Adult Refugees Research Articles

Health-related impacts of climate change and air pollution on older adult, child, and adolescent immigrants and refugees globally: a scoping review

Health-related impacts of climate change and air pollution on older adult, child, and adolescent immigrants and refugees globally: a scoping review

A Multi-Method Profiling of Adult Refugees and Migrants in an L2 Non-Formal Educational Setting: Language Needs Analysis, Linguistic Portraits, and Identity Texts

This paper will attempt to visualize adult refugees and migrants, as well as a specific multilingual and multicultural educational setting in Greece. This study aspires to depict/present the plurilingual profiles, language needs, and challenges of L2 Greek students through a variety of tools/methods, e.g., questionnaires, portraits, narratives, needs analysis, and assessment tools. In a complementary way, this research focuses on highlighting the value of language portraits, identity texts, and translanguaging in L2 Greek classrooms. Conditions regarding the educational process in the specific educational setting will also be discussed. This was a case study conducted in an open school for migrants in Greece. Eight volunteer teachers at the school and twenty students participated in this research through a multimethod research design. Multilingual profiles and learners’ needs and goals became visible, and the teachers managed to “hear” the multilingual voices of their students and understand their multilingual profiles. Overall, it is clear that these findings pave the way for large-scale research to investigate in depth everything presented in this research. Using language portraits and identity texts as group activities helps to conduct a productive discussion in the classroom, through which students gain access to the use of concepts such as “multilingualism”, “multiculturalism”, and “diversity”.

Associations between postmigration living situation and symptoms of common mental disorders in adult refugees in Europe: updating systematic review from 2015 onwards

BackgroundRefugees and asylum seekers have a high prevalence of psychiatric disorders such as post-traumatic stress disorder (PTSD), anxiety, and depression. The postmigration context inheres different risk and protective factors for mental health of refugees and asylum seekers in host countries. We conducted a systematic review to update knowledge on the association between characteristics of the postmigration living situation (PMLS) and mental health outcomes in Europe since 2015.MethodsWe searched in five databases according to the PRISMA statement. From a total of 5,579 relevant studies published in 2015–22, 3,839 were included for title and abstract screening, and 70 full texts screened for eligibility. Out of these, 19 studies on refugees and asylum seekers conducted in European countries after 2014 were included in this systematic review. The quality of studies was assessed by using the Mixed Methods Appraisal Tool (MMAT) – version 2018. We performed a narrative synthesis using the four layers of the social determinants of health framework.ResultsA wide range of risk and protective factors for mental health in the PMLS were identified as exposure measures, which included individual factors (e.g., language skills), social and community networks (e.g., family concerns, loneliness and social support, discrimination), living and working conditions (e.g., legal status, duration of residence, unemployment and financial hardship, housing) as well as general socio-economic, cultural and environmental factors (e.g., social status, acculturation). We found postmigration stressors are positively associated with symptoms of depression, anxiety, and PTSD, albeit not consistently so. Especially, the general socio-economic, cultural and environmental factors showed weak associations with mental health.ConclusionsHeterogenous study characteristics likely explain the inconsistent associations between characteristics of the PMLS and mental health outcomes. However, broken down in its component layers, most risk and protective factors of the PMLS were significantly associated with symptoms of mental disorders showing the same direction of association across the included studies, while the association between some stressors or resources of the PMLS and mental health turns out to be less homogeneous than expected. Characteristics of the PMLS contribute to the high prevalence of mental diseases of refugees and asylum seekers. Disadvantages in general socio-economic conditions, living and working conditions, in access to social and community networks need to be redressed, in addition to better access to health care.

P20-033-23 Functional Potential of the Gut Microbiome in NH Bhutanese Refugee Adults With Glycemic Impairment

P20-033-23 Functional Potential of the Gut Microbiome in NH Bhutanese Refugee Adults With Glycemic Impairment

The Influence of Leisure on the Quality of Life of Refugees in Turkey

ABSTRACT Quality of life (QOL) is of great concern for refugees who experience significant hardship and life changes. Leisure may support refugees’ QOL, however, a review of the literature reveals a gap in understanding the influence of leisure availability and participation on the QOL of adult refugees residing in Turkey. This study examined the influence of different dimensions of leisure (i.e. active, passive, and social) on the QOL of refugees (i.e. physical, psychological, social, and environmental) using the WHOQOL-BREF scale. Responses from 203 adult refugees residing in Turkey were analysed using structural equation modelling. Results showed that both leisure availability (β = .80, p < .001) and participation (β = .32, p < .001) strongly influenced QOL. Leisure availability also indirectly and positively influenced QOL through participation (β = .39, p < .001). The calculated R-squared (R2 = .45) showed that variation in leisure availability and participation explains a significant proportion of variation in QOL of refugees who participated in this study. It can be interpreted that improving refugees’ perceived and actual access to leisure and facilitating their leisure participation may substantially improve their QOL when coupled with other interventions.

Distribution, preparedness and management of Ukrainian adult refugees on dialysis-an international survey by the Renal Disaster Relief Task Force of the European Renal Association.

Due to the Russian-Ukrainian war, some of the about 10 000 adults requiring dialysis in Ukraine fled their country to continue dialysis abroad. To better understand the needs of conflict-affected dialysis patients, the Renal Disaster Relief Task Force of the European Renal Association conducted a survey on distribution, preparedness and management of adults requiring dialysis who were displaced due to the war. A cross-sectional online survey was sent via National Nephrology Societies across Europe and disseminated to their dialysis centers. Fresenius Medical Care shared a set of aggregated data. Data were received on 602 patients dialyzed in 24 countries. Most patients were dialyzed in Poland (45.0%), followed by Slovakia (18.1%), Czech Republic (7.8%) and Romania (6.3%). The interval between last dialysis and the first in the reporting center was 3.1±1.6 days, but was ≥4 days in 28.1% of patients. Mean age was 48.1±13.4 years, 43.5% were females. Medical records were carried by 63.9% of patients, 63.3% carried a list of medications, 60.4% carried the medications themselves and 44.0% carried their dialysis prescription, with 26.1% carrying all of these items and 16.1% carrying none. Upon presentation outside Ukraine, 33.9% of patients needed hospitalization. Dialysis therapy was not continued in the reporting center by 28.2% of patients until the end of the observation period. We received information about approximately 6% of Ukrainian dialysis patients, who had fled their country by the end of August 2022. A substantial proportion were temporarily underdialyzed, carried incomplete medical information and needed hospitalization. The results of our survey may help to inform policies and targeted interventions to respond to the special needs of this vulnerable population during wars and other disasters in the future.

Barriers and facilitators to education access for marginalised non-citizen children in Malaysia: A qualitative study.

In Malaysia, marginalised non-citizen children are excluded from formal education at public schools. Recognising education as a fundamental human right, the barriers and facilitators to educational access among refugee and asylum-seeker, migrant, stateless and undocumented children in Malaysia were explored. Qualitative data were collected via 32 in-depth interviews with multiple stakeholders. Data were thematically analysed and organised at three socio-ecological levels. At the 'legislative and policy' level, the requirement of citizenship documents only allows some stateless children to access public schools. Yet, many informal learning centres are not state-endorsed, as they are unable to fulfil licensing criteria. Importantly, denying the right to work for adult refugees and other undocumented people demotivates the pursuit of education among children. At the 'individual and family' level, financial constraints constitute a major reason for school dropouts, especially through expectations on boys to work. Cultural norms partly contribute to the lower enrolment of Rohingya refugee girls in secondary education, but gender parity is maintained for most in primary education. Another factor is proximity to learning centres, which links to safety concerns and transportation costs. Those who accessed public schools reported bullying by local children, which parallels institutional discrimination against marginalised non-citizens. At the 'community and educational institutions' level, inadequate funding for learning centres limits their ability to invest in physical facilities, teachers' salaries and others. Despite difficult operating conditions, learning centres address diverse school readiness, educational backgrounds, and language competencies among students by having sensitised teachers, placement tests and preparatory classes at school entry, and options for vocational training. We propose the gradual inclusion of all children in public schools and the immediate state recognition and support of learning centres. Correspondingly, realising the 'Right to Work' for refugees and stateless peoples will be synergistic in advancing universal education access for all children.

Clinical Characteristics and Outcomes of Cancer Cases Among Syrian Refugees From Southern Turkey

Cancer was a common noncommunicable disease in Syria before the present conflict and is now a major disease burden among 3.6 million Syrian refugees in Turkey. Data to inform health care practice are needed. To explore sociodemographic characteristics, clinical characteristics, and treatment outcomes of Syrian patients with cancer residing in the southern border provinces of Turkey hosting more than 50% of refugees. This was a retrospective hospital-based cross-sectional study. The study sample consisted of all adult and children Syrian refugees diagnosed and/or treated for cancer between January 1, 2011, and December 31, 2020, in hematology-oncology departments of 8 university hospitals in the Southern province of Turkey. Data were analyzed from May 1, 2022, to September 30, 2022. Demographic characteristics (date of birth, sex, and residence), date of first cancer-related symptom, date and place of diagnosis, disease status at first presentation, treatment modalities, date and status at last hospital visit, and date of death. The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision and International Classification of Childhood Cancers, Third Edition, were used for the classification of cancer. The Surveillance, Epidemiology, and End Results system was applied for staging. The diagnostic interval was defined as the number of days from first symptoms until the diagnosis. Treatment abandonment was documented if the patient did not attend the clinic within 4 weeks of a prescribed appointment throughout the treatment. A total of 1114 Syrian adult and 421 Syrian children with cancer were included. The median age at diagnosis was 48.2 (IQR, 34.2-59.4) years for adults and 5.7 (IQR, 3.1-10.7) years for children. The median diagnostic interval was 66 (IQR, 26.5-114.3) days for adults and 28 (IQR, 14.0-69.0) days for children. Breast cancer (154 [13.8%]), leukemia and multiple myeloma (147 [13.2%]), and lymphoma (141 [12.7%]) were common among adults, and leukemias (180 [42.8%]), lymphomas (66 [15.7%]), and central nervous system neoplasms (40 [9.5%]) were common among children. The median follow-up time was 37.5 (IQR, 32.6-42.3) months for adults and 25.4 (IQR, 20.9-29.9) months for children. The 5-year survival rate was 17.5% in adults and 29.7% in children. Despite universal health coverage and investment in the health care system, low survival rates were reported in this study for both adults and children with cancer. These findings suggest that cancer care in refugees requires novel planning within national cancer control programs with global cooperation.

Views and experiences of migrants and stakeholders involved in social and health care for migrants in Italy during the COVID-19 pandemic: a qualitative study

BackgroundThe COVID-19 pandemic has had major and potentially long-lasting effects on mental health and wellbeing across populations worldwide. However, these impacts were not felt equally, leading to an exacerbation of health inequalities, especially affecting vulnerable populations such as migrants, refugees and asylum seekers. Aiming to inform the adaptation and implementation of psychological intervention programmes, the present study investigated priority mental health needs in this population group.MethodsParticipants were adult asylum seekers, refugees and migrants (ARMs) and stakeholders with experience in the field of migration living in Verona, Italy, and fluent in Italian and English. A two-stage process was carried out to examine their needs using qualitative methods including free listing interviews and focus group discussions, according to Module One of the DIME (Design, Implementation, Monitoring, and Evaluation) manual. Data were analyzed using an inductive thematic analyses approach.ResultsA total of 19 participants (12 stakeholders, 7 ARMs) completed the free listing interviews and 20 participants (12 stakeholders and 8 ARMs) attended focus group discussions. Salient problems and functions that emerged during free listing interviews were discussed during the focus group discussions. During the COVID-19 pandemic, ARMs struggled with many everyday living difficulties in their resettlement country due to social and economic issues, revealing a strong influence of contextual factors in determining mental health. Both ARMs and stakeholders highlighted a mismatch between needs, expectations and interventions as factors that may hamper proper implementation of health and social programmes.ConclusionsThe present findings could help in the adaptation and implementation of psychological interventions targeting the needs of asylum seekers, refugees and migrants aiming to find a match between needs, expectations, and the corresponding interventions.Trial registrationRegistration number 2021-UNVRCLE-0106707, February 11 2021.

Refugees' and asylum seekers' experiences of individual psychological therapy: A qualitative meta-synthesis.

The current review aimed to synthesise qualitative literature exploring adult refugees' and asylum seekers' experiences of individual psychological therapy. A comprehensive systematic search of the following databases led to the identification of eight studies for inclusion in this review: PsycINFO, PsycARTICLES, MEDLINE, EMBASE, CINAHL and Academic Search Ultimate. All selected studies used qualitative methodology to explore refugees' and asylum seekers' experiences of individual psychological therapy. Studies were appraised using an adapted version of the Critical Appraisal Skills Programme (CASP) Tool. The data from these selected studies were then synthesised using a meta-ethnographic approach. The synthesis of selected studies resulted in the development of five themes; (i) the importance of recognition and validation within therapy, (ii) building a human connection within the therapeutic relationship and the importance of cultural competency, (iii) revisiting trauma, managing difficult emotions from therapy and regaining hope, (iv) the value of practical interventions, (v) 'one should not wake up the djinns (demons)'-cultural stigma and accessing therapy. These themes illustrated the complexities of working therapeutically with asylum seekers and refugees and the vital role of building trust and safety within the therapeutic relationship prior to engagement in therapeutic work. The results also highlighted varied responses to engaging in trauma work ranging from participants finding the experience transformative to others finding it unhelpful, some participants preferred more practical interventions. Participants' cultural backgrounds and pre-conceptions around therapy impacted on engagement and the therapist's cultural competency was a significant factor in therapeutic engagement. Working therapeutically with asylum seekers and refugees involves a number of factors for consideration. Forced migrants' socio-political context was seen as central to their experiences of distress and recognition of these factors was imperative for positive therapeutic engagement. This review highlights a number of clinical implications to guide practitioners working therapeutically with this community.

A Review of Program Inquiry for Refugee Adult Education in the United States

According to the UN Refugee Agency's annual&nbsp;Global Trends Report, 68.5 million people were forcibly displaced worldwide as of June 2018. This humanitarian crisis raises the question of responsibility on host countries to address the dire need for education access. Questions around how existing adult refugee educational programs should be evaluated remain relatively unexplored. The purpose of this review is to examine existing bodies of academic literature on how evaluation is applied in adult educational programming for refugees within community organizations and how programs utilize evaluation to improve their effectiveness in serving adult refugee populations in the United States. This literature review explores two questions:&nbsp;(1) how is evaluation structured in practice in nonformal educational programs for refugee young adults and adults in the United States? (2) What outcomes typically follow the implementation of evaluation within these programs (i.e. does evaluation influence the effectiveness and accessibility of adult educational programming, such as by providing educational and vocational training?). Considerations which emerged from this review include utilizing theory knitting in evaluation to reduce theoretical segregation and accumulate additional theory that may be present within the current literature. Exploring socio-cultural capital frameworks such as Yosso’s Community Cultural Wealth can further categorize and investigate additional experiences based on specific ethnicities in emerging literature within refugee integration in a country of resettlement in addition to Ager and Strang’s Understanding Integration Framework. Lastly, to better identify the approaches on use of evaluation within the scope of nonformal adult educational settings for adult refugees, expanding Alkin &amp; Christie’s Evaluation Theory Tree to include international perspectives from the development sector should be considered.

Addressing the mental health needs of older adult refugees: Perspectives of multi-sector community key informants

Addressing the mental health needs of older adult refugees: Perspectives of multi-sector community key informants

Risk factors for common mental disorders in young refugees from Iran, Somalia and Syria to Sweden.

Our primary aim was to determine sociodemographic and health-related risk factors for diagnosed common mental disorders (CMDs) among young refugees in Sweden. All young adult refugees from Iran, Somalia and Syria (n=7192), who were residents in Sweden in 2009, were followed from 2010 to 2013 regarding diagnosed CMDs. Cox regression models were used to compute hazard ratios (HRs) of CMDs with 95% confidence intervals (CIs). Those arriving as unaccompanied refugee minors had a lower risk of being diagnosed with CMDs (HR: 0.7; 95%CI: 0.6-0.9) than those arriving as accompanied refugee minors. A higher risk of being diagnosed with CMDs was also found in female refugees (HR: 1.3; 95%CI: 1.1-1.5) compared with male refugees. In addition, individuals with a low (HR: 1.7; 95%CI: 1.3-2.3) or a medium (HR: 1.4; 95%CI: 1.1-1.8) educational level were found to have a higher risk of being diagnosed with CMDs compared with individuals with a high educational level. Refugees from Iran (HR: 2.3; 95%CI: 1.8-2.9) had a higher risk of a diagnosis of a CMD than refugees from Somalia. Moreover, refugees with a diagnosis of a mental disorder other than a CMD (HR: 4.2; 95%CI: 2.8-6.1), digestive (HR: 1.5; 95%CI: 1.0-2.2) or musculoskeletal diseases (HR: 1.5; 95%CI: 1.0-2.2) had a higher risk of being diagnosed with subsequent CMDs, compared with those with no such disorders. Pre-existing diagnoses of mental disorders other than CMDs, and digestive and musculoskeletal disorders should be carefully considered in clinical assessments to initiate early interventions to prevent CMDs.

Konsep Perlindungan Hukum Bagi Pengungsi Anak Dari Ukraina Dalam Perspektif Hukum Pengungsi Internasional

Introduction: The war in Ukraine caused Ukrainian refugees, including children, to be forced to leave their homes to seek protection in areas that were still safe within the country of Ukraine as Internally Displaced Persons or IDPs.Purposes of the Research: This study aims to find out how the concept of legal protection for children who become refugees as a result of armed conflict and how the implementation of legal protection for children who become internally displaced persons in Ukraine.Results of the Research: The concept of humanitarian intervention to protect child refugees is the responsibility of the state as the national authority of Ukraine. but the conditions of war make a country unable to carry out its responsibilities as well as possible to protect internally displaced children as victims of war in their country. Although without intending to ignore the rights of child refugees, a country in a war situation will certainly place more strategic interests on military defense as its top priority, rather than other affairs and interests. the lack of proper livelihood and education for child refugees in Ukraine is one of the proofs showing that the Ukrainian state has not been successful as the main responsibility for protecting child refugees in the country. Therefore, the main responsibility cannot only be placed solely on the national authorities of the Ukrainian state, but must be the responsibility of all nations in the name of humanity, as is the case with international refugees who receive international protection. Children are a vulnerable group, very different from adult refugees. They need special attention so that they require more or different protection and handling measures because of their age. The best principle for the child (best interest of the child) must be the basis of his protection.

Access to Healthcare Among US Adult Refugees: A Systematic Qualitative Review.

Refugees encounter numerous healthcare access barriers in host countries, leading to lower utilization rates and poorer health outcomes. In the US, social inequities and fragmented health systems may exacerbate these disparities. Understanding these factors is necessary to ensure equitable care of refugee populations. A systematic literature review of qualitative studies on US adult refugee healthcare access from January 2000 to June 2021 was performed in accordance with PRISMA. Studies were analyzed deductively and then inductively to incorporate previous findings in other resettlement countries and emergence of US-specific themes. 64 articles representing 16+ countries of origin emerged from the final analysis, yielding nine interrelated themes related to health literacy, cost of services, cultural beliefs, and social supports, among others. The main challenges to refugees' healthcare access emerge from the interactions of care fragmentation with adverse social determinants. Given diverse barriers, integrated care models are recommended in treating refugee populations.

Relationship between Posttraumatic Stress Disorder and Sleep Disturbances in Syrian Refugees in the United States.

Background Posttraumatic stress disorder (PTSD) is associated with disturbed sleep. However, the impact of sleep disturbances and PTSD symptomology in refugee populations is not well known. This study examined how PTSD-related sleep symptoms and overall sleep quality were impacted by previous and current traumatic and stressful experiences. Methods Adult Syrian refugees living in Southeast Michigan were assessed via scheduled in-home interviews. Overall sleep quality was measured using the Pittsburgh Sleep Quality Index. PTSD-related sleep disturbances were measured using the Pittsburgh Sleep Quality Index Addendum. The presence of PTSD symptomatology was assessed via self-report using the Posttraumatic Stress Disorder Checklist. The Life Events Checklist for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition-5 screened for prior traumatic events experienced and the Postmigration Living Difficulties Questionnaire was assessed for postmigration stressors. Correlational analysis was conducted between overall sleep quality, PTSD symptom severity, and previous trauma experienced. A stepwise linear regression analysis was conducted to examine the role of overall sleep quality, PTSD-specific sleep disturbances, current living difficulties, and the number of preimmigration traumatic events directly experienced or witnessed due to the presence of overall PTSD symptomology. Results A total of 53 adults completed the study. PTSD-disturbed sleep was found to be positively associated with overall poor sleep quality ( r = 0.42, p < 0.01), PTSD symptomology ( r = 0.65, p < 0.01), and current living difficulties ( r = 0.37, p < 0.05). The PTSD-related sleep disturbances (B = 0.66, p < 0.01) and postmigration living difficulties (B = 0.44, p < 0.01) were found to be the strongest predictors of PTSD symptoms. Conclusion Disturbed sleep is strongly associated with current stressful experiences and PTSD symptomology among Syrian refugees.

The Association Between Perceived Relationship Quality and Psychological Symptoms in Refugees

Introduction: Relationship quality plays an important role in mental health, but little is known about its importance among resettled refugees. We investigated the association between perceived relationship quality and psychological symptoms among refugees resettled in Australia. Methods: Participants were 738 adult refugees (principal applicants, 83.5% male, M = 43.2 years, SD = 12.3) and their partners who participated in the Building a New Life in Australia (BNLA) study across 5 years from 2013 to 2017. Participants were assessed for psychological distress, posttraumatic stress symptoms (PTSS), and perceived relationship quality, using the Kessler scale (K6), the Posttraumatic Stress Disorder-8 (PTSD-8), and the Dyadic Adjustment Scale-4 (DAS-4), respectively. Results: Multiple regression analyses found that, among principal applicants, perceived relationship quality predicted psychological distress (p = .0006) at post-arrival, and changes in perceived relationship quality predicted changes in PTSS (p = .0003) across a one-year interval. When partners were analyzed, results were broadly consistent with those of the principal applicants, except that changes in relationship quality did predict changes in psychological distress, but not changes in PTSS. Discussion: Relationship quality appeared to be associated with psychological distress, but improvements in relationship quality may have particular utility for reductions in posttraumatic stress disorder (PTSD) symptoms. These results highlight the importance of relationship quality as a key correlate of refugee mental health.

Where do Critical Pedagogy and Language Needs Analysis meet? English as an Additional Language for Adult Refugees and Mi-grants in Greece: A Case Study

Background. Language classes organized for adult refugees and migrants are heterogeneous. Students in these educational settings differ across a number of various aspects, including language competences, educational background and levels of literacy. Seen through the Critical Pedagogy lens language is considered not simply as a means to express or communicate, but as a product constructed by the ways language learners recognise themselves, their social surroundings, their histories, and their potentialities for the future.&#x0D; Purpose. The purpose of our study is to unfold and identify the language needs of a specific group of migrants learners learning English as an additional language in Greece, where English is not the dominant language. We will try to focus and analyse language needs through the critical pedagogy lens and thus make the whole procedure an empowerment tools for the adult refugees and migrants.&#x0D; Method. As a case study, this study follows a qualitative research design. Τhis small-scale study focuses on a specific target group of language learners and their needs and attitudes towards learning. Class observations, field notes, interviews with the participants and questionnaires with open-ended questions were used as main methodological tools.&#x0D; Results. The present article examines the needs of a group of immigrant adult learners attending English language classes at a non-formal educational setting located in Greece. The participants come from diverse ethnic and linguistic backgrounds and the majority of them speak Greek fluently since they have resided in Greece for a long time. A focal point throughout the process was students’ greater involvement in the learning procedure and decision-making processes regarding the content and the presentation of the educational material.&#x0D; Conclusion. Although the systematic needs analysis revealed that the reasons for participation and competence levels among participants varied a lot, a common goal for everyone was achieving oral fluency in the target language. Moreover, the results of this attempt were expressed n terms of learners’ contributions, willingness to share their stories, even to talk about difficulties they met and caring about their classmates’ stories. Thus, we suggest that the incorporation of personal experience in the learning process, not only functions as a link between students and language but also a process for team bonding and motivation.

Hepatitis C Screening and Antibody Prevalence Among Newly Arrived Refugees to the United States, 2010–2017

Six refugee screening sites collaborated to estimate the prevalence of hepatitis C virus (HCV) antibodies among newly arrived refugees in the United States from 2010 to 2017, identify demographic characteristics associated with HCV antibody positivity, and estimate missed HCV antibody-positive adults among unscreened refugees. We utilized a cross-sectional study to examine HCV prevalence among refugees (N = 144,752). A predictive logistic regression model was constructed to determine the effectiveness of current screening practices at identifying cases. The prevalence of HCV antibodies among the 64,703 refugees screened was 1.6%. Refugees from Burundi (5.4%), Moldova (3.8%), Democratic Republic of Congo (3.2%), Burma (2.8%), and Ukraine (2.0%) had the highest positivity among refugee arrivals. An estimated 498 (0.7%) cases of HCV antibody positivity were missed among 67,787 unscreened adults. The domestic medical examination represents an opportunity to screen all adult refugees for HCV to ensure timely diagnosis and treatment.

The Mental Health of Syrian Refugees in the United States: Examining Critical Risk Factors and Major Barriers to Mental Health Care Access

Owing to the 2011 civil war, many Syrians have become displaced internally within the country, have fled to neighboring countries in the region, or have resettled as refugees in the United States (US) through the United States Resettlement Program (USRP). Few studies have been conducted on the mental health of adult Syrian refugees in the US. We conducted an ecological study on the relationship between the mental health status of Syrian refugees in the US, risk factors that negatively affect their mental health post-settlement, and the barriers that prevent them from seeking mental health care. We found that racialization, targeting, under-employment, and concerns about relatives still in Syria negatively affect the mental health of Syrian refugees post-settlement. Challenges with the English language, stigma, lack of access to adequate insurance and transportation, and poor health system acculturation were barriers to Syrian refugee mental health care-seeking behavior in the US. While the US is accepting and resettling Syrian refugees in various parts of the country, it is also important that it focuses on and invests in the mental health needs of the refugees, so as to improve their physical and mental well-being. Copyright © 2023 Arsmtrong-Mensah et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License CC BY 4.0.