By Guest Writers Eszter Szocs, MHP, MA; Khawla Nasser Aldeen, MPH
Global displacement is currently at a record high, and most countries are becoming more ethnically diverse and multicultural (IOM, 2022). The reasons people migrate are diverse, ranging from employment or education, to forced displacement due to environmental, political, economic, or social pressures. People living outside of their countries of origin are facing racism, xenophobia, and discrimination, which has become increasingly evident in recent years through increased reports of mistreatment (ILO, IOM, OHCHR, 2001). Discrimination and racism can occur on systemic, interpersonal, or internalised levels, and have an impact on health, including negative effects on individual and community wellbeing (Schmitt., Branscombe, Postmes, & Garcia, 2014). Not enough research has been done on the links between racism and discrimination and the wellbeing of people on the move (Ziersch, Due, & Walsh, 2020).
Migrants, refugees, and asylum-seekers often report experiencing discrimination based on their country of origin, or because they belong to a specific identity (or are perceived as such). One example of systemic discrimination against them is restricted access to housing, education, and healthcare, which necessarily affect health (Ziersch, Due, & Walsh, 2020). On an interpersonal level, migrants are often scapegoated in mediatised discussions on ‘national identity’, particularly by the right-wing press, which can lead to experiences of feeling othered (Schouler-Ocak et al., 2021). Women migrants may carry a double burden from the intersection between racism and sexism. For instance, not only do they experience high rates of gender-based violence along migration routes, but they are also more likely not to receive proper psychological, legal, and health support services (Pittaway & Bartolomei, 2001).
From a health perspective, facing compounded social injustices poses a risk of poor health outcomes among people on the move, such as high levels of psychological distress (Schouler-Ocak et al., 2021). Living with mental illness has been found to affect social adaptation processes, and vice versa; and discrimination interacts with both (Montgomery & Foldspang, 2008). Furthermore, studies show that mental illnesses, such as posttraumatic stress disorder (PTSD), depression, anxiety, and psychosis, are more common among refugees (Montgomery & Foldspang, 2008). Facing discrimination after moving countries can compound previously experienced trauma. In the long-term, systemic solutions for racism, xenophobia and discrimination are essential, but early professional support and access to culturally-sensitive mental health resources are also critical for supporting people on the move (Stathopoulou et al., 2019).
The consequences of discrimination on health can persist throughout a person’s life (Ziersch, Due & Walsh, 2020; Szaflarski & Bauldry, 2019). Internalising experiences of discrimination could have damaging effects on the self-worth of people on the move, especially youth, leading to diminished self-esteem (Goosby & Heidbrink, 2013). This could lead to social exclusion and isolation, making it harder to feel a sense of belonging and cultural adaptation (Ziersch, Due, & Walsh, 2020; ILO, IOM, OHCHR, 2001). Lack of access to employment, healthcare, and decent housing exacerbates this processof othering and marginalisation (Szaflarski & Bauldry, 2019). If left unchallenged, this could lead to a cycle of isolation, destitution and poor wellbeing outcomes for people on the move, as is visible across Europe today. Given the consequences of racism can be inherited transgenerationally, there is also a concern that this could result in persistent disparities between communities (Schouler-Ocak et al., 2021; Goosby & Heidbrink, 2013).
Addressing discrimination and racism as a health risk for people on the move requires urgent action. Promoting multiculturalism – the celebration of ethnic diversity and respect of people’s values and identities – could be a powerful tool for ending hostility against people on the move. More research is required on the experiences of people on the move and the impact of discrimination on their health. Participatory, person-centered qualitative and ethnographic research tools can help researchers to understand the complexities of lived experiences of people on the move with discrimination and racism during different phases of migration or displacement. But perhaps most importantly, we must stage interventions against systemic and institutional racism and discrimination, and call for protective policies for people on the move.