How Will COVID-19 Magnify Existing Health Inequalities for Refugees and People Seeking Asylum?
(COVID-19 Blog Series)

By Dr Karen Block
Co-leader, Migration and Social Inclusion Research Program, Melbourne Social Equity Institute
Associate Director, Child and Community Health Unit, Centre for Health Equity

Thursday 7 May 2020

In early February this year, I was lucky enough to be returning from a fabulous overseas holiday. I had been following from a distance the grim news about our terrible bushfires and smoke-choked cities and was processing the fact that taxi drivers in Spain were keen to discuss Australia’s "climate-change-denying government".

News was also percolating through that the worrying new virus affecting Wuhan in China had spread to Italy, and I was relieved to be leaving for Australia then - just in case things got worse in Europe. Bizarrely (with 20-20 hindsight), it didn’t seem to occur to me at that time that COVID-19 would soon be wreaking profound changes to our lives here as well.

A few short weeks later, the fact that we were facing a global pandemic was clear. As a population health researcher in the Centre for Health Equity, my thoughts immediately turned to worry about the ways in which this virus, and the public health measures put in place to contain it, would disproportionately affect those in our own society and globally who were already disadvantaged. In Australia, I was concerned about the homeless, people with disabilities, people in prisons and immigration detention, women experiencing family violence and anyone with insecure work or housing or here on a temporary visa.

My own research focuses on how we can better support social inclusion for people with migrant and refugee backgrounds. One of the things I soon turned my attention to was ways in which people with refugee backgrounds in Australia are at heightened risk during the pandemic, both in terms of susceptibility to infection and the impacts of response measures. I share here the following summary (which I put together with my colleague, Cathy Vaughan) to aid advocacy and support research into their needs. Many of these factors are shared by a number of at-risk groups.

Poverty, insecure housing and unemployment

Many already experience poverty, unemployment, discrimination, insecure housing and co-morbidities that may be exacerbated by COVID-19 responses. Overcrowded housing is common and reduces capacity to undertake physical distancing or self-isolation. If employed, household members often face high risk of workplace exposure to COVID-19 (in occupations including aged care, cleaning, delivery services, childcare etc.) and/or have precarious employment with increased pressure to attend work even if unwell. Immigration detention settings are recognised as particularly high-risk sites for infection spread, ultimately endangering the health of the entire community.

Access to health care and welfare benefits

People seeking asylum on temporary or bridging visas may have no access to Medicare and, as temporary migrants, have been explicitly excluded from a range of supports, yet have no option to ‘return home’ leaving them highly exposed to destitution. Even those eligible for health and welfare benefits may have little understanding of how to access financial supports and services, or of their rights as tenants.

Access to information and communication technologies

Information about COVID-19 and physical distancing in first languages may be unavailable. Even when available, lower rates of literacy and health literacy in particular may reduce comprehension. Many refugee and asylum seeker households will not have access to communications infrastructure (computers, home Wi-Fi etc.) needed for effective work or study from home.

Education

Lack of access to communication technologies, English fluency and literacy, and understanding of the Australian education system, combined with overcrowded housing, mean that families are likely to be particularly disadvantaged when it comes to supporting children and young people attempting to study at home. This will have long-term consequences, magnifying existing educational disadvantage and disengagement.

Mental health

Refugees and people seeking asylum are often dealing with past trauma, and have higher rates of mental health conditions likely to be exacerbated by the pandemic. They are also cut off from and anxious about family living in other countries with poorer health systems. This population group also already experiences high rates of social isolation that may be exacerbated at this time.

All of these factors created inequalities before the pandemic. Our challenge going forward will be to use the spotlight COVID-19 shines on the lives of those in our midst who are less privileged, to help create a fairer society on the other side.

Dr Karen Block is the Academic Convenor of the Melbourne’s Social Equity Institute’s Interdisciplinary PhD Program in Migration, Statelessness and Refugee Studies and co-leads the Institute’s program of research on migration and social inclusion. She is also the Associate Director of the Child and Community Wellbeing Program, Centre for Health Equity, in the Melbourne School of Population and Global Health. Her recent and current research includes a range of projects involving immigrant and refugee-background young people, women and families focused on social inclusion across the life course, health inequalities, gender-based violence, evaluating complex interventions, and working in collaborative partnerships with communities and community-based organisations.