When there is no sleep: forced migration and the social determinants of health during post-migration

Abstract

Abstract Attending to and addressing the public health needs of forced migrants, especially those who experience torture due to their identities as sexual minorities, is increasingly challenging in socio-political landscapes that may negatively impact access to health resources and health care services. A great deal of public health intervention work has focused on pre-migration and migration contexts but post-migration contexts remain less developed in regards to the social determinants of health. The significance of post-migration challenges to refugee and asylum seekers' health need to integrate social determinants of health frameworks that meaningfully engage with the risk and protective factors in the complex sociocultural conditions in post-migratory experiences that include social, economic and political factors that impinge on housing, legal representation, employment, education food security and health access. This presentation provides findings from an integrated biopsychosocial and spiritual intervention that focused on LGBTQ refugee and asylum-seeking populations seeking health care services at a health clinic in North America. These findings recommend horizontal approaches that engage in transdisciplinary teams that address physical, emotional, social, spiritual and mental health arenas to engage in a social determinants of health framework. Key messages Integrated, trauma-responsive biopsychosocial and spiritual interventions may be most effective post-migration. Increased public health activism must support post-migration health interventions.