Association between housing and health of refugees and asylum seekers in Germany: explorative cluster and mixed model analysis

Verena Dudek,Odile Sauzet,Oliver Razum

doi:10.1186/s12889-021-12458-1

Verena Dudek, Odile Sauzet + Show 1 more

Open Access

https://doi.org/10.1186/s12889-021-12458-1

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Journal: BMC Public Health	Publication Date: Jan 8, 2022
Citations: 15	License type: open-access

Affiliation: Bielefeld University

Abstract

BackgroundAccommodation for asylum seekers and refugees (ASR) in Germany differs in many ways depending on a range of political, structural, social, and environmental factors. These contextual differences present a challenge for assessing health impacts of refugee accommodation. We aimed to devise a broad typology of refugee accommodation that allows to assess associations between housing and health of ASR.MethodsWe performed a cluster analysis of population-based, cross-sectional secondary data in Germany to identify clusters of refugee accommodation. We then assessed health disparities across clusters by performing bivariate analysis and linear mixed model regression analysis.ResultsWe identified four clusters, three of them reflected different types of private accommodation and one pointed to collective accommodation. The collective accommodation cluster clearly differed from the private accommodation clusters in terms of space, area, level of restrictions, social connections and respondent satisfaction. Across private accommodation clusters we also found differences in space, area, and level of restrictions. In regression analysis, belonging to one of the private accommodation cluster was significantly associated with better mental health compared to belonging to the collective accommodation cluster. Physical health was significantly lower in one private accommodation cluster characterized by poor access to public transport and a higher level of restrictions compared to a private accommodation cluster showing better connections and a lower level of restrictions.ConclusionWe demonstrate that unfavourable conditions cluster in collective accommodation with negative outcomes for mental health but not for physical health. We also found health disparities across types of private accommodation. We conclude that housing plays a role in the production of health inequalities in ASR but needs to be assessed in a differentiated, multidimensional way.

Highlights

The way asylum seekers and refugees (ASR) are housed, i.e., their accommodation, is a postmigration risk factor impacting health: a higher satisfaction with housingDudek et al BMC Public Health (2022) 22:48 housing through which the overall housing context of Asylum seekers and refugees (ASR) is not mirrored adequately.The housing situation of ASR in resettlement countries is subject to substantial variabilities in terms of political factors determining the housing situation, structural factors of the dwelling, and other factors of the physical and social environment
This study underlines that collective accommodation settings clearly differ from private accommodation settings in terms of structures, the physical environment and the social opportunities attached to it, legal restrictions resulting from the asylum process, and the level of individual’s housing satisfaction
Our findings support that collective accommodation negatively affects mental health of ASR

Summary

Introduction

The way asylum seekers and refugees (ASR) are housed, i.e., their accommodation, is a postmigration risk factor impacting health: a higher satisfaction with housingDudek et al BMC Public Health (2022) 22:48 housing through which the overall housing context of ASR is not mirrored adequately.The housing situation of ASR in resettlement countries is subject to substantial variabilities in terms of political factors determining the housing situation, structural factors of the dwelling, and other factors of the physical and social environment. The way asylum seekers and refugees (ASR) are housed, i.e., their accommodation, is a postmigration risk factor impacting health: a higher satisfaction with housing. Living in private accommodation is generally possible but access is limited, depending on the asylum status, the willingness and ability of municipalities to reallocate ASR to private accommodation as well as on the local housing market [6]. Accommodation for asylum seekers and refugees (ASR) in Germany differs in many ways depending on a range of political, structural, social, and environmental factors. These contextual differences present a challenge for assessing health impacts of refugee accommodation.

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