Post-Migration Stressors and Health-Related Quality of Life in Refugees from Syria Resettled in Sweden

Abstract

The link between post-migration stressors and mental ill health is well documented in refugees resettled in high-income host countries, but the consequences of these stressors on refugees’ health-related quality of life (HRQoL) are less known. This study examined the association between post-migration stressors and HRQoL among Syrian adult refugees resettled in Sweden using a preference-based value set obtained from the general Swedish population. A total of 1215 Syrian adults, ages 18–64 years, granted residency in Sweden, responded to a postal questionnaire in 2016 regarding various aspects of their resettlement. The European Quality of Life Five Dimensions Five Level (EQ–5D–5L) questionnaire was used to assess HRQoL through an EQ–5D–5L index score (range; 0=dead to 1=full health). The index score was preference weighted using a Swedish population value set. Predictors were four self-reported post-migration stressors related to daily living in the host country: financial strain, social strain, competency strain and perceived discrimination divided into low, medium and high levels of experienced stress. Multivariable linear regression models were employed to assess the association between post-migration stressors and HRQoL index score, adjusting for potentially traumatic events in the pre- and peri-migration phase as well as sociodemographic confounders/covariates (sex, age, education, civil status, immigration year). The Syrian refugees had a mean EQ–5D–5L index score of 0.863 (SD = 0.145). There was strong evidence of a negative dose-response association in both unadjusted and adjusted models between HRQoL and the post-migration stressors financial strain and social strain—i.e., there was a stepwise, and statistically significant, decrease in HRQoL when going from low to medium to high strain. Competency strain and discrimination were only associated with lower HRQoL when experienced at high levels in fully adjusted models. High exposure to potentially traumatic experiences before or during flight was also associated with lower HRQoL. Syrian refugees resettled in Sweden reported a lower HRQoL than the general Swedish population and lower than age-matched Swedish adults. The present study results point to the possible adverse effects of post-migration stressors on HRQoL.

Refugees’ experiences of healthcare in IRAN: A qualitative study

“…Also, in a study conducted by Matilda Sengoelge et al in Sweden on post-migration stressors and health-related quality of life in Syrian refugees, there was substantial evidence for a negative dose-response relationship (in both unadjusted and modi ed models) with post-migration stress, i.e. nancial and social stress (14). On the other hand, in the research done so far, no study has investigated the quality of life, health, and welfare of Afghans living in refugee camps in the country.…”

“…On the other hand, in the research done so far, no study has investigated the quality of life, health, and welfare of Afghans living in refugee camps in the country. However, previous studies have shown that the services provided to foreign nationalities is not acceptable (14). This issue requires more attention of the o cials to be paid to the importance of the issue and proper planning to provide services in education, health, and livelihood.…”

Forms of Aid Provided to Refugees of the 2022 Russia–Ukraine War: The Case of Poland

“…Having experienced the traumas of war, refugees have to face new stressors connected with being a minority in a foreign country that include learning a foreign language and new social and cultural norms [ 21 ], family-related problems (i.e., being separated from the family and conflicts with relatives), and financial or housing problems or unemployment. It was shown that the stressors related to relocation derive from experiences that are detrimental to mental health, leading in particular to post-traumatic stress disorder (PTSD), anxiety, and depression [ 23 ]. Therefore, such a challenging task such as helping refugees to fully participate in and to contribute to the society should engage authorities at all levels (central, regional, and local) as well as many other entities.…”

Migration-related determinants of health-related quality of life of persons with direct migration background in Germany: a study based on the German Socio-Economic Panel

“…However, no association was found between the years since immigration to Germany, German citizenship, and HrQoL ( 13 ). A recent study on post-migration stressors and HrQoL among Syrian refugees in Sweden found negative associations between financial and social stress and HrQoL ( 16 ). Furthermore, possible associations between HrQoL, competency stress, and discrimination were identified.…”