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

项目摘要劳动剥削是健康的结构性决定因素，研究不足，移徙者受到剥削性就业条款和条件的风险更高。这一研究项目的目的是为移民劳动剥削对健康的影响提供关键证据，为政策和实践提供信息。根据所确定的研究差距，目标有三个方面：1。1 .从流行病学角度估计移徙者劳动剥削造成的全球、区域和国家疾病负担；从方法学角度，在研究健康的宏观社会决定因素时严格采用和调整全球疾病负担方法，并提出改进方法学的建议；说谎。从政策角度，提出劳动剥削的关键定义，并制定一个多层次的因果框架，阐明劳动剥削如何影响移徙者的死亡率和发病率。这个博士项目将需要先进的定量技能，特别是应用创新的统计方法来分析大型和多样化的数据集，利用已用于衡量全球疾病负担的建模工具，并应用这些方法来估计劳动剥削的负担。它还需要使用流行病学工具和系统审查/荟萃分析方法来估计未得到充分研究的从事不稳定或低工资工作或强迫劳动的移徙工人人口的发病率和死亡率。该项目将包括分析关于全球劳动力移徙和剥削的发病率/死亡率和负担的各种数据集，并确定其对健康的影响，例如利用国际劳工组织的劳动力调查、童工调查和强迫劳动调查、国际移徙组织的人口贩运幸存者数据库以及常规国家监测数据。它将审议调查结果对移徙接收国和移徙派遣国个人卫生和卫生系统应对能力的影响。该项目还需要全球疾病负担模型方面的专门知识和培训，该模型使用一种基于时间的衡量标准，衡量因过早死亡或残疾而损失的健康寿命年数，并按残疾的严重程度加权。此外，它将采取跨学科的方法，审查移徙劳工的健康和社会需要，并审查临床影响，包括按移徙者身份和职业分类的死亡情况。该项目还将涉及定性研究（深度访谈研究）和设计横断面调查，以了解移徙者的观点，并考虑减少剥削和推动健康改善的战略，包括提供服务的创新方法。利用这些混合方法得出的结论，该项目将提出对移徙劳工健康和受剥削的关键决定因素的定义。

Project summaryLabour 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; and3. 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.