The Impact of the Covid-19 Pandemic and the Lockdown on the Health and Living Conditions of Undocumented Migrants and Migrants Undergoing Legal Status Regularization

Abstract

Introduction: Undocumented migrants are at high risk of adverse consequences during crises because of a lack of access to essential securities and sources of support. This study aims to describe the impact of the COVID-19 crisis on the health and living circumstances of precarious migrants in Switzerland and to assess whether those undergoing legal status regularization fared better than undocumented migrants.Materials and methods: This cross-sectional mixed methods study was conducted during the COVID-19 lockdown in April–May 2020. Undocumented and recently regularized migrants taking part in an ongoing cohort study were asked to respond to an online questionnaire. A subsample was selected to undergo semi-directed phone interviews.Results: Overall, 117 of the 379 (30.9%) cohort study participants responded to the questionnaire. Seventeen interviews were conducted. Migrants faced cumulative and rapidly progressive difficulties in essential life domains. As a consequence, they showed high prevalence of exposure to COVID-19, poor mental health along with frequent avoidance of health care. Moreover, the loss of working hours and the related income overlapped with frequent food and housing insecurity. Around one participant in four had experienced hunger. Despite these unmet needs, half of the participants had not sought external assistance for reasons that differ by legal status. Both groups felt that seeking assistance might represent a threat for the renewal or a future application for a residency permit. While documented migrants were less severely affected in some domains by having accumulated more reserves previously, they also frequently renounced to sources of support.Conclusions: The cumulated difficulties faced by migrants in this period of crisis and their limited search for assistance highlight the need to implement trust-building strategies to bridge the access gap to sources of support along with policies protecting them against the rapid loss of income, the risk of losing their residency permit and the exposure to multi-fold insecurities.

Equity in access to COVID-19 testing for undocumented migrants and homeless persons during the initial phase of the pandemic

“…This is even more the case in situation of health crisis which poses the risk of increasing health inequalities ( Okonkwo et al, 2020 ). Indeed, the social and economic consequences of the current COVID-19 pandemic have been shown to rapidly worsen the pre-existing vulnerability of underserved groups and concern have been raised that health policies may be blind to the need of groups at the margin of the mainstream society ( Burton-Jeangros et al, 2020 , Page and Flores-Miller, 2020 , Bhopal, 2020 ).…”

“…Different hypothesis have been formulated to explain these disparities in exposure and impact, including pointing out the role of individual, medical, socioeconomic and structural factors ( Bhala et al, 2020 ). Minorities and underserved groups have been shown to have more preexisting risk factors for severe COVID-19 infection ( Agyemang and van den Born, 2019 , Adams et al, 2020 ), to have less capacity to implement protective measures both at home and at the workplace ( Burton-Jeangros et al, 2020 ), to delay seeking medical assistance upon the occurrence of suggestive COVID-19 symptoms and to present more severe disease at admission ( Joseph et al, 2020 ). While some of these factors may be amenable to improvement by adapting healthcare structures to new COVID-19 related health needs of underserved populations, there is a dearth of empirical evidence about the effect of equity policies regulating access to care in this context.…”

Health-Related Quality of Life and Risk Factors among Chinese Women in Japan Following the COVID-19 Outbreak

“…These poor health results, whether before or after the COVID-19 pandemic, reveal that the Chinese women living in Japan generally experience health issues, especially that of well-being in the mental health domain. An existing study reported that during the COVID-19 pandemic, the residence status of immigrants is a significant risk factor for poor health among immigrant women [43]. Many foreign workers in Japan have lost their jobs due to the pandemic [44], which may have further negatively influenced their health status.…”

Exposure to a SARS-CoV-2 infection at work: development of an international job exposure matrix (COVID-19-JEM)

“…In the context of the COVID-19-JEM, precarious work is of particular interest as temporary jobs, multiple jobs, and/or insecure jobs typically involve poorer working conditions (24) and an increased risk for less stringent enforcement of mitigation actions. Similarly, migrants are often employed in precarious work, and their risk of becoming infected may be amplified by poor housing and commuting conditions, such as crowding and inadequate ventilation (25).…”