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Health changes of refugees from Afghanistan, Iran and Somalia: the role of residence status and experienced living difficulties in the resettlement process.
Eur J Public Health. 2015 Dec; 25(6):917-22.EJ

Abstract

INTRODUCTION

Worldwide, refugees show a poorer mental and physical health than the populations among which they resettle. Little is known about the factors influencing health after resettlement. We examined the development of mental and physical health of refugees. As experienced living difficulties might decrease with obtaining a residence permit, we expected this to play a central role in health improvement after resettlement.

METHODS

A two-wave study conducted in the Netherlands among a cohort of 172 recent (n = 68) and longstanding (n = 104) permit holders from Afghanistan, Iran and Somalia between 2003 and 2011. Multivariate mediation analyses were conducted for the effect of changes in living difficulties on the association between change in status and changes in health. Health outcomes were self-reported general health, number of chronic conditions, PTSD and anxiety/depression.

RESULTS

Recent permit holders had larger decreases in PTSD score (-0.402, CI -0.612; -0.192) and anxiety/depression score (-0.298, CI -0.464; -0.132), and larger improvements in self-rated general health between T1 and T2 (0.566, CI 0.183; 0.949) than longstanding permit holders. This association was not significant for changes in number of chronic conditions. Mediation analyses showed that the effect of getting a residence permit on health improvements transited through an improvement in living conditions, in particular employment and the presence of family/social support.

CONCLUSION

These results suggest that change in residence permit is beneficial for health mainly because of the change in living difficulties. These results add up to the evidence on the role of social circumstances for refugees upon resettlement, and point at labour participation and social support as key mechanisms for health improvements.

Authors+Show Affiliations

1 Department of Public Health, Faculty of Medicine, University of Amsterdam, Amsterdam, The Netherlands m.lamkaddem@amc.uva.nl.1 Department of Public Health, Faculty of Medicine, University of Amsterdam, Amsterdam, The Netherlands.2 NIVEL (Netherlands Institute for Health Services Research), Utrecht, The Netherlands 3 Medical Anthropology and Sociology Unit, Faculty of Social and Behavioural Sciences, University of Amsterdam, The Netherlands 4 Pharos, Utrecht, The Netherlands.5 Epidemiologist at Epi Results, Louis Trichardt, South Africa.1 Department of Public Health, Faculty of Medicine, University of Amsterdam, Amsterdam, The Netherlands.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25863280

Citation

Lamkaddem, Majda, et al. "Health Changes of Refugees From Afghanistan, Iran and Somalia: the Role of Residence Status and Experienced Living Difficulties in the Resettlement Process." European Journal of Public Health, vol. 25, no. 6, 2015, pp. 917-22.
Lamkaddem M, Essink-Bot ML, Devillé W, et al. Health changes of refugees from Afghanistan, Iran and Somalia: the role of residence status and experienced living difficulties in the resettlement process. Eur J Public Health. 2015;25(6):917-22.
Lamkaddem, M., Essink-Bot, M. L., Devillé, W., Gerritsen, A., & Stronks, K. (2015). Health changes of refugees from Afghanistan, Iran and Somalia: the role of residence status and experienced living difficulties in the resettlement process. European Journal of Public Health, 25(6), 917-22. https://doi.org/10.1093/eurpub/ckv061
Lamkaddem M, et al. Health Changes of Refugees From Afghanistan, Iran and Somalia: the Role of Residence Status and Experienced Living Difficulties in the Resettlement Process. Eur J Public Health. 2015;25(6):917-22. PubMed PMID: 25863280.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Health changes of refugees from Afghanistan, Iran and Somalia: the role of residence status and experienced living difficulties in the resettlement process. AU - Lamkaddem,Majda, AU - Essink-Bot,Marie-Louise, AU - Devillé,Walter, AU - Gerritsen,Annette, AU - Stronks,Karien, Y1 - 2015/04/10/ PY - 2015/4/12/entrez PY - 2015/4/12/pubmed PY - 2016/9/22/medline SP - 917 EP - 22 JF - European journal of public health JO - Eur J Public Health VL - 25 IS - 6 N2 - INTRODUCTION: Worldwide, refugees show a poorer mental and physical health than the populations among which they resettle. Little is known about the factors influencing health after resettlement. We examined the development of mental and physical health of refugees. As experienced living difficulties might decrease with obtaining a residence permit, we expected this to play a central role in health improvement after resettlement. METHODS: A two-wave study conducted in the Netherlands among a cohort of 172 recent (n = 68) and longstanding (n = 104) permit holders from Afghanistan, Iran and Somalia between 2003 and 2011. Multivariate mediation analyses were conducted for the effect of changes in living difficulties on the association between change in status and changes in health. Health outcomes were self-reported general health, number of chronic conditions, PTSD and anxiety/depression. RESULTS: Recent permit holders had larger decreases in PTSD score (-0.402, CI -0.612; -0.192) and anxiety/depression score (-0.298, CI -0.464; -0.132), and larger improvements in self-rated general health between T1 and T2 (0.566, CI 0.183; 0.949) than longstanding permit holders. This association was not significant for changes in number of chronic conditions. Mediation analyses showed that the effect of getting a residence permit on health improvements transited through an improvement in living conditions, in particular employment and the presence of family/social support. CONCLUSION: These results suggest that change in residence permit is beneficial for health mainly because of the change in living difficulties. These results add up to the evidence on the role of social circumstances for refugees upon resettlement, and point at labour participation and social support as key mechanisms for health improvements. SN - 1464-360X UR - https://www.unboundmedicine.com/medline/citation/25863280/Health_changes_of_refugees_from_Afghanistan_Iran_and_Somalia:_the_role_of_residence_status_and_experienced_living_difficulties_in_the_resettlement_process_ L2 - https://academic.oup.com/eurpub/article-lookup/doi/10.1093/eurpub/ckv061 DB - PRIME DP - Unbound Medicine ER -