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Health-related quality of life among Syrian refugees resettled in Sweden
The Swedish Red Cross University College, Department of Health Sciences. Uppsala University.ORCID iD: 0000-0002-5837-8263
The Swedish Red Cross University College, Department of Health Sciences.
The Swedish Red Cross University College, Department of Health Sciences.
The Swedish Red Cross University College, Department of Health Sciences. Karolinska Instiutet.ORCID iD: 0000-0001-5376-5048
2020 (English)In: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 29, no 2, p. 505-514Article in journal (Refereed) Published
Abstract [en]

Purpose The main purpose of this study was to assess health-related quality of life (HRQoL) among Syrian refugees resettled in Sweden. Further, we wanted to investigate whether sex, age, education, area of residence, cohabitation and social support were associated with HRQoL in this population. Methods This is a cross-sectional study including 1215 Syrian refugees from a randomly selected sample frame resettled in Sweden between the years 2011 and 2013. HRQoL was measured by the EQ-5D-5L descriptive system, and EQ-5D-5L index values were calculated. Associations between sex, age, education, area of residence, cohabitation, social support and EQ-5D-5L were investigated using multiple linear regression analysis. Results Depression/anxiety was the most commonly (61.9%) reported EQ-5D-5L problem among the group of Syrian refugees. The mean EQ-5D-5L index value was found to be 0.754. Male sex, younger age, cohabitation and social support were found associated with a higher EQ-5D-5L index score. Conclusions Our results concerning long-lasting health problems among the study population indicate that there is a profound need for policies and interventions promoting refugees' health. Our results also show that social support, a modifiable factor, is relevant to refugees' overall health, pointing to the importance of public health interventions and policies targeting the facilitation, mobilization and enhancing of refugees' social support.

Place, publisher, year, edition, pages
Springer, 2020. Vol. 29, no 2, p. 505-514
Keywords [en]
Quality of life, Refugees, Social support, Syria, Resettlement
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:rkh:diva-3053DOI: 10.1007/s11136-019-02323-5PubMedID: 31617059OAI: oai:DiVA.org:rkh-3053DiVA, id: diva2:1367734
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2016-07194Swedish Red CrossAvailable from: 2019-11-05 Created: 2019-11-05 Last updated: 2025-01-20Bibliographically approved
In thesis
1. New beginnings, new challenges: health & housing of asylum seekers and refugees in their early post-migration period in Sweden
Open this publication in new window or tab >>New beginnings, new challenges: health & housing of asylum seekers and refugees in their early post-migration period in Sweden
2024 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Asylum seekers and recently resettled refugees are at an increased risk of poor mental health. Besides pre-migration experiences, the early post-migration period in host countries presents numerous challenges that can negatively impact their mental health and well-being, including challenges such as poor housing, and socioeconomic difficulties. Additionally, Sweden has adopted more restrictive migration policies, which risk leading to a growing tension between mental health needs and the policy objectives of reducing migration. Gaining a deeper understanding of day-to-day challenges faced during the early post- migration period is crucial to effectively address and mitigate their potential adverse impact on the mental health of asylum seekers and refugees.

Study I, a cross-sectional population-based survey, utilized the generic EQ-5D- 5L scale to assess the health-related quality of life index value in a study population of 1,215 individuals from Syria who recently resettled in Sweden. The results showed that the most frequently reported problem on the EQ-5D-5L scale was depression/anxiety, and a low index value was associated with being a woman, older age, and low social support. Study II is a qualitative study based on semi-structured interviews with fourteen asylum seekers at two accommodation centers in Sweden, exploring their experiences of living in these centers. The results indicated that their experiences were heavily influenced by the uncertainty of the asylum process and the constraints imposed by limited resources and housing conditions, often described as living a frozen life. This frozen life was a source of constant worry, leading to concerns about potential long-term effects on their health. Despite these challenges, the asylum seekers highlighted care practices that arose spontaneously among the residents, reflecting a shared concern for each other's well-being. Study III, a qualitative study utilizing the same data collection process used in Study II, explored the experiences of asylum seekers during the COVID-19 pandemic. The findings revealed that the living conditions at the centers shaped how the pandemic was experienced. The asylum seekers reported feeling increasingly excluded from society, a sentiment reinforced by a pandemic response from authorities that was perceived as lacking understanding or care for their unique situation. Study IV is a register-based prospective longitudinal cohort study that includes all adult asylum seekers who received residence permits between 2010 and 2012. The study investigated the association between housing type during the asylum process (institutional or self-organized) and the prescriptions of antidepressants or anxiolytic medication, as well as specialized in- and outpatient visits with diagnoses of CMDs, over a five-year follow-up period after being granted refugee status. The results indicated that individuals who had lived in institutional housing were at greater risk of having more prescriptions for antidepressants or anxiolytic medication, as well as a higher likelihood of specialized in- and outpatient visits with diagnoses of CMDs, compared to those who had lived in self-organized housing.

The thesis emphasizes the importance of post-migration living conditions in shaping the mental health of asylum seekers and refugees in Sweden, with a particular focus on the asylum process and housing as key factors associated with distress. It also suggests that collective institutional accommodation tends to be more harmful to mental health than self-organized housing. Overall, the findings advocate for context-sensitive interventions addressing individual, community, and structural factors, with a focus on improving housing conditions, alleviating day-to-day challenges, and strengthening social support networks to prevent long-term mental health issues. Additionally, the thesis also calls for a transparent and fast-tracked asylum process.

Place, publisher, year, edition, pages
Stockholm: Karolinska Institutet, 2024. p. 97
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:rkh:diva-5010 (URN)10.69622/27161475.v2 (DOI)978-91-8017-821-1 (ISBN)
Public defence
2025-01-23, Emmy Rappesalen T1, Hälsovägen 11, Huddinge, 09:00 (English)
Opponent
Supervisors
Funder
Swedish Red Cross University
Available from: 2025-01-20 Created: 2025-01-20 Last updated: 2025-01-20Bibliographically approved

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Gottvall, MariaSjölund, SaraArwidson, CharlottaSaboonchi, Fredrik

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