patients. Im/migrants are a distinct yet heterogeneous patient population. They come to the U.S. for a variety of reasons, with a great diversity of backgrounds, upbringings, experiences, and ways of life. Considering the structural violence and push and pull factors directly connected to reasons for im/migration and experiences of distress upon settlement in the U.S., the central framework of this thesis is im/migration as a structural determinant of health. The operations of social structures, through policy, law enforcement, and discriminatory belief systems, make im/migrants structurally vulnerable. When healthcare providers treat im/migrant patients from a structurally informed approach to care, the context of these patients’ needs become more apparent and likelihood of positive health outcomes increases. Central to this structural approach, as I explain, is understanding how to best communicate with, gain the trust of, and provide effective social interventions for im/migrant patients relative to the operations of violent social structures. Im/migrant status truly is a determinant of health in its own right, and accordingly, care for im/migrant patients is also a specialized clinical realm with specific skills and competencies. As I argue, healthcare providers can only attain—embody—the competence for treating im/migrants through an awareness of how social structures affect these patients’ lives and modifies the delivery of care.