FXB Center Reports and Policy Briefs

Confronting Major and Everyday Discrimination. Romani Experiences in Canada’s Greater Toronto-Hamilton Area.

Study Contributors: FXB Center for Health and Human Rights: Stephanie Martinez-Fernandez, Edita Rigova, Margareta Matache, Aqil Arif Merchant, Keisha Bush, Jacqueline Bhabha. Canadian Romani Alliance: Gina Csanyi-Robah (Executive Director), Shayna Plaut (Board Member) 

The François-Xavier Bagnoud (FXB) Center for Health and Human Rights at Harvard University and the Canadian Romani Alliance published a groundbreaking study measuring both major and everyday discrimination experienced by Romani individuals in the Greater Toronto-Hamilton area (GTHA) in Canada.

This study examined previously uncounted experiences of everyday discrimination – daily experiences of ethno-racial insults, jokes, stereotype-based questioning, passive or active distancing, and incidents where Romani people are misunderstood, underestimated, overlooked, or ignored. The research team interviewed 87 Canadians (64 Romani adults and 23 non-Romani adults), with the majority of Roma being emigrants or refugees from Central and Eastern Europe.

Key findings reveal widespread incidents of everyday discrimination. Almost all of the Romani Canadians who were interviewed experienced one or more incidents of everyday discrimination, particularly: identity misconceptions, ethnoracial insults or jokes, distancing, stereotype-based questioning.  

The research team also examined major discrimination, including the denial of resources, differential treatment, and ethno-racial profiling in institutional and social settings; more than two-thirds of Romani respondents reported personal experiences of major discrimination. Denial of housing was the most widely reported experience of major discrimination: approximately half of respondents who were denied rental (8 out of 15) attributed the denial to their Hungarian Roma origins.

The study’s findings also indicate a partial level of awareness of Romani identity in GTHA and a broader societally ingrained portrayal of Europeans as phenotypically white. In this context, physical and cultural traits, as well as racializing tropes, have been used to identify/misidentify, classify, or misrepresent Romani people. Importantly, most non-Romani interviewed by the research team did not know much about Romani history, culture, and practices.

The report reveals that the views held by non-Romani Canadian respondents towards Romani, both as individuals and as a group, align with how Romani individuals believe they are being perceived.

Gina Csanyi-Robah, Executive Director of the Canadian Romani Alliance and the study’s field research director, concludes that the dearth of scholarly work on and with Romani Canadians contributes to a vicious cycle that makes it difficult to fully and clearly understand Romani people’s place within societal structures such as education, employment, or healthcare and to analyze how their social and political exclusion is being perpetuated by dominant actors.

Ensuring the Highest Attainable Standard of Health for Children Deprived of their Liberty 

Study Contributors: Kelly, T., Campbell A., Young, J., McLeod, K., Bhabha, J., Pearce, L., Southalan, L., Borschmann, R., Ratnam Raman, V., Kinner, S., 2024. Murdoch Children’s Research Institute, Justice Health Group at Curtin University, François-Xavier Bagnoud (FXB) Center for Health and Human Rights at Harvard University.

A team of researchers from the Murdoch Children’s Research Institute (MCRI) in Melbourne, Australia, the Justice Health Group at Curtin University, and the François-Xavier Bagnoud (FXB) Center for Health and Human Rights at Harvard University collaborated on identifying, critiquing, and synthesizing current standards for healthcare for children deprived of their liberty in order to shine a light on one of the most neglected areas in the protection of children. 

Children who experience deprivation of liberty are distinguished by complex health problems that typically precede and contribute to their detention, and that may be further compounded by experiences of detention, particularly when the quality of healthcare in detention is suboptimal. With more than seven million children experiencing deprivation of liberty globally each year, the health of these children is important to global health and to efforts to reduce health inequalities. Despite this, remarkably little is known about either the health status of children deprived of liberty, or the health services available to them in these settings. Similarly, very little is known about children’s health outcomes after being deprived of liberty. The available evidence suggests that health services in places of detention are often inadequate, although the bulk of the evidence comes from a handful of high income, mostly Western countries. 

The aim of this report is to identify gaps in the system and assist the United Nations Task Force (UNTF) in its efforts to support the implementation of the UN Convention on the Rights of the Child (UNCRC) and ensure that all children, including those deprived of their liberty in all settings, achieve the highest attainable standard of health. Setting and implementing minimum standards for healthcare in detention can help to drive improvements in the quality of care, and thereby improve health outcomes for children who experience deprivation of liberty. Read the report.

Building Inclusion, Sustaining Solidarity Towards Migrants in Frontline Local Communities: The case of Poland during the Ukrainian refugee crisis 

Study Contributors: Digidiki, V., Bhabha, J., Markowska-Manista, U. & Dobkowska, J., 2024. FXB Center for Health and Human Rights at Harvard University, Boston, USA.

The availability and persistence of local community solidarity are crucial resources for distress migrants, as they cope with the consequences of ruptured lives. However, this solidarity is neither inherent nor permanent. It is rather a fragile and finite resource that can erode if not properly sustained and reinforced. Anecdotal data from the field shows that when states fail to accompany and support their citizens in their spontaneous expression of solidarity toward distress migrants, solidarity rapidly dissipates and is replaced by fatigue, resentment and eventually outright hostility.

This preliminary empirical study’s goals are to document the factors that generate local solidarity and examine whether generous, well implemented state policies fueled by state actors’ preemptive attention to predictable needs can protect local communities from fatigue, and instead sustain solidarity and social inclusion of distress migrants over time.

To achieve this goal, the FXB Center conducted exploratory, qualitative research in 5 frontline local communities in Poland. Poland was chosen because of its state-driven vigorous and welcoming response to the very sizeable numbers of fleeing Ukrainians crossing into Poland after the Russian invasion in February, 2022. The dramatic asymmetry in the Polish response to Ukrainians arriving at Poland’s eastern border (with Ukraine) compared to all other recent refugee arrivals provides an additional lens for examining the impact of the different types of state engagement on local responses to distress migrants, responses that range from solidarity to virulent anti-migrant sentiment. Read the report.

Child Migrants in Family Immigration Detention in the US: An Examination of Current Pediatric Care Standards and Practices

Study Contributors: Sridhar, S., Digidiki, V., Kunichoff D., Bhabha, J., Sullivan, M., Gartland, MG., 2024. FXB Center for Health and Human Rights at Harvard University, Boston and MGH Asylum Clinic at the Center for Global Health.

Between 2017 and 2021, more than half a million children were detained in immigration detention, with more than 200,000 of these children being held for more than 72 hours. Violating basic children’s rights, the US continues to detain children for lengthy and arbitrary periods of time, placing them in detention facilities unsuitable for child health and safety. Furthermore, reporting and oversight from governmental and non-governmental agencies has documented devastatingly harmful conditions for children in family immigration detention including separation from parents, the use of prison facilities inappropriate for housing children, and limited access to qualified medical professionals leading to grave physical and mental health consequences. Medical studies have documented long-term consequences of detention on children in the US and around the world; however, to our knowledge there are no systematic studies describing the quality of pediatric health care based on primary medical documentation within the US family immigration detention system.

The Refugee and Immigrant Center for Education and Legal Services (RAICES), the Child Health Immigration Research Team based out of the Massachusetts General Hospital (MGH) Asylum Clinic at the MGH Center for Global Health, and the FXB Center for Health and Human Rights at Harvard University, collaborated to analyze the medical records of 165 children, between 6 months and 18 years old, detained at Karnes County Family Residential Center (KCFRC) ​​between June 2018 and October 2020.

Broadly, we found that existing health issues and care needs relating to physical and mental health were under-identified due to poor screening and minimal documentation of medical care, resulting in fragmentated and inadequate medical care. During prolonged detention the children in the study had limited access to basic healthcare, including key screenings and management of acute medical and mental health issues. Read the report.

From Evidence to Action: Twenty years of IOM child trafficking data to inform policy and programming

Study Contributors: Digidiki, V., Bhabha J., Connors K., Cook H., Galez-Davis C., Hansen C., Lane M., Laursen S., and Wong L., 2023. FXB Center for Health and Human Rights at Harvard University, Boston and International Organization for Migration (IOM), Geneva.

In July 2023, the International Organization for Migration (IOM) and François-Xavier Bagnoud Center for Health and Human Rights at Harvard University (FXB) published “From Evidence to Action: Twenty years of IOM child trafficking data to inform policy and programming.”

This report, a first of its kind, is based on analysis of extensive, globally sourced data, using the IOM Victims of Trafficking Database (VoTD), the largest available international database of individual victims of trafficking which contains primary data collected from approximately 69,000 victims of human trafficking of 156 nationalities, trafficked in 186 countries, who registered with IOM in 113 countries where IOM operates.

The study assessed the factors that drive vulnerability to trafficking, and revealed trends for the trafficking were mostly gendered, informed by education and income levels of the victims (and their families). For instance, boys were almost twice as likely to be trafficked as children than girls and had 39 per cent less likelihood of being trafficked internationally than domestically, as compared to girls. Victims with little or no education were more than 20 times more likely to be trafficked than victims who had attended high school while children from low-income countries were five times more likely to be trafficked as a child (rather than as an adult) when compared to victims from high-income countries. Read the report.

The Roma Holocaust/Roma Genocide in Southeastern Europe Report

Study Contributors: Margareta Matache, Gabriela Ghindea, Matei Demetrescu, Bogdan Chiriac, Mirko Đuković, Ram Hadroj, Hikmet Karčić, Eleni Argiro Kouki, Vjollca Krasniqi, Hristo Kyuchukov, David Dragoljub Orlović, Milovan Pisarri, Deniz Selmani, Alenka Janko Spreizer, and Serioja Bocsok

In June 2022, the Auschwitz Institute for the Prevention of Genocide and Mass Atrocities and the Roma Program at the François Xavier Bagnoud Center for Health and Human Rights published “The Roma Holocaust/Roma Genocide in Southeastern Europe,” which provides synoptic knowledge that can be used to understand the place of Southeast Europe Roma in the Holocaust and WWII history, to examine practices of acknowledgment, memorialization, and commemoration, and to identify patterns of Roma Holocaust/Roma Genocide denial and distortion in eleven Southeast Europe countries: Albania, Bosnia and Herzegovina, Bulgaria, Croatia, Greece, Kosovo, Montenegro, North Macedonia, Romania, Serbia, and Slovenia. Read the report.

Making the Public Health Case for Reparations: Landscape Report

In February 2022, the FXB Center released “Making the Public Health Case for Reparations: Landscape Report,” a first-of-its-kind report on reparations for Black Americans. The report considers whether longstanding racial health inequities could be mitigated by reparations efforts with the goal of engaging more health scholars in this conversation. Read the report.

Frontier Dialogue Consultations on Addressing Structural, Racial and Ethnicity-Based Discrimination

Frontier Dialogue consultations were led by WHO and UNESCO with support by OHCHR, IOM, UNDCO & UNDESA, under the umbrella of the UNSDG Task Team on Leaving No One Behind, Human Rights and the Normative Agenda, October 2020 to February 2021. With oversight from and co-authorship by a dedicated project steering group, this report was commissioned to the François-Xavier Bagnoud Center for Health and Human Rights at Harvard University. The objective of this report is to provide United Nations country and humanitarian teams with a package of interventions, for adaptation to specific country contexts, to support rebuilding from the COVID-19 tragedy in a way that results in more just, equal and resilient societies.

See Migration Like Water: An Analysis of IOM Flow Monitoring Survey Data on Migration Flows in West and Central Africa

Vasileia Digidiki, Jacqueline Bhabha, Abhishek Bhatia, Samuel Peisch and the International Organization for Migration: Verena Sattler, Benedetta Cordaro, Harry Cook

This FXB Center and International Organization for Migration (IOM) report analyzes intersecting aspects of migrant vulnerability across the most popular West and Central African migration routes – examining risk and protective factors at the individual, household, community, and structural level – and provides recommendations to protect migrants. Watch the FXB Center’s Professor Jacqueline Bhabha and Dr. Vasileia Digidiki discuss the report’s findings with IOM researchers here, and read the report in English and French.

From the War on Drugs to Harm Reduction: Imagining a Just Response to the Overdose Crisis

In Spring 2020, the FXB Center for Health and Human Rights at Harvard University, Doris Duke Charitable Foundation, First Focus on Children, and Open Society Foundations convened a group of experts in public health, harm reduction, drug policy, and child welfare. The experts shared ideas on how to direct the opioid litigation settlement funds toward structural and policy reform that advances public health and health equity. “From the War on Drugs to Harm Reduction: Imagining a Just Response to the Overdose Crisis,” released December 16, 2020, reflects the views of these leading experts and contains specific recommendations for policy makers and advocates. Read the report here and view the infographic.

Romani Realities in the United States: Breaking the Silence, Challenging the Stereotypes

Margareta Matache, Jacqueline Bhabha, Ian Alley, Murphy Barney, Samuel Francis Peisch, Veronica Lewin and Voice of Roma: Carol Silverman, Kristin Day

This FXB Center for Health and Human Rights at Harvard University report explores the social and economic conditions of Romani people in the United States. The research project was undertaken to improve the understanding of Romani Americans and generate an empirical base to challenge widely inaccurate characterizations relating to them. The FXB Center for Health and Human Rights at Harvard and Voice of Roma collaborated on this research project. Read the report here and view the infographic.

Recent Working Papers

Politicians, power, and the people’s health: US elections and state health outcomes, 2012-2024, HCPDS Working Paper Volume 24, Number 1, September 12, 2024

Nancy Krieger, Soroush Moallef, Ruchita Balasubramanian, Tori L. Cowger, Alecia J. McGregor, Mary T. Bassett (Co-Authors)

FXB Short Papers

Reflections on the current war in Palestine (as of November 12, 2023)

Jennifer Leaning, MD, SMH, Senior Research Fellow, Harvard FXB Center for Health and Human Rights, Harvard University; Professor of Health and Human Rights, retired, Harvard School of Public Health; former Director of the Harvard FXB Center; and former Associate Professor of Emergency Medicine, Harvard Medical School.

FXB Center Newsletters

June 2024 FXB Newsletter

Our June 2024 newsletter marked the end of the 2023-2024 academic year with reflections by FXB Director, Mary Bassett, MD, MPH, and Director of Research, Jacqueline Bhabha, JD, MSc. This newsletter serves as an overview of recent FXB activity, including three newly-published reports, and includes links to virtual events since December 2023 as well as an announcement regarding the Health and Human Rights Journal’s June 2024 issue which commemorates the Journal’s 30th anniversary. Read it here and sign up to subscribe here.

More newsletters and reports can be found below in the FXB Center Publication Archives.

FXB Center Publication Archives

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