Introduction

Siobhan Farmer's introduction to the report

I start this year’s report with a question for all who read it: can you imagine what it would be like to feel so unsafe that you had to leave your home? For this is the reality for the thousands of refugees and asylum seekers who make this incredibly difficult decision each year. Conflict and persecution are the reasons that so many people are forced to leave their family, friends, livelihoods and everything they know and love in their home country. Their journey to find somewhere where they might be welcomed and be supported to feel safe is often traumatic, sometimes with poor sanitation and the risk of abuse. Then, when they arrive in a country that is offering sanctuary, they may still experience uncertainty, social exclusion and stigma.

The World Health Organisation describes migration as a ‘wider determinant’ of health, reflecting the impact that displacement has on our health and emotional wellbeing. Refugees and asylum seekers are recognised as a particularly vulnerable group of migrants, due to their experiences before, during or after migration. ’Wider determinants’ (or ‘building blocks’) of health, recognise the environmental and social factors which impact on our health and wellbeing, such as our living conditions and housing, and our access to employment and education. The report looks at the health and wellbeing of refugees and asylum seekers through this ‘wider determinants’ lens.

In addition, this year’s report will focus on the health inequalities faced by refugees and asylum seekers. Health inequalities refer to avoidable and preventable differences in health between different groups of people, and can be reflected in someone’s health outcomes, such as their risk of disease, their experience of accessing healthcare, as well as their living and working conditions.

Addressing inequalities requires a co-ordinated approach and the report describes the role which local authorities and public bodies play, alongside the NHS, other local services and, crucially, local communities, in collectively supporting refugees and asylum seekers in the county.

The report also reflects on the importance of language and the impact of the words and phrases we use to describe people’s situation. Language and terminology can be stigmatising and ‘othering’; implying that someone is different in some way. We have sought to use neutral and inclusive terms and keep the human at the centre, but we recognise that we may not always get it right and we will continue to listen and learn.

I am also delighted that we have included a reading and watching list for the first time in one of the Gloucestershire reports. I encourage you to dip into this and read through these stories of what that experience of being forced to leave your home and your life as you know it might feel like.

Finally, in producing this report, I wanted to ensure we gave a voice to individuals with ‘lived experience’. The report includes a series of videos and stories featuring both refugees and asylum seekers who have settled in our county, and those groups and organisations who have supported them. I hope that you will explore these and feel as moved and inspired as I was when I watched them. I would like to offer my sincere thanks to everyone who took part in sharing their experiences. Without them, this report would not have been possible. Together, we can continue to build an even more inclusive, welcoming and supportive community across Gloucestershire, offering sanctuary and safety for people for many years to come.