Refugees, asylum policies, and health outcomes

Time period: 2019-01-01 to 2022-12-31

Project leader: Linna Martén

Funder: Forte, Swedish Research Council for Health, Working Life and Welfare

Type of award: Unclassified

Total fundning: 3 330 000 SEK

More than 3 million have applied for asylum in Europe since 2015, and governments have faced the biggest refugee crisis since the Second World War. There is vast evidence that refugees, in particular women, have poorer mental health than natives (e.g. Norredam et al., 2009; Fazel et al., 2005), and the next generation may also suffer, as children born to refugee parents after migration have an increased risk of psychotic disorders (Saraiva Le ̃ao et al., 2005). This pattern can be explained by both pre-migration factors, such as exposure to traumas, as well as post-migration factors, such as the asylum process, access to health care, and economic hardship. Mental health issues are particularly problematic for immigrant youth, as childhood exposure to stress and adversity is linked to health issues in adulthood (Shonkoff et al., 2012). Yet, there is limited evidence of the type of policies that may mitigate these health disparities, since researchers have not studied the causal impacts of asylum policies. Policy makers thereby have difficulties with making informed decisions about how to design the asylum process.Our project will evaluate refugees’ health status and the effect of different asylum policies. We will examine who takes the voluntary health screenings, as well as the health impact of having access to primary care during the asylum process, the type of residence permit (temporary or permanent), and the support given to unaccompanied minors. Sweden offers an ideal setting to evaluate the impact of asylum policies due recent policy reforms that can be evaluated with quasi- random designs, the large number of asylum seekers, and the availability of unique administrative register data. Understanding the factors that exacerbates refugees’ health problems is essential for understanding the full impact of asylum policies, developing policies that safeguards refugees’ well-being, and improving the health sector’s ability to meet refugees’ specific needs.