Abstract
BackgroundHuman rights violations have adverse consequences for health. However, to date, there remains little empirical evidence documenting this association, beyond the obvious physical and psychological effects of torture. The primary aim of this study was to investigate whether Australian asylum policies and practices, which arguably violate human rights, are associated with adverse health outcomes.MethodsWe designed a mixed methods study to address the study aim. A cross-sectional survey was conducted with 71 Iraqi Temporary Protection Visa (TPV) refugees and 60 Iraqi Permanent Humanitarian Visa (PHV) refugees, residing in Melbourne, Australia. Prior to a recent policy amendment, TPV refugees were only given temporary residency status and had restricted access to a range of government funded benefits and services that permanent refugees are automatically entitled to. The quantitative results were triangulated with semi-structured interviews with TPV refugees and service providers. The main outcome measures were self-reported physical and psychological health. Standardised self-report instruments, validated in an Arabic population, were used to measure health and wellbeing outcomes.ResultsForty-six percent of TPV refugees compared with 25% of PHV refugees reported symptoms consistent with a diagnosis of clinical depression (p = 0.003). After controlling for the effects of age, gender and marital status, TPV status made a statistically significant contribution to psychological distress (B = 0.5, 95% CI 0.3 to 0.71, p ≤ 0.001) amongst Iraqi refugees. Qualitative data revealed that TPV refugees generally felt socially isolated and lacking in control over their life circumstances, because of their experiences in detention and on a temporary visa. This sense of powerlessness and, for some, an implicit awareness they were being denied basic human rights, culminated in a strong sense of injustice.ConclusionGovernment asylum policies and practices violating human rights norms are associated with demonstrable psychological health impacts. This link between policy, rights violations and health outcomes offers a framework for addressing the impact of socio-political structures on health.
Highlights
Human rights violations have adverse consequences for health
The results indicated a significant difference between the two visa categories in their experience of psychosocial stressors, with Temporary Protection Visa (TPV) refugees reporting, on average, less social support, more life constraints and higher state anger scores
Interviews with TPV refugees revealed that they felt socially isolated owing to policy restrictions on reuniting with family members, and the structural barriers that prevented them from fully participating in society
Summary
Human rights violations have adverse consequences for health. The primary aim of this study was to investigate whether Australian asylum policies and practices, which arguably violate human rights, are associated with adverse health outcomes. Perhaps most notable in the evolution of the health and human rights paradigm is the recognition that many human rights violations (HRVs) have adverse consequences for health. While the link between HRVs and health seems intuitive, beyond the obvious health effects of torture [3,4], the empirical assessment of the health impacts of HRVs is in its infancy [5]. More research is required to assess the broad health impact of HRVs and to identify the pathways by which violations become embodied as poor health outcomes
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