Sociological Perspectives of Migrant Health Disparities and Access to Healthcare Services during and beyond the COVID-19 Pandemic: Voices of Immigrant and Refugee Women in Greece

Published: Jan 2, 2023
Sociology of Health Healthcare Access Women Refugees Migration Integration
Theodoros Fouskas

As the COVID-19 pandemic, as grew into a global health crisis, it created perilous and uncertain situations for vulnerable groups such as migrants, asylum seekers and refugees in the context of measures restricting mobility, social, economic, and educational life. This article, using the fields Sociology of Migration and Sociology of Health, focuses on female immigrants and refugees and their health and access to healthcare services in Greece. According to the results of in-depth interviews, based on the findings of two research projects carried out between 2020-2022 during the COVID-19 pandemic: “Voices of Immigrant Women” (VIW) project (Erasmus+ 2020-1-ES01-KA203-082364) (2020-2022) and “Local Alliance for Integration (LION/GSRI/University of West Attica/81018): Migrant and Refugee integration into local societies in times of the COVID-19 pandemic in Spain and Greece” (2021-2022) implementing a qualitative methodology, migrant and refugee women migrants are entrapped in a frame of invisibility, precarious living and exploitative working conditions and discrimination. On the one hand, one of the greatest challenges that Greece is currently facing is the existence of significant disparities in the health services provided to the population in general, and on the other hand, the problem is particularly severe for migrants. The research emphasizes that the health services to female immigrants and refugees are included in an elliptical system of Public Health policy which fails to address significant claims and fields while the COVID-19 pandemic has intensified vulnerability.

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Abedi, V., Olulana, O., Avula, V., Chaudhary, D., Khan, A., Shahjouei, S., Li, J., & Zand, R. (2021). Racial, economic, and health inequality and COVID-19 infection in the United States. Journal of racial and ethnic health disparities, 8(3), 732-742.
Ahmad, W. I., & Bradby, H. (2007). Locating ethnicity and health: exploring concepts and contexts. Sociology of health & illness, 29(6), 795-810.
Anderson, B. & Phizacklea, A. (1997). Migrant Domestic Workers: A European Perspective. Leicester University.
Anderson, B. & Shutes, I. (ed.) (2014). Migration and Care Labour: Theory, Policy and Politics. Palgrave Macmillan
Balibar, E. (1991). Racism and Nationalism. In Balibar, E., Wallerstein, I. M., & Wallerstein, S. R. I. Race, nation, class: Ambiguous identities. London: Verso, 37-68.
Banton, M. (2018). The Concept of Racism. In Zubaida, S. (Ed.). Race and racialism (Vol. 23). London Routledge, 17–34.
Baptiste, D. L., Commodore‐Mensah, Y., Alexander, K. A., Jacques, K., Wilson, P. R., Akomah, J., Sharps, P. & Cooper, L. A. (2020). COVID‐19: Shedding light on racial and health inequities in the USA. Journal of clinical nursing, 29, 2734–2736.
Berman, G., & Paradies, Y. (2010). Racism, disadvantage and multiculturalism: towards effective anti-racist praxis. Ethnic and Racial Studies, 33(2), 214-232.
Blackburn, C. (1991). Poverty and Health: Working with Families, Milton Keynes: Open University Press.
Bradby, H. (2009). Medical sociology: an introduction. London: Sage.
Bunton, R., Burrows, R., & Nettleton, S. (2003). Sociology and health promotion. London: Routledge.
Campani, G. (2000). Immigrant Women in Southern Europe: Social Exclusion, Domestic Work and Prostitution in Italy, in: King R., Lazaridis G., Tsardanidis C. (eds.), Eldorado or Fortress? Migration in Southern Europe. Palgrave Macmillan, 147-169.
Campani, G., Fabelo Concepción, S., Rodriguez Soler, A., & Sánchez Savín, C. (2022). The Rise of Donald Trump Right-Wing Populism in the United States: Middle American Radicalism and Anti-Immigration Discourse. Societies, 12(6), 154. MDPI AG. Retrieved from
Castles, S. & Miller, M. J. (2014). The Age of Migration: International Population Movements in the Modern World, 5thEdition.The Guilford Press.
Centers for Disease Control & Prevention (CDC). COVID-19 Racial and Ethnic Health Disparities. 2020. Available online: (accessed on 30 June 2022).
Cervi, L., García, F., & Marín-Lladó, C. (2021). Populism, Twitter, and covid-19: narrative, fantasies, and desires. Social Sciences, 10(8), 294.
Chowkwanyun, M., & Reed Jr, A. L. (2020). Racial health disparities and Covid-19—caution and context. New England Journal of Medicine, 383(3), 201-203.
Croucher, S. M., Nguyen, T., & Rahmani, D. (2020). Prejudice toward Asian Americans in the COVID-19 pandemic: The effects of social media use in the United States. Frontiers in Communication, 5, 39.
Dalsania, A. K., Fastiggi, M. J., Kahlam, A., Shah, R., Patel, K., Shiau, S., Rokicki, S. & DallaPiazza, M. (2022). Journal of racial and ethnic health disparities, 9(1), 288-295.
Deléchat, C. & Medina, L. (eds.), (2021). The Global Informal Workforce: Priorities for Inclusive Growth.International Monetary Fund.
Elias, A., Ben, J., Mansouri, F., & Paradies, Y. (2021). Racism and nationalism during and beyond the COVID-19 pandemic. Ethnic and Racial Studies, 44(5), 783-793.
Esses, V. M., Medianu, S., & Lawson, A. S. (2013). Uncertainty, threat, and the role of the media in promoting the dehumanization of immigrants and refugees. Journal of social issues, 69(3), 518-536.
European Migration Network (EMN). (2018). Asylum and Migration Glossary 6.0; European Migration Network (EMN): Brussels, Belgium, 2018; Available online: (accessed on 30 June 2022).
Fasani, F., & Mazza, J. (2020). Being on the frontline? Immigrant workers in Europe and the COVID-19 pandemic. CEPR Discussion Paper No. DP15590. 2020. Available online: (accessed on 1 August 2022).
Fassani, F., & Mazza, J. (2020). A vulnerable workforce: Migrant workers in the COVID-19 pandemic. Luxembourg: Publications Office of the European Unio; Available online: (accessed on 30 June 2022).
Federico, V.; Baglioni, S. (Eds.) (2021). Migrants, Refugees and Asylum Seekers’ Integration in European Labour Markets: A Comparative Approach on Legal Barriers and Enablers, Cham, Switzerland. Springer
Fouskas, T. (2018). Precarious employment repercussions on migrants’ perceptions regarding healthcare. International Journal of Human Rights in Healthcare, 11(3), 298-311.
Fouskas, T. (2019). (Un)Maid in Greece: Repercussions of precarious, low-status work on family and community networks of solidarity of migrant Filipina live-in domestic workers and race discrimination at work, in J. Vassilopoulou, O. Kydiakidou, V. Showunmi and J. Brabet (Eds.) Race discrimination and the management of ethnic diversity at work. European countries perspectives.Emerald, 225-250.
Fouskas, T. (2020). Migrants, asylum seekers and refugees in Greece in the midst of the COVID-19 pandemic. Comparative Cultural Studies-European and Latin American Perspectives, 5(10), 39-58.
Fouskas, T. (2021). Lives (un)maid in Greece: Migrant Filipina Live-In Domestic Workers, New York, NY, Nova Science Publishers.
Fouskas, T. (Ed.), (2021a). Immigrants, Asylum Seekers and Refugees in Times of Crises: A. An International Handbook on Migration and Refugee Studies, Management Policies and Governance (Foreword by Giovanna Campani), European Public Law Series, vol. CXXIV, Athens: European Public Law Organization (EPLO)
Fouskas, T. (Ed.), (2021b). Immigrants, Asylum Seekers and Refugees in Times of Crises: B. An International Handbook on Migration, Asylum, Social Integration and Exclusion (Foreword by Marco Martiniello), European Public Law Series, vol. CXXV, Athens: European Public Law Organization (EPLO).
Fouskas, T., & Koulierakis, G. (2022). Demystifying Migration Myths: Social Discourse on the Impact of Immigrants and Refugees in Greece. Urbanities, 12, 9–28.
Fouskas, T., Gikopoulou, P., Ioannidi, E., & Koulierakis, G. (2019). Health inequalities and female migrant domestic workers: Accessing healthcare as a human right and barriers due to precarious employment in Greece. Collectivus, 6(2), 71-90.
Fouskas, T., Koulierakis, G., Mine, F.-M., Theofilopoulos, A., Konstantopoulou, S., Ortega-de-Mora, F., Georgiadis, D. & Pantazi, G. (2022).
Racial and Ethnic Inequalities, Health Disparities and Racism in Times of COVID-19 Pandemic Populism in the EU: Unveiling Anti-Migrant Attitudes, Precarious Living Conditions and Barriers to Integration in Greece. Societies, 12(6), 189. MDPI AG. Retrieved from
Fouskas, T., Koulierakis, G.., Lyberopoulou, L., & De Maio, A. (2022). From invisibility to gender empowerment and migrant integration? Repercussions of live-in domestic work and caregiving on female migrants in Greece. Cuestiones Pedagógicas. Revista De Ciencias De La Educación, 1(31), 77–100.
Fouskas, T., Sidiropoulos, S., & Vozikis, A. (2019). Leaving no one out? Public health aspects of migration: Health risks, responses and accessibility by asylum seekers, refugees and migrants in Greece, 7, 13–28.
Galanis, P., Sourtzi, P., Bellali, T., Theodorou, M., Karamitri, I., Siskou, O., Charalambous, G., & Kaitelidou, D. (2013). Public health services knowledge and utilization among immigrants in Greece: a cross-sectional study. BMC Health Services Research, 13(1), 1-8.
Gómez, C. A., Kleinman, D. V., Pronk, N., Gordon, G. L. W., Ochiai, E., Blakey, C., ... & Brewer, K. H. (2021). Practice Full Report: Addressing Health Equity and Social Determinants of Health Through Healthy People 2030. Journal of Public Health Management and Practice, 27(6), S249.
Gover, A. R., Harper, S. B., & Langton, L. (2020). Anti-Asian hate crime during the COVID-19 pandemic: Exploring the reproduction of inequality. American journal of criminal justice, 45(4), 647-667.
Government Gazette D1a/GP.ok.61055/27.10.2022 Extension of the validity of the D1a/GP. co. 51236/8.9.2022 Joint Ministerial Decision on Emergency Measures to Protect Public Health from the Risk of Further Spread of the COVID-19 Coronavirus throughout the Territory until Monday, November 14, 2022 at 06:00. 2022. Available online: (accessed on 1 August 2022). (In Greek).
Graetz, V., Rechel, B., Groot, W., Norredam, M., & Pavlova, M. (2017). Utilization of health care services by migrants in Europe—a systematic literature review. British medical bulletin, 121(1), 5-18.
Gravlee, C. C. (2020). Systemic racism, chronic health inequities, and COVID‐19: A syndemic in the making?. American Journal of Human Biology, 32, e23482.
Greenaway, C., Hargreaves, S., Barkati, S., Coyle, C. M., Gobbi, F., Veizis, A., & Douglas, P. (2020). COVID-19: Exposing and addressing health disparities among ethnic minorities and migrants. Journal of travel medicine, 27(7), taaa11.
Gurría, A. (2016). The Integration of Migrants and Refugees: Challenges and Opportunities; Organisation for Economic Co-operation and Development (OECD): France Paris; Available online: (accessed on 30 June 2022).
Hennebry, J., & Hari, K. C. (2020). Quarantined! Xenophobia and migrant workers during the COVID-19 pandemic Geneva: International Organization for Migration (IOM). Available online: (accessed on 1 August 2022).
Hennebry, J., Caxaj, C. S., McLaughlin, J., & Mayell, S. (2020). Coronavirus: Canada stigmatizes, jeopardizes essential migrant workers. The Conversation, 3. Available online: (accessed on 1 August 2022).
Hondagneu-Sotelo, P. (2002). Doméstica: Immigrant workers cleaning and caring in the shadows of affluence. University of California Press.
Jacobsen, K., & Simpson, C. (2020). Integration and Resettlement of Refugees and Forced Migrants. Social Sciences, 8, 212.
Johnson-Agbakwu, C. E., Ali, N. S., Oxford, C. M., Wingo, S., Manin, E., & Coonrod, D. V. (2020). Racism, COVID-19, and Health Inequity in the USA: a Call to Action. Journal of racial and ethnic health disparities, 1-7.
Krieger, N. (2020). ENOUGH: COVID-19, structural racism, police brutality, plutocracy, climate change—and time for health justice, democratic governance, and an equitable, sustainable future. American Journal of Public Health, 110(11), 1620-1623.
Labour Institute of the General Confederation of Greek Workers (LI-GCGW), Annual Report 2019: The Greek Economy and Employment, Athens: INE-GSEE (in Greek).
Lan, P. (2006). Global Cinderellas: Migrant Domestics and Newly Rich Employers in Taiwan. Duke University Press.
Land, S. (2019). Maid: Hard Work, Low Pay, and a Mother's Will to Survive. Hachette.
Laster Pirtle, W. N., & Wright, T. (2021). Structural gendered racism revealed in pandemic times: Intersectional approaches to understanding race and gender health inequities in COVID-19. Gender & Society, 35(2), 168-179.
Laurencin, C. T., & Walker, J. M. (2020). A pandemic on a pandemic: Racism and COVID-19 in Blacks. Cell systems, 11(1), 9-10.
Lazaridis, G. (2000). “Filipino and Albanian Women Migrant Workers in Greece: Multiple Layers of Oppression,” in F. Anthias and G. Lazaridis (eds.) Gender and Migration in Southern Europe: Women on the Move, 49-79
Lucassen, L., Oltmer, J., & Feldman, D. (2006). Paths of integration: migrants in Western Europe (1880-2004). Amsterdam University Press.
Maroukis, T. (2018). Migrant care workers' trajectories in a familistic welfare regime: Labour market incorporation and the Greek economic crisis reality-check. Journal of Ethnic and Migration Studies, 44(14), 2358-2374
Mengesha, Z., Alloun, E., Weber, D., Smith, M., & Harris, P. (2022). “Lived the Pandemic Twice”: A Scoping Review of the Unequal Impact of the COVID-19 Pandemic on Asylum Seekers and Undocumented Migrants. International Journal of Environmental Research and Public Health, 19(11), 6624.
Modesti, P. A., Perticone, F., Parati, G., Agabiti Rosei, E., & Prisco, D. (2016). Chronic disease in the ethnic minority and migrant groups: time for a paradigm shift in Europe. Internal and emergency medicine, 11(3), 295-297.
Monreal Gimeno, M., Terrón Caro, M.T., Cárdenas Rodríguez, M. (2014). Women inmigratory movements in the northern border of Mexico-USA, Pedagogía social: Revistainteruniversitaria,3(23),45-69.
Moreno Barreneche, S. (2020). Somebody to blame: On the construction of the other in the context of the COVID-19 outbreak. Society Register, 4(2), 19-32.
Nettleton, S. (2021). The Sociology of Health and Illness, London: Polity.
Parreñas, R. (2001). Servants of Globalization: Women, Migration and Domestic Work.Stanford University Press.
Paul, R. (2020). Europe’s essential workers: Migration and pandemic politics in Central and Eastern Europe during COVID‐19. European policy analysis, 6(2), 238-263.
Pavli, A., & Maltezou, H. (2017). Health problems of newly arrived migrants and refugees in Europe. Journal of travel medicine, 24(4)., tax016.
Pazhoohi, F., & Kingstone, A. (2021). Associations of political orientation, xenophobia, right-wing authoritarianism, and concern of COVID-19: Cognitive responses to an actual pathogen threat. Personality and Individual Differences, 182, 111081.
Proudfoot, P., & Rohwerder, B. (2022). Anti-Migrant Authoritarian Populism and the Global Vaccination Challenge. IDS Bulletin 2022, 53, 67-80.
Psimmenos, I. (2007). Work Culture and Migrant Women’s Welfare Marginalization. Greek Review of Social Research, 124(3), 9-33.
Rea, A.; Martiniello, Μ.; Mazzola, A. & Meuleman, B. (Eds.) (2019). The Refugee Reception Crisis in Europe. Polarized Opinions and Mobilizations, Bruxelles, Éditions de l’Université de Bruxelles, Available online: (accessed on 1 August 2022).
Recio-Román, A., Recio-Menéndez, M., & Román-González, M. V. (2021). Vaccine hesitancy and political populism. An invariant Cross-European perspective. International Journal of Environmental Research and Public Health, 18(24), 12953.
Reid, A., Ronda‐Perez, E., & Schenker, M. B. (2021). Migrant workers, essential work, and COVID‐19. American Journal of Industrial Medicine, 64(2), 73-77.
Reny, T. T., & Barreto, M. A. (2022). Xenophobia in the time of pandemic: othering, anti-Asian attitudes, and COVID-19. Politics, Groups, and Identities, 10(2), 209-232.
Sassen, S. (2016). A massive loss of habitat: New drivers for migration, in Fouskas, Theodoros (Ed.). Immigrants, Asylum Seekers and Refugees in Times of Crises: A. An International Handbook on Migration and Refugee Studies, Management Policies and Governance (Foreword by Giovanna Campani), Athens, European Public Law Organization (EPLO), 59-92.
Schneider, F. & Williams, C. (2013). The Shadow Economy. London, Institute of Economic Affairs, 52-96.
Su, R., & Shen, W. (2021). Is nationalism rising in times of the COVID-19 pandemic? Individual-level evidence from the United States. Journal of Chinese political science, 26(1), 169-187.
Tagliacozzo, S., Pisacane, L., & Kilkey, M. (2021). The interplay between structural and systemic vulnerability during the COVID-19 pandemic: Migrant agricultural workers in informal settlements in Southern Italy. Journal of Ethnic and Migration Studies, 47(9), 1903-1921.
Tai, D. B. G., Shah, A., Doubeni, C. A., Sia, I. G., & Wieland, M. L. (2021). The disproportionate impact of COVID-19 on racial and ethnic minorities in the United States. Clinical Infectious Diseases, 72(4), 703-706.
Tastsoglou, E. & Maratou-Alipranti, L. (2003). Gender and International Migration. Greek Review of Social Research, 110, 5-22.
Tazreiter, C., & Metcalfe, S. (2021). New vulnerabilities for migrants and refugees in state responses to the global pandemic, COVID-19. Social Sciences, 10(9), 342.
Townsend, P. B., Whitehead, M., & Davidson, N. (1982). Inequalities in Health: The Black Report & the Health Divide (new third edition). Penguin Books Ltd.
Triandafyllidou, A. (ed.), (2013). Irregular Migrant Domestic Workers in Europe: Who cares? Ashgate.
Turner-Musa, J., Ajayi, O., & Kemp, L. (2020, June). Examining social determinants of health, stigma, and COVID-19 disparities, 9(2), 168.
Vega Macías, D. (2021). The COVID-19 pandemic on anti-immigration and xenophobic discourse in Europe and the United States. Estudios fronterizos, 22.
Vosko, L. F. (Ed.). (2006). Precarious employment: Understanding labour market insecurity in Canada. McGill-Queen's Press-MQUP.
Wang, S., Chen, X., Li, Y., Luu, C., Yan, R., & Madrisotti, F. (2021). ‘I'm more afraid of racism than of the virus!’: racism awareness and resistance among Chinese migrants and their descendants in France during the Covid-19 pandemic. European Societies, 23(sup1), S721-S742.
Watson, T. (2002). Sociology, work and industry. London: Routledge.
Yamane, S. (2021). Gender equality, paid and unpaid care and domestic work: Disadvantages of state-supported marketization of care and domestic work. The Japanese Political Economy, 47(1),44-63.
Yeates, N. (2009). Globalizing care economies and migrant workers: explorations in global care chains. Palgrave Macmillan.
Yilmaz, G. & Ledwith, S. (2017). Migration and Domestic Work: The Collective Organisation of Women and their Voices from the City. Springer.