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

Jenny Phillimore, Sin Yi Cheung

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Grace and colleagues (2018) introduced the idea of violent uncertainty 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 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 with hypotheses about the ameliorating effect of religion only partially supported. Our findings supports existing theory and findings from 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.
Original languageEnglish
Article number114154
JournalSocial Science and Medicine
Early online date18 Jun 2021
Publication statusE-pub ahead of print - 18 Jun 2021


  • asylum policy
  • asylum seeker waiting time
  • gender
  • refugee emotional health
  • refugee integration
  • refugee physical health
  • religion
  • violent uncertainty


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