Refugees in Australia are far behind in health and well-being. Here is the reason

Health outcomes for refugees and people on humanitarian visas are significantly worse than the general Australian population. They are more likely to report long-term conditions, including diabetes (80% higher), kidney disease (80%), stroke (40%) and dementia (30%).

Among hospitals for refugees and humanitarian migrants, one in 14 are for preventable conditions. New data shows that when it comes to COVID, they are more than five times more likely than permanent immigrants to be hospitalized.

And those who have been held for long periods of time in immigration detention bear significant health care costs – an estimated 50% more than other asylum seekers.

Why is the health of refugees and aid workers so much worse than the rest of the country? And what can we do about it?

Greater risk of physical and mental health problems

Health is a basic human right. But refugees and humanitarians in Australia face many challenges that prevent them from fully enjoying this right.

Compared to the rest of the population, Australians on humanitarian visas are at greater risk of physical and mental health problems. The factors contributing to this are complex, interrelated and interconnected.

People fleeing persecution are likely to have experienced significant human rights abuses, torture and trauma, which affect their mental health and well-being.

While in captivity, they are likely to have experienced poor living conditions with limited access to water, sanitation and hygiene, as well as food shortages and limited access to basic care of health.

This can lead to significant health problems. The most common include:

• mental illnesses
• malnutrition
• infectious diseases
• the vaccine is low
• poor oral and eye health
• chronic diseases that are not well controlled
• delayed growth and development of children.

These conditions may require immediate care or long-term management – ​​or both.

One study measured the burden of mental health disorders – such as post-traumatic stress disorder (PTSD) – in refugees and migrants in Australia over five years. It found more than 34% had PTSD or major depression.

Chronic mental illness was associated with loneliness, discrimination, unsafe housing, financial problems and chronic living conditions.

3 refugee camps

People from refugee backgrounds have unique health and cultural beliefs, practices and needs that are often misunderstood by doctors. These special needs can affect the quality of care they receive.

1. Language barriers

Most of the refugees and aid workers do not speak English well and some do not know how to write in their own languages.

This can make keeping up with health conditions a challenge. Difficulties understanding diagnoses, treatment options, and the need for follow-up can greatly complicate chronic conditions such as diabetes and high blood pressure, which require ongoing testing and treatment.

Although the government pays for translation and interpretation services, research shows that they are often underutilized and ineffective. Finding an interpreter for smaller or emerging groups can also be more difficult, as services tend to cater to existing language groups.

Language barriers can also limit employment opportunities and lead to financial stress, which has a negative impact on health and overall well-being.

2. Health literacy

Health literacy is the ability to access, understand and use health information to make informed decisions about our health. It is associated with improved self-reported health, lower health care costs, increased health literacy and reduced hospitalizations.

Some refugees and aid workers have poor health literacy, which is linked to poor health outcomes.

Research we did at the beginning of the outbreak with Arabic, Karen, Dari and Dinka-speaking refugees showed participants with low health literacy were less willing to receive COVID vaccines. Their skepticism about the vaccine and the virus was further reinforced by conspiracy theories and misinformation on the internet.

3. Continuity of care

Patients from refugee families can fall into trouble when services are not coordinated or tracked.

For example, Australia’s National Childhood Immunization Program is very extensive compared to other countries. But most childhood vaccines require multiple doses over time. When the need for sequence agreements is not defined correctly – or the memory system is not culturally appropriate – it may be missed.

Looking to the future

Improving the health and well-being of refugees and aid workers is difficult. We need a strong foreign policy that promotes stability and basic services overseas, as well as humanitarian aid for crises.

In Australia, non-medical factors also affect health outcomes. They include housing, safe work, working conditions, social inclusion, protection against discrimination and general literacy, as well as health literacy.

We need to recognize and use the security factors that are most relevant to the health and well-being of people from refugee families. These include things like social connection, resilience, sense of worth and identity, and adapting to a new culture.

We need more research into what helps and hinders the health and well-being of refugees. It must include people from refugee backgrounds, civil society organizations and educational institutions.

Our health services need to be responsive, compassionate and inclusive. This is important to meet the unique cultural and social needs of people of refugee backgrounds.