‘I don’t think there’s anything I can do which can keep me healthy’: how the UK immigration and asylum system shapes the health &amp; wellbeing of refugees and asylum seekers in Scotland

Isaacs, Anna; Burns, Nicola; Macdonald, Sara; O’Donnell, Catherine

doi:10.1080/09581596.2020.1853058

Cited by 9 publications

(17 citation statements)

References 35 publications

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“…In relation to people seeking asylum, there is documented evidence of healthcare discrimination experienced by Eritrean women in Israel (Gebreyesus et al, 2020), sub‐Saharan Africans in the United Kingdom (Isaacs et al, 2020) and Ethiopians in Norway (Schein et al, 2019). Discrimination is associated with less sense of belonging, lower levels of trust, reduced sense of control and less hope among asylum seekers and refugees (Ziersch et al, 2020), in addition to increased rates of mental disorder (Jannesari et al, 2020).…”

Section: Racism and Discrimination Towards People Seeking Asylummentioning

confidence: 99%

Racism, healthcare access and health equity for people seeking asylum

2021

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People seeking asylum are at risk of receiving poorer quality healthcare due, in part, to racist and discriminatory attitudes, behaviours and policies in the health system. Despite fleeing war and conflict; exposure to torture and traumatic events and living with uncertainty; people seeking asylum are at high‐risk of experiencing long‐term poor physical and mental health outcomes in their host country. This article aims to raise awareness and bring attention to some common issues people seeking asylum face when seeking healthcare in high‐income countries where the health system is dominated by a Western biomedical view of health. Clinical case scenarios are used to highlight instances of racist healthcare policies and practices that create and maintain ongoing health disparities; limited access to culturally and linguistically appropriate health services, and lack of trauma‐informed approaches to care. Nurses and midwives can play an important role in countering racism in healthcare settings; by identifying and calling out discriminatory practice and modelling tolerance, respect and empathy in daily practice. We present recommendations for individuals, organisations and governments that can inform changes to policies and practices that will reduce racism and improve health equity for people seeking asylum.

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Section: Racism and Discrimination Towards People Seeking Asylummentioning

confidence: 99%

Racism, healthcare access and health equity for people seeking asylum

2021

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“…Population health experts consider discrimination an important and under‐researched influence on health, with various individual and structural pathways through which discrimination impacts health 47 . Experiences of discrimination are also a common feature of lay accounts of the social determinants of health 46,48 . That diversity and inclusion were central to participants' improved versions of society supports calls for increasing social cohesion and eliminating discrimination to address inequalities.…”

Section: Resultsmentioning

confidence: 99%

“…This aligns with existing qualitative accounts of social determinants which identify fear and stigmatisation as important factors constraining health (by restricting people's access to spaces and activities) and which suggest that such experiences are not equally distributed but concentrated in already disadvantaged communities. 45,46 Addressing similar concerns, Figure 3 depicts a harmonious society. Population health experts consider discrimination an important and under-researched influence on health, with various individual and structural pathways through which discrimination impacts health.…”

Section: Imagining Alternative Futuresmentioning

confidence: 99%

Young people's perspectives on addressing UK health inequalities: utopian visions and preferences for action

Fergie

Vaczy

Smith

et al. 2023

Health Expectations

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IntroductionIt is increasingly recognised by UK researchers and population health advocates that an important impetus to effective policy action to address health inequalities is activation of public dialogue about the social determinants of health and how inequalities might be addressed. The limited body of existing scholarship reaches varying conclusions on public preferences for responding to health inequalities but with consensus around the importance of tackling poverty. Young people's perspectives remain underexplored despite their increasingly visible role in activism across a range of policy issues and the potential impact of widening inequalities on their generation's health and wellbeing.MethodsSix groups of young people (39 in total) from two UK cities (Glasgow and Leeds) were engaged in online workshops to explore views on health inequalities and potential solutions. Inspired by calls to employ notions of utopia, artist–facilitators and researchers supported participants to explore the evidence, debating solutions and imagining a more desirable society, using visual and performance art. Drawing together data from discussions and creative outputs, we analysed participants' perspectives on addressing health inequalities across four domains: governance, environment, society/culture and economy.FindingsProposals ranged from radical, whole‐systems change to support for policies currently being considered by governments across the United Kingdom. The consensus was built around embracing more participatory, collaborative governance; prioritising sustainability and access to greenspace; promoting inclusivity and eliminating discrimination and improving the circumstances of those on the lowest incomes. Levels of acceptable income inequality, and how best to address income inequality were more contested. Individual‐level interventions were rarely presented as viable options for addressing the social inequalities from which health differences emanate.ConclusionYoung people contributed wide‐ranging and visionary solutions to debates around addressing the enduring existence of health inequalities in the United Kingdom. Their reflections signal support for ‘upstream’ systemic change to achieve reductions in social inequalities and the health differences that flow from these.Public ContributionAn advisory group of young people informed the development of project plans. Participants shaped the direction of the project in terms of substantive focus and were responsible for the generation of creative project outputs aimed at influencing policymakers.

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“…Likewise, Aisha's time is relational and intricately connected to both the temporal routines of caring for her family and the sociocultural conditions within which they occur. Similarly to Labani, as an economically marginalised migrant mother, race, class and gender intersect to position her as ‘structurally vulnerable’ (Isaacs et al., 2020). Thus, ‘giving herself time’ is not straightforward.…”

Section: Subjective Experiences Of Timementioning

confidence: 99%

‘He called me out of the blue’: An ethnographic exploration of contrasting temporalities in a social prescribing intervention

Gibson

Moffatt

Pollard

2022

Sociology Health & Illness

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Social prescribing, a way of connecting patients to local services, is central to the NHS Personalised Care agenda. This paper employs ethnographic data, generated with 19 participants between November 2018 and July 2020, to explore the socio-temporal relations shaping their experiences of a local social prescribing intervention. Our focus is on the ways in which the intervention synchronised with the multitude of shifting, complex and often contradictory 'timespaces' of our participants. Our focus on the temporal rhythms of everyday practice allows us to trace a tension between the linearity and long horizon of the intervention and the oft contrasting timeframes of participants, sometimes leading to a mismatch that limited the intervention's impact. Further, we observed an interventional 'drift' from continuity towards unsupported signposting and 'out-of-the-blue' contacts which favour the temporality of the intervention. We demonstrate a need for intervention planning to be flexible to multiple, often conflicting, temporalities. We argue that health interventions must account for the temporal relations lived by the people they seek to support.

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‘I don’t think there’s anything I can do which can keep me healthy’: how the UK immigration and asylum system shapes the health & wellbeing of refugees and asylum seekers in Scotland

Cited by 9 publications

References 35 publications

Racism, healthcare access and health equity for people seeking asylum

Racism, healthcare access and health equity for people seeking asylum

Young people's perspectives on addressing UK health inequalities: utopian visions and preferences for action

‘He called me out of the blue’: An ethnographic exploration of contrasting temporalities in a social prescribing intervention

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