An investigation into the health-related quality of life of refugees and asylum seekers in Britain and France.

This thesis is concerned with the health-related quality of life of two groups of refugees and asylum seekers from the Democratic Republic of the Congo, who are resident in Britain and France. Drawing on theories of health inequalities and psycho-social stress, the thesis argues that the health-related quality of life of refugees and asylum seekers is mediated by their immigration and citizenship status.
Introductory chapters set the scene for the study, giving consideration to patterns of immigration and the emergence of minority ethnic groups in Britain and France, thus setting the context for the arrival and reception of refugees and asylum seekers during the 1990s. Citizenship, health inequalities, and the existing knowledge concerning the health of refugees and asylum seekers are addressed.
Qualitative research, informed by phenomenology, is used to explore the health-related quality of life of these refugees and asylum seekers. The findings are presented and discussed in three chapters in the body of the thesis. Problems with psychological health dominate the findings; issues relating to physical health are presented largely within the context of seeking access to health care. A fourth chapter critically interprets the findings and locates them within wider literature.
The thesis concludes that the health-related quality of life of refugees and asylum seekers is affected by their immigration status and by their lack of citizenship in their host countries. In the absence of citizenship of either Britain or France, refugees and asylum seekers are located in hierarchical societies, characterized by civic stratification, which confers a different set of rights on citizens, refugees and asylum seekers. Asylum seekers have fewer rights than refugees, who, in turn, have fewer rights than citizens. This thesis suggests that these relative statuses contribute to psycho-social stress and thus the health-related quality of life of refugees and asylum seekers.

A Thesis submitted to Middlesex University in partial fulfilment of the requirements for the degree of Doctor of Philosophy.