Abstract
BackgroundForced migrants can be exposed to various stressors that can impact their health and wellbeing. How the different stages in the migration process impacts health is however poorly explored. The aim of this study was to examine changes in self-rated health (SRH) and quality of life (QoL) among a cohort of adult Syrian refugees before and after resettlement in Norway.MethodWe used a prospective longitudinal study design with two assessment points to examine changes in health among adult Syrian resettlement refugees in Lebanon accepted for resettlement in Norway. We gathered baseline data in 2017/2018 in Lebanon and subsequently at follow-up one year after arrival. The main outcomes were good SRH measured by a single validated item and QoL measured by WHOQOL-BREF. We used generalized estimating equations to investigate changes in outcomes over time and incorporated interaction terms in the models to evaluate effect modifications.ResultsIn total, 353 subjects participated in the study. The percentage of participants reporting good SRH showed a non-significant increase from 58 to 63% RR, 95%CI: 1.1 (1.0, 1.2) from baseline to follow-up while mean values of all four QoL domains increased significantly from baseline to follow-up; the physical domain from 13.7 to 15.7 B, 95%CI: 1.9 (1.6, 2.3), the psychological domain from 12.8 to 14.5 B, 95%CI: 1.7 (1.3, 2.0), social relationships from 13.7 to 15.3 B, 95%CI: 1.6 (1.2, 2.0) and the environmental domain from 9.0 to 14.0 5.1 B, 95%CI: (4.7, 5.4). Positive effect modifiers for improvement in SRH and QoL over time include male gender, younger age, low level of social support and illegal status in transit country.ConclusionOur results show that good SRH remain stable while all four QoL domains improve, most pronounced in the environment domain. Understanding the dynamics of migration and health is a fundamental step in reaching health equity.
Highlights
We are witnessing a time in which forced migration is surging and the need to ensure protection, health, and wellbeing of people on the move is ever so vital
Our results show that good self-rated health (SRH) remain stable while all four quality of life (QoL) domains improve, most pronounced in the environment domain
It remains unclear if the selection described in the ‘healthy migrant effect’ that postulates migrants’ health advantage compared to both citizens in the home country and in the host country holds true for refugees and other forced migrants [4, 6]
Summary
We are witnessing a time in which forced migration is surging and the need to ensure protection, health, and wellbeing of people on the move is ever so vital. This sentiment is echoed in the Sustainable Development Goals of leaving no one behind [1]. Forced migrants differ from other types of migrants in that they are survivors of persecution, violence, and war - factors that might add to their health vulnerability. The aim of this study was to examine changes in self-rated health (SRH) and quality of life (QoL) among a cohort of adult Syrian refugees before and after resettlement in Norway
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