Social and mental health risks faced by undocumented migrants during the COVID-19 pandemic: Evidence from three surveys in France

BackgroundThe often-precarious life circumstances of undocumented migrants are likely to heighten the detrimental impact of the COVID-19 pandemic on their lives. Given the paucity of research exploring how undocumented migrants are affected by the COVID-19 pandemic, we set out to explore the association between being an undocumented migrant and a range of social and mental health measures. MethodsOur study draws on three complementary surveys conducted among migrants in France between April 1st and June 7th 2020 (APART TOGETHER, MAKASI, ECHO; n = 716). We tested associations between eight outcome measures, covering health literacy, prevention behaviours, perceptions of government responses, livelihoods and mental health (PHQ-9 score), and the participants legal status as either undocumented or documented. We modelled the probability of food insecurity increase, job loss, depression, and responses to SARS-COV-2 symptoms with logistic regression models, adjusted for age, gender and legal status. ResultsUndocumented migrants had a higher probability of experiencing food insecurity increase (aORs=10.40 [3.59, 30.16], and 2.19 [1.39, 3.50] in APART TOGETHER and ECHO), a higher probability of depression (aOR=2.65 [1.01, 6.97] in MAKASI). In all three surveys, undocumented migrants were more likely to lose their job (aORs=6.51 [1.18, 36.00], 8.36 [1.08, 64.70] and 3.96 [1.79, 9.16] in APART TOGETHER, MAKASI and ECHO respectively). ConclusionOur results suggest that the lives of undocumented migrants have been dramatically worsened by the COVID-19 pandemic, exposing and amplifying the inequalities facing this group. There is an urgent need for action to address these inequalities. O_TEXTBOXHighlights O_LIUndocumented migrants in Europe are often living in difficult socioeconomic circumstances and experience important barriers in access to healthcare C_LIO_LIUndocumented migrants are a hard-to-reach population and may be not included in surveys that explore the social and sanitary consequences of the COVID-19 pandemic C_LIO_LITo date there is scarce quantitative evidence on the social and mental health risk among undocumented migrants during the COVID-19 pandemic C_LIO_LIOur study shows that in France, undocumented migrants had a higher probability of losing their job, experiencing food insecurity increase and depression during the first wave of the Covid-19 pandemic (March-May 2020) than migrants with legal resident permit. C_LIO_LIResults on COVID-19-prevention knowledge are ambivalent and show area for improvement C_LI C_TEXTBOX