Visible, Included, Thriving: Advancing Occupational Health and Targeted Health Interventions for Migrant Workers (VITAL)

The health impact of hazardous work conditions, precarious employment terms, and healthcare exclusion on low-wage migrant workers – who are essential to the UK s economy and vital services – remains critically under-researched. Migrant workers are largely invisible in health metrics, absent from surveillance systems, and neglected in health interventions. Addressing these health equity gaps is a pressing challenge in the field of Work and Health and the central focus of this research. The proportion of migrant workers in the UK workforce has risen sharply, from 9% in 2004 to 21% in 2024. Low-wage migrant workers are disproportionately employed in night shifts, non-permanent jobs and gig work, and high-risk sectors including so-called 3D (dirty, dangerous, and degrading) jobs. They experience preventable workplace risks and everyday exploitation , which range from long, erratic working hours, unsafe conditions and unfair work terms, to severe abuses such as human trafficking and modern slavery. Our datasets on occupational health have found significantly higher injury rates among low-wage migrant workers than native counterparts in high-income countries, significantly higher risk of fatal occupation-related injuries among migrant workers in agriculture, construction, mining, and service industries (n=44,338 migrant worker deaths across 16 countries), and higher risks of work-related fatalities, musculoskeletal pain, stress, poor self-reported health, and injuries (ocular, falls, dislocations, assaults) (n=12,168 low-skilled migrants across 13 countries). Yet, studies on health service use show migrant workers are significantly less likely to use services than local workers. The health needs of migrant workers are often excluded from policy and intervention planning and budgeting, due, in part, to the absence of national health data and limited UK-based research on their health. Health data on migrants are missing from NHS systems, and occupational injury surveillance fails to adequately capture injuries and illnesses in low-wage sectors, especially among migrants in irregular jobs. Working in partnership with a diverse range of migrant workers (e.g., work sectors, legal status, nationalities), this project aims to improve data collection and identify entry points for innovative prevention and service interventions for migrant workers in the UK. Across 4 Work Packages, we will optimise the use of existing data sources to produce policy-ready evidence on the health and wellbeing of migrant workers, and assess scalable, replicable health interventions to be developed and tested in the UK. We will use this targeted evidence in Stage 2 to develop standardised, validated measures to assess labour conditions and worker health to guide migrant-inclusive health policies and services, and co-design and evaluate high-impact scalable interventions that enhance healthcare access and use by migrant workers. Our Consortium for Migrant Worker Health unites UK researchers, stakeholders, and migrant workers with international experts to leverage expertise to strengthen data collection and improve health outcomes for marginalised workers, aligning with key UK strategies to tackle health inequalities in marginalised populations.