Refugees In Australia Research Articles

Factors Leading to Health Care Exclusion Among African Refugees in Australia: The Case of Blood Donation

Factors Leading to Health Care Exclusion Among African Refugees in Australia: The Case of Blood Donation

Factors Leading to Health Care Exclusion Among African Refugees in Australia: The Case of Blood Donation

Developed countries that accept refugees are obligated, under the UN Convention for Refugees, to integrate refugees into host communities, with inclusion in the health system being pivotal. Integration programs can be difficult though, because many refugees’ home countries have different health systems, lower health literacy, and different expectations of health services. Country health system differences require cultural adaptation of host country services when designing targeted, inclusive health care programs. Using a sample of 317 Australian-based African refugees, the authors examine how refugees’ acculturation, perceptions of discrimination, past behavior, objective knowledge, and medical mistrust affect their health inclusion, depending on their blood donation intentions. The results indicate that perceived discrimination and objective blood donation knowledge directly affect donation intentions. Perceived discrimination mediates the relationships between acculturation and intentions and between medical mistrust and donation intentions, and objective knowledge mediates the relationship between past behavior and donation intentions. The authors offer recommendations to policy makers designing social inclusion programs and health service providers designing and delivering targeted initiatives, to better facilitate refugee participation in host country health systems.

Erratum

The below articles were initially published using different DOIs. The original DOIs included the number 07439156, which was an outdated ISSN for the Journal of Public Policy & Marketing. The number 07439156 in each DOI has been updated to 07439156 to reflect the journal’s current ISSN. The specific changes are as follows: The DOI 10.1177/0743915618813118 has been corrected to 10.1177/0743915618813118 The DOI 10.1177/0743915618813115 has been corrected to 10.1177/0743915618813115 The DOI 10.1177/0743915618813582 has been corrected to 10.1177/0743915618813582 The DOI 10.1177/0743915618811850 has been corrected to 10.1177/0743915618811850 The DOI 10.1177/0743915618811851 has been corrected to 10.1177/0743915618811851 The DOI 10.1177/0743915618810438 has been corrected to 10.1177/0743915618810438 The DOI 10.1177/0743915618810448 has been corrected to 10.1177/0743915618810448 The DOI 10.1177/0743915618810440 has been corrected to 10.1177/0743915618810440 The complete references for the impacted articles are as follows: Anderson, Stephanie, Kathy Hamilton, and Andrea Tonner (2018), “‘They Were Built to Last’: Anticonsumption and the Materiality of Waste in Obsolete Buildings,” Journal of Public Policy & Marketing, 37 (2), 195-212. 10.1177/0743915618810438 Cherrier, Hélène, and Ronald Paul Hill (2018), “Anticonsumption as Tactical Response to Institutionalized Subordination: The Case of Materially Deprived Anticonsumers,” Journal of Public Policy & Marketing, 37 (2), 213-226. 10.1177/0743915618811850 Dholakia, Utpal, Jihye Jung, and Nivriti Chowdhry (2018), “Should I Buy This When I Have So Much? Reflection on Personal Possessions as an Anticonsumption Strategy,” Journal of Public Policy & Marketing, 37 (2), 260-273. 10.1177/0743915618813582 Guillard, Valérie (2018), “Anticonsumption Consciousness in Pursuit of Sustainability,” Journal of Public Policy & Marketing, 37 (2), 274-290. 10.1177/0743915618813118 Kropfeld, Maren Ingrid, Marcelo Vinhal Nepomuceno, and Danilo C. Dantas (2018), “The Ecological Impact of Anticonsumption Lifestyles and Environmental Concern,” Journal of Public Policy & Marketing, 37 (2), 245-259. 10.1177/0743915618810448 Polonsky, Michael Jay, Ahmed Shahriar Ferdous, Andre M. N. Renzaho, Neil Waters, and Zoe McQuilten (2018), “Factors Leading to Health Care Exclusion Among African Refugees in Australia: The Case of Blood Donation,” Journal of Public Policy & Marketing, 37 (2), 306-326. 10.1177/0743915618813115 Scheurenbrand, Klara, Elizabeth Parsons, Benedetta Cappellini, Anthony Patterson (2018), “Cycling into Headwinds: Analyzing Practices That Inhibit Sustainability,” Journal of Public Policy & Marketing, 37 (2), 227-244. 10.1177/0743915618810440 Scott, Kristin A., and S. Todd Weaver (2018), “The Intersection of Sustainable Consumption and Anticonsumption: Repurposing to Extend Product Life Spans,” Journal of Public Policy & Marketing, 37 (2), 291-305. 10.1177/0743915618811851

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

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.

Responding to Refugees in Australia: What is the Christian Response?

What role should Christians play in dealing with the march of displaced people across the globe? What moral and spiritual obligations do we owe the distant stranger — the refugee? We can learn from the experience of the Hebrew refugees leaving Egypt and the inclusive nature of the early Christian Church. In the Australian context, this article explores the historical and current attitudes towards asylum seekers and calls for a faith-led movement to stand shoulder to shoulder with those who are demonised and dehumanised.

The Structural and Institutional Exclusion of Refugees in Australia

Australia has been involved in the UNHCR resettlement program since 1977 and is one of the top three resettlement countries in the world. Despite considerable experience and policy and program efforts, humanitarian migrants experience lower economic and social integration than other immigrants. This paper examines how social structures and institutional responses and practices play part to these outcomes. Drawing on data from an ethnographic study with recently settled South Sudanese refugees, and a longitudinal survey of humanitarian migrants in Australia, the chapter demonstrates that the main reason for this poor outcome is a lack of accessible pathways to refugee migrants.

Refugee family reunion: What might have been

This article demonstrates that many refugees in Australia are deliberately denied a realistic prospect of achieving family reunion. It then explains why, in cases not involving child refugees in Australia, Australia has significant room to deny any international obligation to enable refugee family reunion. Finally, it discusses what might have been, if international legal history had played out a little differently.

Depression, Anxiety, and Acculturative Stress Among Resettled Bhutanese Refugees in Australia

Despite awareness of the difficulties faced by refugees in flight, little is known about their mental health following resettlement. This article investigated rates, predictors, and moderators of anxiety, depression, and acculturative stress among members of the resettled Bhutanese refugee community in northern Queensland. A total of 148 participants (51% male), 18 to 83 years of age, participated in this cross-sectional study. A questionnaire was comprised of bilingual (English–Nepali) versions of the Depression, Anxiety, and Stress Scale (DASS-21; anxiety and depression), the Multidimensional Acculturative Stress Scale (MASS; acculturative stress), Brief-COPE (coping style), Multidimensional Scale of Perceived Social Support (MSPSS; social support), and socio-demographics. Participants reported severe levels of anxiety and moderate levels of depression, and moderate to high levels of acculturative stress. Acculturative stress was a substantive contributor to both depression and anxiety scores. Additional risk factors included the use of maladaptive/avoidant coping styles, age, and education. English language proficiency was strongly protective, as was education to Year 12 and current employment. This research is the first of its kind with this refugee group in Australia, and highlights the longevity and severity of mental health issues that affect Bhutanese refugees resettled in Australia.

Histories of Migrants and Refugees in Australia

This article canvasses recent scholarship on migrants and refugees in Australian history. It covers broadly three main fields of enquiry: White Australia, postwar immigration and refugees since the Vietnam War. We argue there is a new dynamism to the field while simultaneously making the case that migrant and refugee history has hitherto been largely quarantined from mainstream Australian historiography.

2.11-P17Psychological trauma and access to primary health care services for asylum seekers and refugees in Australia

2.11-P17Psychological trauma and access to primary health care services for asylum seekers and refugees in Australia

Achieving the four dimensions of food security for resettled refugees in Australia: A systematic review

Food security is defined by four dimensions: food availability, access, utilisation and stability. Resettled refugees face unique struggles securing these dimensions and, thus, food security when moving to a new country. This systematic review aimed to identify the challenges Australian refugees experience in achieving the four dimensions of food security. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed; the SPIDER tool was used to determine eligibility criteria. Three databases were searched using terms relating to food in/security and refugees from 2000 to 20 May 2017. Seven articles were retained for analysis. Studies were categorised against the four dimensions, with four studies identifying challenges against all dimensions. Challenges contributing to high levels of food insecurity in each dimension included: availability and cost of traditional foods, difficulty in accessing preferred food outlets, limited food knowledge and preparation skills and food stability due to low income and social support. Food insecurity adversely impacts refugee health and integration. Methodical research framed by the four dimensions of food security is imperative to address challenges to securing food security in refugee groups and assisting in the development of sustainable interventions.

Influence of the social determinants of health on access to healthcare services among refugees in Australia.

Refugees in Australia are not fully utilising the healthcare system for several reasons and this may be affecting their overall health outcomes. This qualitative systematic review examined the influence of the social determinants of health on refugees' access to healthcare services in Australia. Electronic databases were searched using terms relating to refugees, social determinants, healthcare services, barriers, enablers and Australia. Only peer-reviewed studies published in English since 2006, which focused on refugees and specifically discussed social determinants influencing refugees' access to healthcare services in Australia, were included. The studies were critically analysed using standard Critical Appraisal Skills Programme Tools. Eight studies were included in the review. Findings reveal multiple factors influence refugees' access to healthcare in Australia, and these can be conceptualised within a social-ecological model of health; that is, they operate across individual, interpersonal, environmental, organisational and policy levels. The novel finding of this review was the re-occurrence of similar influences across multiple healthcare service settings in Australia. The prevalence and re-occurring nature of the social determinants of health suggests that refugees are experiencing multilayered barriers to accessing Australian healthcare. All levels of a social-ecological model must be addressed in any attempt to break down these barriers.

“I am still passionate despite the challenges”: Nurses navigating the care for refugees

To report the challenges faced by the nursing workforce in refugee health. Nurses are in the forefront of care provision for refugees who are recognised as one of the most vulnerable population groups in the world. The number of refugees in Australia is increasing, and more nurses are needed as care providers. Research on the challenges faced by refugee health nurses is sparse. Qualitative research methodology was used to study the experience of refugee health nurses. Using a descriptive qualitative research approach, a better understanding of the ongoing challenges of caring for refugees is presented. Semi-structured interview with a convenience sample of registered nurses who worked in New South Wales refugee health services was conducted and digitally recorded in 2013. Responses were transcribed verbatim and analysed for themes. Six refugee health nurses who have been working in New South Wales refugee health services between 1-8years participated in this study. A thematic analysis of the data led to three main themes: caring for clients with challenging needs; challenges in the course of caring for refugees; and passion in caring for refugees. Participants reported what it means to be refugee health nurses, they explored their roles and emphasised the need to understand refugee health issues. This study provides more insight into the unique experiences nurses have when caring for refugees. More debriefing opportunities and resources may reduce the challenges of caring. The refugee health nurses' stories support the need for further role refinement for nurses caring for refugees in the community, rural areas and health clinics. This is essential in promoting their well-being and that of the vulnerable population they are caring for.

Immunisation for refugees in Australia: a policy review and analysis across all States and Territories

ObjectiveAlthough people of refugee background are likely to be under‐immunised before and after resettlement, no study to date has evaluated refugee specific immunisation policies in Australia. We developed a framework to analyse immunisation policies across Australia to highlight the strengths and gaps so as to inform development of more effective refugee specific immunisation policies. MethodsWe sourced publicly available immunisation policy documents from state and territory government websites. Content analysis of seven policy documents was undertaken using a developed framework comprising crucial policy determinants. ResultsImmunisation policy differed substantially across the jurisdictions. While most policies did not highlight the importance of data collection on immunisation for refugees and the public funding of vaccines for refugees, policy determinants such as accessibility and obligations were fulfilled by most jurisdictions. ConclusionOur findings indicate stark differences in immunisation policy for people of refugee background across Australia. Highlighted gaps demonstrate the need to revise current policies so that they are aligned with their intended outcome of enhancing uptake of vaccines and improving immunisation coverage among resettled refugees in Australia. Implications for public healthImmunisation policy development for refugees needs to be robust enough to ensure equitable health services to this group.

Single mothering as experienced by Burundian refugees in Australia: a qualitative inquiry

BackgroundRefugee mothers have fled from their homeland to escape persecutions with their children only to find other threats to their well-being in the new country. Building on previous research, it is known that being a new immigrant is challenging and requires adaptation. The adaptation process, known as acculturation, may not be successful leading to psychological distress. It is also known that a generation gap can occur when children acculturate faster than their parents. What was lacking was understanding about the experiences of single refugee mothers.MethodsInterpretative phenomenological study was undertaken to explore the lived experiences of eight Burundian refugee single mothers in Australia. Data were collected by in-depth interviews. Each interviews were transcribed and analyzed using thematic analysis.ResultsFindings revealed three themes. First theme ‘Traditional mothering practices of Burundian culture’ illustrated mothering strategies as practiced prior to their arrival in Australia including mothering with sufficient social support, strong position of parents, and regular use of physical disciplining. Second theme ‘Challenges identified after arrival to new country’ revealed that mothers felt their children acculturated faster than themselves which led to intergenerational gap. This has also led participants to live in a continuous dilemma, experiencing inner conflicts and struggles associated with their mothering practices, especially when mothers had arrived with a lack of knowledge relating to acceptable mothering practices in a new culture. Final theme, ‘Reforming family life in Australia’ highlighted the decisions made by single refugee mothers which is to embrace both new and original cultures, leading to successful acculturation. However, lack of appropriate knowledge of acceptable mothering practices led to involvement of legal authorities who threatening to remove children from the mother’s care. This has led mothers feeling change of power from ‘mother to child, ‘to child to mother’, raises concerns for family wellbeing.ConclusionsA need for parenting information when entering a new country including education about any legal obligations for parents such as a Child Protection Act will assist successful acculturation. As nurses are likely to encounter refugee single mothers, they are well placed to provide support and education to new refugee single mothers.

Does Employment Status Vary by Demographics? An Exploratory Study of Former Refugees Resettled in Australia

ABSTRACTThis study examined the associations between employment status and demographic factors of former refugees from Ethiopia, Burma, and Democratic Republic of Congo resettled in Australia. Two hundred and twenty-two participants completed a survey, following which chi square analysis was conducted. The results indicated that country of origin, gender, education, English language proficiency (i.e., speaking, reading, and writing), and length of stay in Australia, were associated with being employed. Ethiopians, who had been in Australia for a longer duration, were more likely to be employed. Participants from Burma, whose resettlement was relatively recent, were focused on upskilling themselves. Education qualifications were associated with likelihood of securing employment. A moderate level of education, compared to high or low, provided participants more chances to gain employment. These outcomes help in understanding the employment-related experiences of individuals from a refugee background. Implications and future directions are discussed.IMPLICATIONSEmployment is fundamental to successful integration of refugees. Country of origin, gender, education, English language proficiency, and length of stay are associated with employment for former refugees in Australia from Ethiopia, Burma, and Democratic Republic of Congo.Understanding these factors can assist stakeholders to better focus their efforts when working with these populations.

The mental health and help-seeking behaviour of resettled Afghan refugees in Australia

BackgroundPsychological trauma, in particular, posttraumatic stress disorder (PTSD) and depression, are highly prevalent among resettled refugees. However, little is known regarding the mental health status and associated help-seeking behaviour of resettled Afghan refugees in Australia.MethodsA sample of 150 resettled Afghan refugees (74 males; mean age 32.8 years, SD = 12.2) living in Adelaide, South Australia were recruited. Self-reported measures of PTSD, depression, exposure to traumatic events, functional impairment, self-recognition of PTSD symptomatology and help-seeking behaviours were completed. Multivariate analysis of variables associated with help-seeking was conducted.ResultsForty-four percent of participants met criteria for clinically significant PTSD symptoms and all but one participant reported being exposed to 1 or more traumatic and/or conflict related events, such as ‘losing your property and wealth’. Moreover, 14.7% of participants had symptoms suggestive of clinically significant depression. General practitioners were the most common source of help in relation to mental health problems, with very few participants (4.6%) seeking help from specialist trauma and torture mental health services. Self-recognition of having a PTSD related mental health problem and functional impairment levels were both found to be independent predictors of help-seeking (p ≤ .05).ConclusionsThe findings provide further evidence for high rates of PTSD symptomatology and low uptake of mental care among resettled refugees. Poor self-recognition of the presence and/or adverse impact of PTSD symptoms may need to be targeted in mental health promotion programs designed to improve “mental health literacy” and thereby promote early and appropriate help-seeking where this is needed.

Challenges in immunisation service delivery for refugees in Australia: A health system perspective

Refugees are at risk of being under-immunised in their countries of origin, in transit and post-resettlement in Australia. Whilst studies have focused on identifying barriers to accessibility of health services among refugees, few focus on providers' perspectives on immunisation service delivery to this group. Health service providers are well placed to provide insights into the pragmatic challenges associated with refugee health service delivery, which can be useful in identifying strategies aimed at improving immunisation coverage among this group. A qualitative study involving 30 semi-structured interviews was undertaken with key stakeholders in immunisation service delivery across all States and Territories in Australia between December 2014 and December 2015. Thematic analysis was undertaken. Variability in accessing program funding and vaccines, lack of a national policy for catch-up vaccination, unclear roles and responsibilities for catch-up, a lack of a central immunisation register and insufficient training among general practitioners were seen as the main challenges impacting on immunisation service delivery for refugees. This study provides insight into the challenges that impact on effective immunisation service delivery for refugees. Deliberate strategies such as national funding for relevant vaccines, improved data collection nationally and increased guidance for general practitioners on catch-up immunisation for refugees would help to ensure equitable access across all age groups.

Incommensurable Futures and Displaced Lives: Sovereignty as Control over Time

The recent mass displacement of refugees has been described internationally as a “crisis.” But crisis implies eventfulness: a distinct problem that can be solved. The urgency of solving this problem of displacement has seen the use of expansive techniques of sovereignty across Europe, the epicenter of the crisis. Focusing exclusively on the formation of sovereignty through the analytical locus of crisis continues, however, to reproduce the trope of the “refugee” as a category of exception. This essay considers the experiences of people who were resettled as refugees in Australia and whose displacement has ostensibly been resolved. Drawing attention to their continuing experiences of violence, it considers how the temporal framing of displacement is itself a way to conceal formations of sovereignty embedded in the very processes designed to resolve displacement. Doing so opens up new ways to think about control over time as a technique of sovereignty.

Factors Leading to Health Care Exclusion among African Refugees in Australia: The Case of Blood Donation

Abstract Developed countries that accept refugees are obligated, under the UN Convention for Refugees, to integrate refugees into host communities, with inclusion in the health system being pivotal. Integration programs can be difficult, as many refugees' home countries have different health systems, they have lower health literacy, and different expectations of health services. Country health system differences, require cultural adaption of host country services when designing targeted inclusive health care programs. Using a sample of 317 Australian-based African refugees, this study examines how refugees' acculturation, perceptions of discrimination, past behavior, objective knowledge and medical mistrust influence their health inclusion, based on their blood donation intentions. The results indicate that perceived discrimination and objective blood donation knowledge directly affect donation intentions. Perceived discrimination mediates the relationship between acculturation and intentions, and between...