An Investigation into the Association of Pre- and Post-Migration Experiences on the Self-Rated Health Status Among New Resettled Adult Humanitarian Refugees to Australia: A Longitudinal Study

Abstract

Background: Refugees are potentially at an increased risk for health problems due to their past and current migration experiences. How migration factors shape refugee health is not well understood. We examined the association between migration factors and the self-rated health of adult humanitarian refugees living in Australia. Methods: We analysed the first three waves of data from the 'Building A New Life in Australia' survey of 2399 humanitarian refugees resettled in Australia. Outcomes were self-rated health measured by the 36-Item Short Form Health Survey; the Kessler Psychological Distress Scale and Posttraumatic Stress Disorder-8 items. Predictors were migration process and resettlement factors. We used generalized linear mixed models to investigate the relationship between predictor and outcome variables. Findings: Poor health persisted among this refugee population at high levels throughout the three-year follow-up. Pre-migration trauma predicted serious mental illness and PTSD. Increasing number of financial difficulties and loneliness were positively associated with all study outcomes. Serious mental illness and poorer general health were associated with offshore immigration detainment in a seemingly protective fashion and lower language proficiency. Language barrier stress and unemployment were significantly associated with poorer general health. Interpretation: Pre-migration trauma, financial difficulties and social isolation appear particularly problematic for the health of humanitarian refugees in Australia. There is also a high prevalence of ill-health throughout the early years of resettlement. Our findings highlight opportunities for intervention as a way of alleviating the health burden of resettling refugees. Funding Statement: The authors declare No funding was secured for this study. The BNLA is funded by the Australian Government’s Department of Social Services and had no involvement in the preparation of this manuscript. Declaration of Interests: All authors declare that they have no competing interests. Ethics Approval Statement: De-identified BNLA data is accessible by authorized researchers who have obtained permission from the Australian Department of Social Services. This permission was obtained by study authors AD, JE and GR. Ethics exemption to use the data was granted by the Monash University Research Ethics Committee.