A six-year descriptive analysis of hospitalisations for ambulatory care sensitive conditions among people born in refugee-source countries

Background: Hospitalisation for ambulatory care sensitive conditions (ACSHs) has become a recognised tool to measure access to primary care. Timely and effective outpatient care is highly relevant to refugee populations given the past exposure to torture and trauma, and poor access to adequate health care in their countries of origin and during flight. Little is known about ACSHs among resettled refugee populations. With the aim of examining the hypothesis that people from refugee backgrounds have higher ACSHs than people born in the country of hospitalisation, this study analysed a six-year state-wide hospital discharge dataset to estimate ACSH rates for residents born in refugee-source countries and compared them with the Australia-born population. Methods: Hospital discharge data between 1 July 1998 and 30 June 2004 from the Victorian Admitted Episodes Dataset were used to assess ACSH rates among residents born in eight refugee-source countries, and compare them with the Australia-born average. Rate ratios and 95% confidence levels were used to illustrate these comparisons. Four categories of ambulatory care sensitive conditions were measured: total, acute, chronic and vaccine-preventable. Country of birth was used as a proxy indicator of refugee status. Results: When compared with the Australia-born population, hospitalisations for total and acute ambulatory care sensitive conditions were lower among refugee-born persons over the six-year period. Chronic and vaccine-preventable ACSHs were largely similar between the two population groups. Conclusion: Contrary to our hypothesis, preventable hospitalisation rates among people born in refugee-source countries were no higher than Australia-born population averages. More research is needed to elucidate whether low rates of preventable hospitalisation indicate better health status, appropriate health habits, timely and effective care-seeking behaviour and outpatient care, or overall low levels of health care-seeking due to other more pressing needs during the initial period of resettlement. It is important to unpack dimensions of health status and health care access in refugee populations through ad-hoc surveys as the refugee population is not a homogenous group despite sharing a common experience of forced displacement and violence-related trauma

New Middle-Class Labor Migrants

Migration researchers have tended to focus on social extremes: either highly skilled elites, on the one hand, or low-wage workers on the other. Less attention has been directed toward “ordinary” middle-class professional movers, and there have been no reviews of this literature to date. The chapter addresses this gap and identifies five important themes to guide future class-orientated migration research. First, the complex relationship between migration, social mobility, place, and middle-class membership is examined. Second, age is shown to be an important consideration in middle-class migration decision-making. Third, the cultural versus economic basis of the mobile middle-class is explored, and the role of lifestyle factors in shaping migration is critically examined. Fourth, middle-class migration decisions are connected to gendered household strategies, with the preponderance of dual-career couples now taking migration decision-making well beyond the individual career path. Finally, the social and communal emplacement of middle-class migrants is considered as an important but neglected dimension of research. Overall, it is clear that the class-based analysis of migration is an important yet neglected field of study, and this is especially true for middle-class movers

Skilled refugees, employment and social inclusion: A Perth case study of three communities

The social inclusion of refugees in their host country is largely determined by their success in the labour market, and this affects many other aspects of life including social networks, income and general wellbeing. Using data from an ARC-funded study of the effects of 'visible difference' on refugee employment, this paper explores several dimensions of disadvantage that refugees in Western Australia face, and their impact on social inclusion. Five specific issues are discussed: employment outcomes; refugees in the secondary labour market; employers' explanations for inequitable outcomes and discriminatory practices in recruitment processes; perceptions of employment assistance services; and the effects of these phenomena on refugees' overall life satisfaction. Our data show a massive loss of occupational status among refugees, which is not only disadvantaging for the refugees but is also an economic and social loss to the Australian community. Data come from a survey of 150 refugees from three broad groups: ex-Yugoslav, Middle Eastern and African, as well as 40 interviews with employers and recruitment agents, four focus groups and nine follow up interviews with key informants

Refugees and employment: The effect of visible difference on discrimination

This is the final report of the sociological research project Refugees and employment: the effect of visible difference on discrimination funded by the Australian Research Council’s Discovery Project scheme. Although this scheme predominantly funds ‘fundamental’, theoretically-oriented research, the current project lends itself to policy applications; hence this report seeks not only to communicate the findings, but to address a number of policy implications in the areas of refugee resettlement, qualification and skills recognition, employment assistance for culturally and linguistically diverse migrants and especially refugees, and equal opportunity and anti-discrimination. We are keen to communicate the findings to policymakers and service providers through this report, rather than solely addressing academic audiences. We would appreciate feedback on this report and are enthusiastic to establish research and other links with government and non-governmental agencies in the area of migrant settlement and employment, equal opportunity and anti-discrimination. The project was based at Murdoch University and ran for three years (2004, 2005, 2006). The chief investigators were Dr Val Colic-Peisker and Dr Farida Tilbury from Murdoch University and Dr Nonja Peters from Curtin University

They're all cleaning: recent refugees in the secondary labour market

This paper draws from a collaborative, ARC-funded project titled 'Refugees and employment: the influence of visible difference on discrimination' (2004-2006), focused on three refugee groups (ex-Yugoslavs, black Africans and people from the Middle East) in Western Australia. Our research shows that the recent refugee arrivals are concentrated in labour market niches such as cleaning services, aged care, meat processing, taxidriving and security. These employment niches are situated in the 'secondary labour market' comprising low-status and low-paid jobs that locals avoid or shun altogether. This article identifies several interrelated mechanisms through which the recent Australian refugee intake is relegated to these jobs: non-recognition of qualifications as a systemic barrier, 'ethnic-path integration' and the lack of mainstream social networks that could assist the job search, discrimination on the basis of race and cultural difference by employers, and the recent government policy of 'regional sponsored migration scheme' through which the governments tries to fill (low-skilled) labour shortages in depopulating regional areas. Our data show massive loss of occupational status among skilled and highly skilled refugees

Human capital, acculturation and social identity: Bosnian refugees in Australia

This article explores the processes of acculturation and identity among refugees from Bosnia and Herzegovina who resettled in the Australian cities of Perth and Sydney during the 1990s. We start from the idea that refugees, through the process of forced migration, lose aspects of their identities that were embedded in their former communities, jobs, skills, language, and culture. Upon arrival in a new society, they seek to reconstruct their identity, and we argue that this happens in the context of the process of acculturation. We use two social psychological perspectives, social identity theory and acculturation theory, and the sociological theory of the migration of human capital, to examine our data collected by qualitative research methods from refugees and Australian professionals who work in the government-funded refugee resettlement programme. Our data highlight the loss of identity experienced in forced migration, difficulties in refugee acculturation and identity reconstruction, and collective and individual strategies in acculturation and identity adaptation. We see our perspective as essentially interdisciplinary, and take an interactional view of the acculturation and identity processes, as the characteristics of both the host society and the immigrants affect them

Free floating in the cosmopolis? exploring the identity-belonging of transnational knowledge workers

In this article I explore what I call the identity-belonging of transnational knowledge workers, a diverse group of serially migrating career professionals who have spent extended periods of time in at least three countries, usually following career opportunities. Unlike most recent writing on transnationalism, which focuses on enduring connections of migrants with their home countries/places, here I explore a transnationalism that may transcend the national, and generally the territorial, principle, with repercussions for identity-belonging. In this context, how transnational knowledge workers position themselves towards belonging to a nation and towards the idea of cosmopolitanism is of particular interest. From data collected through in-depth interviews in Australia and Indonesia, I conclude that their globally recognized profession forms the central axis of their identity-belonging, alongside a weak identification with their nation of origin. The feeling of belonging to and identifying with particular locales and local communities was articulated flexibly and instrumentally in association with professional and wider social networks, while no primordial territorial attachments could be identifie

'At least you're the right colour': Identity and social inclusion of Bosnian refugees in Australia

This paper explores the Australian resettlement of the largest recent refugee group, Bosmans. It is argued that Bosnians (and other ex-Yugoslavs) were Australia's preferred humanitarian immigrants during the 1990s because of their European background (based on social-cohesion and 'resettlement-potential' arguments) and because of the presence of ex-Yugoslav communities in Australia which were expected to support newly arrived refugees during their early resettlement (the 'community argument'). The 'whiteness'/'Europeanness' of Bosnians enabled them to remain largely 'invisible' in the country they perceived as 'white Australia' and to initially claim an 'insider status'. For many people, however, this self-inclusion is thwarted in the second stage of resettlement when they are expected to find jobs and 'acculturate', as the language barrier and their non-English-speaking background become a basis of difference and potential exclusion. Their economic and social inclusion thus appears to be determined by factors beyond visibility and remains limited almost a decade after the largest wave of Bosnians arrived in Australia