Refugees, asylum seekers and migrants in the UK face systematically worse health outcomes than the general population, driven not just by limited healthcare access but by a cascade of linked disadvantages—poor housing, insecure employment, language barriers, discrimination, and forced moves. This research aims to build a practical framework that helps local health systems (Integrated Care Systems) tap into existing community strengths—such as local charities, volunteer networks, and cultural groups—rather than relying solely on stretched NHS services. If successful, the project would give health commissioners and frontline practitioners a replicable, evidence-based model for designing services that are cheaper, more accessible, and easier to scale across different regions. The work is interdisciplinary, bringing together academics, policymakers, community developers, healthcare staff, and creative practitioners to co-create solutions directly with affected communities. While the immediate focus is on refugee and migrant health, the framework is designed to be transferable to other populations experiencing multiple disadvantage.
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Refugees, asylum seekers and migrants (R/AS/Ms) are varyingly yet systematically disadvantaged (EHRC, 2016) throughout their migration and resettlement journeys, as well as (typically) across the post-migration life-course (Allsopp, Sigona and Phillimore, 2014; BMA, 2021; Kemmak, Nargesi and Saniee, 2021). Inequitable access to health-care (physical and mental) and the ability to meaningfully access NHS/integrated care services, whilst fundamental to counteracting health disadvantage, is but one element in relation to improving wellbeing outcomes for these populations. Poor health experienced by the above groups result from inequitable access to services and opportunities across the social determinants of health (SDOH) including: language barriers, accommodation, employment, education, frequent (often enforced) movement, poverty, and discrimination (Castañeda et al., 2015; Davies, 2006; Marmot et al., 2020). So deep are these exclusions that experience of multiple disadvantage is common, and has been found to persist across the life-course, worsening exponentially for some individuals at particular life-stages, or resulting from possession of 'protected characteristics' (Aldridge et al., 2018; Borhade and Dey, 2018; Dagilyte et al., 2022; The Migration Observatory, 2020) Against this backdrop, our innovative co-created interdisciplinary research proposal which draws together expertise from a broad range of stakeholders from academia, policy professions, community development, healthcare (front-line practitioners, public health commissioners and Integrated Care Systems [ICS]), statutory and local government sectors, civil society agencies and creatives; has been designed. The key research aim (framed through understanding the experiences of R/AS/M migrant communities in relation to how diverse SDOHs impact wellbeing, and which by extension is transferable to wider populations) is: to generate an evidence-based conceptual framework for transdisciplinary interventions in health care that allow community assets to be efficiently integrated; in turn supporting cost-efficient, accessible, scalable services, delivered locally and regionally by ICSs and their key partners.
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