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Comparison of self-reported health & healthcare utilisation between asylum seekers and refugees: an observational study.
Toar, Magzoub O'Brien, Kirsty K Fahey, Tom
Toar, Magzoub
O'Brien, Kirsty K
Fahey, Tom
Advisors
Editors
Other Contributors
Date
2009
Date Submitted
Keywords
Other Subjects
Subject Mesh
Adult
Aged
Cross-Sectional Studies
Female
Health Services
Humans
Male
Middle Aged
Observation
Patient Acceptance of Health Care
Psychometrics
Questionnaires
Refugees
Stress Disorders, Post-Traumatic
Aged
Cross-Sectional Studies
Female
Health Services
Humans
Male
Middle Aged
Observation
Patient Acceptance of Health Care
Psychometrics
Questionnaires
Refugees
Stress Disorders, Post-Traumatic
Planned Date
Start Date
Collaborators
Principal Investigators
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19566954.pdf
Adobe PDF, 247.02 KB
Alternative Titles
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Abstract
BACKGROUND: Adult refugees and asylum seekers living in Western countries experience a high prevalence of mental health problems, especially post traumatic stress disorder (PTSD), depression and anxiety. This study compares and contrasts the prevalence of health problems, and potential risk factors as well as the utilisation of health services by asylum seekers and refugees in the Irish context. METHODS: Cross sectional study using validated self reported health status questionnaires of adult asylum seekers (n = 60) and refugees (n = 28) from 30 countries, living in Ireland. Outcome measures included: general health status (SF-36), presence of PTSD symptoms and anxiety/depression symptoms. Data on chronic conditions and pre or post migration stressors are also reported. The two groups are compared for utilisation of the health care system and the use of over the counter medications. RESULTS: Asylum seekers were significantly more likely than refugees to report symptoms of PTSD (OR 6.3, 95% CI: 2.2-17.9) and depression/anxiety (OR 5.8, 95% CI: 2.2-15.4), while no significant difference was found in self-reported general health. When adjusted by multivariable regression, the presence of more than one chronic disease (OR 4.0, 95%CI: 1.3-12.7; OR 3.4, 95% CI: 1.2-10.1), high levels of pre migration stressors (OR 3.6, 95% CI: 1.1-11.9; OR 3.3, 95% CI: 1.0-10.4) or post migration stressors (OR 17.3, 95% CI: 4.9-60.8; OR 3.9, 95% CI: 1.2-12.3) were independent predictors of self reported PTSD or depression/anxiety symptoms respectively, however, residence status was no longer significantly associated with PTSD or depression/anxiety. Residence status may act as a marker for other explanatory variables; our results show it has a strong relationship with post migration stressors (chi2 = 19.74, df = 1, P < 0.001).In terms of health care utilisation, asylum seekers use GP services more often than refugees, while no significant difference was found between these groups for use of dentists, medication, hospitalisation or mental health services. CONCLUSION: Asylum seekers have a higher level of self reported PTSD and depression/anxiety symptoms compared to refugees. However, residence status appears to act as a marker for post migration stressors. Compared to refugees, asylum seekers utilise GP services more often, but not mental health services.
Language
en
ISSN
1471-2458
eISSN
ISBN
DOI
10.1186/1471-2458-9-214
PMID
19566954