Estimating the global burden of labour exploitation and its impact on health of migrants: a critical social epidemiological approach to inform policy

Project summary
Labour exploitation is an understudied structural determinant of health and migrants are at higher risk of exploitative employment terms and conditions. The aim of this research project is to generate critical evidence on the health impacts of labour exploitation in migrants to inform policy and practice. Based on the research gaps identified, the objectives are threefold:
1. From an epidemiological perspective, to estimate the global, regional and national burden of disease of labour exploitation among migrants;
2. From a methodological perspective, to critically adopt and adapt the global burden of disease approach in studying macrosocial determinants of health and to suggest methodological improvements; and
3. From a policy perspective, to propose key definitions for labour exploitation and to develop a multi-level causal framework elucidating how labour exploitation influences mortality and morbidity in migrants.

MRC skills
This PhD project will require advanced quantitative skills, particularly by applying innovative statistical methods to analyse large and diverse datasets, drawing on modelling tools that have been used to measure the global burden of disease, and applying these methods to estimate the burden of labour exploitation. It will also require the use of epidemiological tools and systematic review/meta-analysis methodology to estimate prevalence of morbidity and mortality in the under-researched population of migrant workers in precarious or low wage work or forced labour. This project will include an analysis of diverse datasets on morbidity/mortality and burden of labour migration and exploitation globally and identify its impact on health, drawing on, for example, Labour Force Surveys, Child Labour surveys and Forced Labour Surveys from the International Labour Organization, Human Trafficking Survivor data base from the International Organisation for Migration, and routine country surveillance data. It will consider the implications of findings for individual health and health systems responsiveness in migrant-receiving and migrant-sending countries. The project also requires expertise and training in the Global Burden of Diseases model, which uses a time-based measure of healthy years of life lost due either to premature mortality or years lived with a disability, weighted by the severity of that disability. In addition, it will adopt interdisciplinary approaches to examine the health and social needs of labour migrants and examine the clinical implications, including deaths disaggregated by migrant status and occupation. The project will also involve qualitative research (in-depth interview studies) and designing cross-sectional surveys to understand the migrant perspective and consider strategies to reduce exploitation and drive improvements in health, including innovative approaches to service delivery. Using findings from these mixed-methods, this project will propose definitions for key determinants of health and exploitation among labour migrants.