March 2025
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Globalization and Health
This paper presents a conceptual model for understanding cross-border precarity during the COVID-19 pandemic. It examines how public health emergencies exacerbate the challenges faced by expatriates and their families in cross-border contexts. The case study illustrates the complex nature of precarity, emphasising how its various forms like systemic, institutional, economic, health, social, and psychological are interacted and intensified during the pandemic, leading to lasting instability for expatriates that extends beyond borders and impacts their families. Findings indicate that restrictive immigration policies, delayed repatriation efforts, and inadequate support mechanisms exacerbated expatriates’ hardships, which in turn amplified the economic and psychological strains faced by dependents in Kerala. This paper argues for integrating expatriate needs into the International Health Regulations (IHR) for managing public health emergencies, including comprehensive guidelines for repatriation and expatriate-inclusive country capacity assessments. This model serves as a tool to inform policymakers, social work practitioners, and public health professionals in designing interventions and policies that address the unique and intersecting forms of precarity in times of crisis, ultimately contributing to a more inclusive, transnational approach to public health resilience.