Food insecurity among migrants in higher-income countries is well documented, to the extent that immigration systems have latterly come to be understood as key drivers of the phenomenon(Reference Jolly, Singh and Lobo1). There are more than 120 million people forcibly displaced globally, and this is set to continue rising(2). While robust evidence on their plight is much needed, the growing suspicion and hostility towards forced migrants in public discourse constitutes a less-than-ideal environment for securing research funding and collecting data for both exploratory and surveillance purposes. Therefore, the drivers and experiences of food insecurity for forced migrants remain under researched(Reference Woods, Booth and Margerison3). The UK is a useful case study for examining this topic. It has a diverse population, varied geography and a contested immigration system that has been linked to poor diet quality(Reference Jolly and Thompson4).
Forced migrants typically undergo a process of assessment in the UK. Asylum seekers are those who have fled their home country and are seeking protection in another due to persecution or the threat of violence. The Home Office will judge their claim, which can take months or years. During this time, they do not have the same rights and freedoms as British citizens. Once an asylum claim is approved, the individual becomes a refugee, conferring significant rights and permission to stay in the country. Trafficked migrants are recruited or moved from one country to another for the purposes of exploitation by the use of threat, force, fraud or abuse of vulnerability. Trafficking is a hidden crime, and it is rarely obvious that individuals have been trafficked. They may live in the UK for extended periods before coming to the attention of the Home Office, if ever.
These categories are not discrete, and people may occupy some or all of them at various points during their migration. However, they are a useful starting point for examining the complexities of migrant food insecurity. Figure 1 (Reference Thompson, Hamilton and Dickinson5) depicts drivers and experiences of UK migrant food insecurity across rural and urban contexts and immigration statuses. The sections that follow expand on this to identify research priorities and, in doing so, we invite the public health nutrition research community to engage.
Infographic – ‘Drivers of migrant food poverty in the UK’, from New guide to raise awareness of food poverty among forced migrants https://arc-eoe.nihr.ac.uk/news-blogs/news-latest/new-guide-raise-awareness-food-poverty-among-forced-migrants (Reference Thompson, Hamilton and Dickinson5)
Figure 1. Long description
Infographic titled ‘UK Immigration System: A structural driver of food inequality’. The infographic is divided into three columns: Urban, Urban/Rural, and Rural. Each column is further divided into three rows labeled Trafficked, Asylum Seekers, and Permission to Stay. Each section contains text and images describing specific challenges faced by migrants in obtaining adequate food. The Urban column highlights issues such as exploitation in illegal work, poor-quality food in asylum hotels, and high living costs. The Urban/Rural column discusses trauma impacts, lack of access to public funds, and limited leave to remain. The Rural column mentions forced labor, lack of access to food outlets, and low-paid work without welfare support.
Trafficked migrants
Trafficked migrants are considered victims of modern slavery in the UK. Lacking legal documents to enter or stay in a country, they are not permitted to do paid work. They can be unwilling to present themselves to the authorities for fear of recriminations or removal. Therefore, their hardship and food insecurity remains hidden, and they are largely unable to access the support of charities like food banks. The level of trauma these migrants have experienced can impact upon their everyday functioning, making routine tasks such as sourcing and preparing food overwhelming(Reference Hamilton, Thompson and Wills6).
Trafficked migrants are often forced to work or engage in criminal behaviour. They can find themselves exploited as illegal labour within the UK food system and, perversely, unable to achieve an adequate diet. In rural areas, trafficked migrants risk forced labour in food production and agricultural settings(Reference Milbourne and Coulson7). Working long hours in remote areas and, for many, not being able to speak English limit capacity to undertake basic food provisioning(Reference Hamilton, Thompson and Wills6,Reference Milbourne and Coulson7) . In urban areas, illegal work in commercial kitchens or food delivery is more common. Long shifts, ready access and proximity to fast food, poor working conditions and little or no pay are all barriers to a healthy diet.
The hunger and dietary challenges of trafficked migrants are not well documented or understood. At the same time, trends in the food environments of higher-income countries, like the growth of food delivery apps, are underpinned by migrant labour, some of which is exploitative and even illegal. Sufficient attention has yet to be paid to these food system practices.
Asylum seekers
Asylum seekers are not allowed to claim mainstream welfare benefits in the UK and are usually prohibited from working under the no recourse to public funds policy. Those with no recourse to public funds are at a higher risk of experiencing food poverty and often rely on food banks and other charities. Donated food is largely inadequate for their needs, lacking in fresh produce, culturally inappropriate and unappealing to their children(Reference Thompson, Hamilton and Wills8). School can off-set some nutritional challenges because, with the exception of Northern Ireland, all children in Reception to Year 2 (four to seven-year-olds) in UK state funded schools receive free meals, regardless of immigration status. Beyond this age, children of asylum seekers who receive support under Section 95 are also entitled to free school meals(9).
The UK Home Office has a legal duty to provide accommodation and minimal financial support to destitute asylum seekers while their claim is being decided or during appeal processes. Insufficient bedspaces and backlogs have required greater use of contingency housing. In urban areas, this has predominantly been re-purposed hotels. ‘Asylum hotels’ usually provide all meals for residents and do not have any facilities in which they can store, prepare and eat their own food. There is very little research on asylum hotel food. What evidence there is identifies grave problems in some sites such as unsafe food, persistent hunger and inadequate provision for children(Reference Thompson, Naish and Brock10). Asylum seekers in urban areas also experience some of the same vulnerabilities as trafficked migrants to exploitation in food system illegal labour, particularly as food delivery drivers(Reference Sigona, Piemontese and Achi11).
Rural areas are increasingly being used for contingency accommodation for asylum seekers, including repurposed military facilities. Their remote locations can result in isolation and reduced access to charities and community facilities(12), thereby amplifying food insecurity. Plans by the UK government to end the use of asylum hotels and instead rely more on repurposed military facilities means that the food provision and resulting dietary challenges inherent to these sites need to be interrogated and addressed.
Refugees with permission to stay
An approved asylum claim means the applicant meets the legal definition of a refugee. At this point, migrants are normally granted ‘leave to remain’ (permission to stay) for a specific duration. They will still have no recourse to public funds status, meaning they are unable to access most social security benefits, but may be allowed to work and/or study. There is also a legal requirement for migrants to leave asylum accommodation to find and pay for somewhere else to live. They will not have been able to save money for rent or accumulated employment references because their former asylum seeker status prohibited work. As such, migrants newly gaining leave to remain can find themselves unemployed, homeless or working long hours at multiple jobs (some legal, some not) to avoid destitution and hunger(Reference Hamilton, Thompson and Wills6). Unfortunately, access to free school meals is more complicated for refugees than asylum seekers. They can only get free school meals, beyond primary school, if they meet standard benefit or income criteria. There is no automatic entitlement or enrolment for these children(9).
The cost of living is higher in urban areas, and refugees struggle to secure adequate housing, resulting in deprivation. Heavy reliance on charity food provision is a common coping strategy for new refugees(Reference Woods, Booth and Margerison3) but, at present, little is known about the impacts upon their dietary health. Research from the US indicates that settled adolescent refugees can experience a deterioration of the healthfulness of their diet over time(Reference Jones-Antwi, Owens and Hadley13)
In rural areas refugees experience difficulty accessing employment and can be trapped in low-paid, insecure jobs in shortage occupations such as social care or food processing(Reference Woods14). These jobs are typically insecure, perpetuating a cycle of (food) poverty and dependence on food aid. There is scarce research on rural food insecurity more broadly, and specifically on how refugees navigate food provisioning in these settings.
Conclusion and recommendations
UK immigration controls impose a particular experience of food insecurity on forced migrants, characterised by precarity and shaped by geographic context. These factors must be robustly investigated and monitored in order to inform interventions and facilitate international comparisons. The following steps outline an initial approach to addressing knowledges gaps.
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• Co-develop measurement tools and protocols to record characteristics and prevalence of food insecurity among forced migrants.
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• Conduct exploratory research to understand how and to what extent trafficked migrants experience food insecurity and how this intersects with modern slavery and food system exploitation.
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• Address the paucity of research on dietary health inequalities for forced migrants in rural areas.
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• Develop the empirical underpinnings of a model of institutional food insecurity to theorise the ways in which immigration systems can impose and perpetuate dietary health inequalities.
Fostering food security for people with refugee backgrounds has been shown to bolster efforts to settle successfully in new communities. A research agenda is needed to guide collaborative work creating interventions targeting cultural food security and autonomy among migrant groups(Reference Gingell, Adhikari and Eltahir15).
Acknowledgements
We thank our collaborators and colleagues with lived experience who gave feedback on the draft and the figure.
Authorship
C.T. formulated the original idea and drafted the paper, with interpretive input from all authors. All authors revised and refined the paper.
Financial support
CT and ROC are supported by the National Institute for Health and Care Research (NIHR) Applied Research Collaboration (ARC) East of England. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. Figure 1 was produced as part of a project funded through the University of Hertfordshire’s Impact Acceleration Account, supported by the Economic and Social Research Council (ESRC). Grant reference ES/X004309/1.
Competing of interests
None.
Ethical standards
Ethics approval not required.
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