University of Sourthern California


Refugee Health: From the Public Health Perspective

The world is currently experiencing the largest refugee crisis since World War II. Many refugees are coming from northern Africa and the Middle East, with roughly 50 percent of the population of Syria seeking refuge from war.

This crisis requires countries that are accepting refugees to have timely and effective healthcare systems in place for their arrival. Not only are refugees and asylum seekers becoming ill and contracting diseases during their travels and upon arrival, but the stress they are experiencing is extremely detrimental to mental health.

It's never been more important than now to build a strong public health system that can cope with the demands of not only the nation's citizens but also this new influx of refugees and asylum seekers.

What Are the Health Issues That Refugees Are Facing?

The needs and health issues of refugees in the United States vary greatly depending on their country of origin, on their experiences during their travel, and on the living conditions that they face once in the U.S.

Many refugees who are arriving in the country now have spent years in refugee camps where the conditions are poor and disease spreads quickly. Some are arriving with tuberculosis, Hepatitis B, or malaria. Many are malnourished and have weakened immune systems.

The biggest health issues that are being seen now are mental health issues. Young men and women are arriving from war-torn countries like Syria and Iraq and are suffering from post-traumatic stress disorder, severe anxiety, persistent headaches, and back pain.

The UNHCR, the UN's Refugee Agency, notes that Syrian refugees are experiencing extreme mental and psychosocial disorders related to the violence they've witnessed, the stress of displacement, the poverty they are experiencing, and the uncertainty about their futures. The UN reports that psychological distress is manifesting itself through emotional, behavioral, cognitive, and social problems. The UN has also documented disorders such as depression, psychosis, prolonged grief disorders, post-traumatic stress disorder, and anxiety disorders. Experts in the public health sector worry that the stress of relocating may exacerbate these issues even further.

What Assistance Do Refugees Need Upon Arrival?

Immediate support through the resettling process can help refugees begin to feel safe and secure. According to the European Journal of Public Health, the majority of refugees who develop anxiety or post-traumatic stress disorder (PTSD) will begin to improve once they feel like they are in a safe place. By helping new arrivals adjust to life in the United States, it is possible to take an almost immediate strain off of the public health system.

The European Journal of Public Health also notes that those who have been separated from their families and those who have had a long asylum-seeking process are more likely to experience prolonged mental health issues. From a public health perspective, this means that by reuniting families and shortening the asylum-seeking process, it's possible to take the strain off of the public health system and ensure that the refugees who are coming to the United States are both physically and mentally stable.

Public Health Issues Arising from the Influx of Refugees

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Image via Flickr by Foreign and Commonwealth Office

Many refugees are arriving with either infectious or non-infectious diseases. The number of medical professionals required to assist with this influx of people is simply not available. After the recent threat of Influenza A, also known as H1N1, and severe acute respiratory syndrome (SARS), the government is incredibly cautious about refugees and asylum seekers entering the country without a comprehensive health check. According to Emerging Health Threats Journal, this often means quarantine, isolation, or complete exclusion. All of these options are costly and time-consuming and often don't actually solve the health problems.

Clinicians also face another obstacle with refugees. In ordinary circumstances, health care specialists are able to differentiate between mental health disorders and normal stress reactions by speaking to their patients and watching their reactions to certain stimuli. However, due to cross-cultural differences and language barriers, clinicians are finding it very difficult to learn about the patient's symptoms and understand their coping mechanisms. This means many refugees are being misdiagnosed.

Health care specialists who are able to are now undergoing training so that they can better understand the way that their patients express distress and illness. However, for every clinician who can undergo this training, there are hundreds who must make do with what is available. This, in turn, puts an incredible amount of stress on the doctors, nurses, and other specialists who are doing their best to help the refugees who have arrived.

Another health issue that has been studied by the UN for several decades is the long-term health effects of dietary changes that the refugees will experience once they settle in the United States. This public health issue is often pushed to the bottom of the list because it is not an immediate issue. Many refugees are coming from countries where, for their entire lives, they have eaten a completely different diet from the foods that are available and affordable in the U.S. This leaves many migrants at higher than normal risk for cardiovascular diseases, diabetes, and certain forms of cancer.

In order to address more long-term health issues relating to refugees and asylum seekers, the public health sector will need to put educational systems in place that help new arrivals to understand what foods are available to them and what constitutes a healthy diet with those available foods.

Educational Opportunities in Public Health

With the refugee crisis growing daily, there is more pressure than ever on the public health system in the United States. More professionals gaining experience in the field can help the United States effectively help refugees who have experienced extreme crisis and improve the public health system for all citizens.

The public health sector is constantly changing and adjusting to new global issues like this one, so it's important to continue your education throughout your career. If you're interested in furthering your career in public health, learn more about the Master of Public Health degree online at the Keck School of Medicine of University of Southern California.

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