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Cited by 64Migration, Health and TraumaMigration, Racism, and Human RightsMigration, Refugees, and Integration

The violence of uncertainty: Empirical evidence on how asylum waiting time undermines refugee health

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Phillimore, Jenny, Cheung, Sin Yi·2021·Social Science & Medicine
DOI 10.1016/j.socscimed.2021.114154
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Abstract

The idea of violent uncertainty was first introduced in the New England Journal of Medicine (Grace et al., 2018) making claims about the deleterious impacts of insecure immigration status on the health of migrants. Policies of uncertainty are said to directly and indirectly create harm by impacting on individual's health via detention and public degradation and undermining healthcare services. We offer original empirical evidence indicating an association with uncertainty, in the form of asylum waiting times, on refugees' self-reported health. We devise four hypotheses that: long waiting time for asylum decisions increases likelihood of self-reported health problems and the effect persists overtime, that female refugees report higher levels of health problems resulting from uncertainty and religion moderates the association between health and uncertainty. We use data from the UK longitudinal Survey of New Refugees wherein all new refugees were sent a baseline survey immediately after receiving refugee status and then follow-up surveys 21 months later. The findings show longer asylum waiting time is associated with poor health. Female refugees were more likely to report poor emotional and physical health. The negative effect of asylum waiting time on emotional health persists 21 months post settlement and is worse for women. The hypothesisabout the ameliorating effect of religion is only partially supported. Our findings supports existing theory and qualitative studies about the deleterious effects of using policies of waiting-related uncertainty for managing migration. Given the wide use of such policies in the Global North, our work is suggestive of likely generalisability. Thus, countries with large refugee populations might want to consider our findings when developing asylum policy which minimises impact on refugee health.

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  • Chronic uncertainty exerts a particularly heavy toll on people living under multiple strains and in precarious conditions, such as refugees and displaced persons, and on people living under continuous traumatic situations intensively covered by the media.

    “Chronic uncertainty exerts a particularly heavy toll on people living under multiple strains and in precarious conditions, such as refugees and displaced persons [51-53], and on people living under continuous traumatic situations intensively covered by the media, such as populations affected by Israeli-Arab conflicts or the war in Ukraine.”

    From Impact of Media-Induced Uncertainty on Mental Health: Narrative-Based Perspective. (2025) · cites this paper as [52]

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Research works printed but not linked: 2

  1. Rouxel, P., Chandola, T., 2018. What are the wider social determinants of refugee health and well- being? Some methodological considerations. Conference paper for Symposium on Refugees Settlement and Wellbeing over the Life Course. Brisbane: University of Queensland. May 21.
  2. Walsh, P. (2020) Asylum and refugee resettlement in the UK. Oxford: Migration Observatory.

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Authors
Phillimore, J., & Cheung, S. Y.
Affiliations
  • University of Birmingham (GB)
  • Cardiff University (GB)
Corresponding author
Phillimore, Jenny
ORCID
Venue
Social Science & Medicine
Publisher
Elsevier BV
Published
2021-08
Volume
282
Pages
114154
ISSN
0277-9536 (ISSN-L)
DOI
10.1016/j.socscimed.2021.114154
OpenAlex
W3173305156
Cited by
64
References
49
Citations by year
2026: 12 · 2025: 21 · 2024: 14 · 2023: 10 · 2022: 6 · 2021: 1
FWCI
5.29
Type
journal article
Language
en
Open access
Licence
Locations
  • Social Science & Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • ORCA Online Research @Cardiff (Cardiff University) (acceptedVersion)
  • University of Birmingham Research Portal (University of Birmingham) (submittedVersion, cc-by-nc-nd)
  • RePEc: Research Papers in Economics (submittedVersion)
  • ORCA Online Research @Cardiff (Cardiff University) (submittedVersion, cc-by-nc-nd)
  • SocArXiv (OSF Preprints) (submittedVersion)
  • SocArXiv (OSF Preprints) (submittedVersion, cc-by-nc-nd)
Funders
Nuffield Foundation
Topics
  • Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
  • Social Sciences › Health › Migration, Racism, and Human Rights
  • Social Sciences › Sociology and Political Science › Migration, Refugees, and Integration
Keywords
refugee health, self-reported health, emotional well-being, physical health, gender differences, asylum policy, refugee settlement
MeSH terms
Female, Humans, Refugees, Transients and Migrants, Violence, Waiting Lists, Uncertainty

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