The nexus of immigration regulation and health governance: a scoping review of the extent to which right to access healthcare by migrants, refugees and asylum seekers was upheld in the United Kingdom during COVID-19

M C Van Hout; R Madroumi; M D Andrews; R Arnold; V D Hope; M Taegtmeyer

doi:10.1016/j.puhe.2024.04.012

The nexus of immigration regulation and health governance: a scoping review of the extent to which right to access healthcare by migrants, refugees and asylum seekers was upheld in the United Kingdom during COVID-19

Public Health. 2024 Jul:232:21-29. doi: 10.1016/j.puhe.2024.04.012. Epub 2024 May 9.

Authors

M C Van Hout¹, R Madroumi², M D Andrews³, R Arnold⁴, V D Hope⁵, M Taegtmeyer⁶

Affiliations

¹ School of Public and Allied Health, Faculty of Health, Liverpool John Moores University, UK. Electronic address: m.c.vanhout@ljmu.ac.uk.
² School of Psychology, Faculty of Health, Liverpool John Moores University, UK. Electronic address: R.Madroumi@2020.ljmu.ac.uk.
³ Department of Clinical Sciences, Faculty of Clinical Sciences and International Public Health, Liverpool School of Tropical Medicine, UK. Electronic address: Dilys.Andrews@lstmed.ac.uk.
⁴ Department of Public Health, Policy and Systems, Institute of Population Health, University of Liverpool, UK. Electronic address: rosalyn.arnold@liverpool.ac.uk.
⁵ School of Public and Allied Health, Faculty of Health, Liverpool John Moores University, UK. Electronic address: V.D.Hope@ljmu.ac.uk.
⁶ Department of Clinical Sciences, Faculty of Clinical Sciences and International Public Health, Liverpool School of Tropical Medicine, UK. Electronic address: Miriam.Taegtmeyer@lstmed.ac.uk.

PMID: 38728905
DOI: 10.1016/j.puhe.2024.04.012

Abstract

Objectives: Complementing the well-established evidence base on health inequalities experienced by migrants, refugees and asylum seekers in the UK; we examined the extent to which their right to equal non-discriminatory access to health services (promotive, preventive, curative) was upheld during the COVID-19 pandemic.

Study design: Arksey and O'Malley's scoping review framework.

Methods: A comprehensive search was conducted on Medline, PubMed, and CINAHL using detailed MESH terms, for literature published between 01 January 2020 and 01 January 2024. The process was supported by a ten-page Google search and hand searching of reference lists. 42 records meeting the inclusion criteria were charted, coded inductively and analysed thematically in an integrated team-based approach.

Results: Dissonance between immigration regulation and health governance is illustrated in four themes: Health systems leveraged to (re)enforce the hostile environment; Dissonance between health rights on paper and in practice; Structural failures to overcome communication and digital exclusion; and COVID-19 vaccine (in)equity exacerbated fear, mistrust and exclusion. Migrants, refugees and asylum seekers encountered substantial individual, structural and policy-level barriers to accessing healthcare in the UK during COVID-19. Insecure immigration status, institutional mistrust, data-sharing and charging fears, communication challenges and digital exclusion impacted heavily on their ability to access healthcare in an equitable non-discriminatory manner.

Conclusions: An inclusive and innovative health equity and rights-based responses reaching all migrants, refugees and asylum seekers are warranted if the National Health Service is to live up to its promise of 'leaving no one behind' in post-pandemic and future responses.

Keywords: Asylum seekers; COVID-19; Healthcare; Human rights; Immigration; Migrants; No recourse to public funds; Refugees; United Kingdom.

Publication types

Review

MeSH terms

COVID-19* / epidemiology
COVID-19* / prevention & control
Emigration and Immigration / legislation & jurisprudence
Health Services Accessibility*
Humans
Refugees* / psychology
Refugees* / statistics & numerical data
SARS-CoV-2
Transients and Migrants* / psychology
Transients and Migrants* / statistics & numerical data
United Kingdom