Previous refugee research has been unable to link pre-displacement trauma with unemployment in the host country. The current study assessed the role of pre-displacement trauma, post-displacement trauma, and the interaction of both trauma types to prospectively examine unemployment in a random sample of newly-arrived Iraqi refugees. Participants (N=286) were interviewed three times over the first two years post-arrival. Refugees were assessed for pre-displacement trauma exposure, post-displacement trauma exposure, a history of unemployment in the country of origin and host country, and symptoms of posttraumatic stress disorder (PTSD) and depression. Analyses found that neither pre-displacement nor post-displacement trauma independently predicted unemployment 2 years post-arrival; however, the interaction of pre and post-displacement trauma predicted 2-year unemployment. Refugees with high levels of both pre and post-displacement trauma had a 91% predicted probability of unemployment, whereas those with low levels of both traumas had a 20% predicted probability. This interaction remained significant after controlling for sociodemographic variables and mental health upon arrival to the U.S. Resettlement agencies and community organizations should consider the interactive effect of encountering additional trauma after escaping the hardships of the refugee's country of origin.

Unemployment is associated with poor health among refugees and immigrants; however, the degree to which discrimination in employment contributes to poor health remains unclear because of methodological limitations. This cross-sectional study aims to investigate factors associated with perceived discrimination, ethnicity and migration status, and their implication on health (self-rated health & depression). Perceived discrimination was investigated in 273 Iraqi skilled-workers, refugees and immigrants, who are members of a professional scientific organization. It was hypothesized that unemployment, ethnicity (Arab), and migration status (refugee) would be associated with perceived discrimination. Additionally, it was hypothesized that participants who endorse discrimination are more likely to report poor health. Results reveal that more individuals who were unemployed (46.4%), reported perceived discrimination (X2(1, N=273) =6.63, p<.05), however, when linear regression modeling was applied, age [OR=1.36], gender [OR=2.13], and ethnicity [OR=2.15], not migration status became significant predictors of discrimination. With respect to health, age [OR=2.25], length of residency [OR.93], language skills [OR=3.00], and perception of discrimination [OR=2.12] were predictors of SRH, while ethnicity [OR=3.93], age [OR=1.39], and discrimination [OR=3.26] were significant predictors of depression. Notably, perceived discrimination was a predictor in both health variables. In conclusion, there appears to be a link between discrimination and health in a homogenous refugee and immigrant sample.

Refugees experience distress from premigration trauma, often exacerbated by postmigration difficulties. To develop effective interventions, risk factors for mental health symptoms need to be determined. Male Iraqi refugees (N = 53) to the United States provided background information and reported predisplacement trauma and psychological health within 1 month of their arrival. An inflammatory biomarker-C-reactive protein (CRP) was assessed approximately 1.5 years after arrival, and a contextual factor-acculturation-and psychological health were assessed 2 years after arrival. We tested whether acculturation and CRP were associated with posttraumatic stress disorder (PTSD) and depression symptoms at the 2-year follow-up, controlling for baseline symptoms, age, body mass index, and predisplacement trauma. Acculturation was inversely related to depression, and CRP was positively related to both PTSD and depression at the 2-year follow-up. Interventions targeting acculturation could help reduce the development of depression symptoms in refugees. The role of CRP in the development of PTSD and depression symptoms warrants further research.