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Measuring the health impact of human rights violations related to Australian asylum policies and practices: a mixed methods study

Johnston, Vanessa, Allotey, Pascale, Mulholland, E. Kim and Markovic, Milica (2009). Measuring the health impact of human rights violations related to Australian asylum policies and practices: a mixed methods study. BMC International Health and Human Rights,9(1):1-12.

Document type: Journal Article
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Title Measuring the health impact of human rights violations related to Australian asylum policies and practices: a mixed methods study
Author Johnston, Vanessa
Allotey, Pascale
Mulholland, E. Kim
Markovic, Milica
Journal Name BMC International Health and Human Rights
Publication Date 2009
Volume Number 9
Issue Number 1
ISSN 1472-698X   (check CDU catalogue open catalogue search in new window)
Start Page 1
End Page 12
Total Pages 12
Place of Publication London, U.K.
Publisher BioMed Central
HERDC Category C1 - Journal Article (DEST)
Abstract Background
Human 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.

Methods
We 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.

Results
Forty-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.

Conclusion
Government 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.
Keywords health impact
human rights violations
Australia
asylum policies
asylum practices
DOI http://dx.doi.org/10.1186/1472-698X-9-1   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)


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