The impact of precarious employment on the health and wellbeing of immigrants: a systematic review

Abstract

Abstract Background Migration and precarious employment are social determinants associated with adverse health outcomes. In the United Kingdom, migration policy and labour market characteristics mean that migrants are often engaged in precarious work. We synthesise evidence on the experiences of migrants and explore the effects of precarious employment on their health and wellbeing. Methods Electronic databases were searched for peer-reviewed qualitative studies describing the experiences of United Kingdom migrants in precarious employment. Title and abstracts were screened, followed by full text screening using pre-specified inclusion and exclusion criteria. Data on employment experiences and effects of working conditions on physical and mental health and perceived wellbeing were extracted. The Centre for Reviews and Dissemination (2009) framework was used to conduct a narrative synthesis. Results Out of 1577 unique citations, 5 met our inclusion criteria. All included studies reported negative outcomes on physical and mental health. 2 reported positive or negative outcomes for perceived wellbeing depending on pre-migration experience. Musculoskeletal pain, exhaustion, anxiety and depression were commonly reported effects of precarious employment. Communication difficulties and over qualification were identified as migrant specific factors influencing health outcomes. Conclusions Stress response theories and risk factors associated with occupational injury explain how employment specific factors influence health. Extrinsic factors such as immigration policies, pre-migration experience, responsibilities in home country and acculturation mediate precarious employment effect on health. Key messages Migrants feel isolated in precarious employment and are vulnerable to negative mental and physical health impacts. Broader migration related policies impact on experiences of employment and health.