Gezondheid en zorggebruik van vluchtelingen

Objective

To analyse changes in health and health care utilisation of refugees after obtaining a residence permit.

Design

Prospective cohort study.

Method

T1 of the study ‘Gevlucht – gezond?’ took place in 2003-2004 among 410 asylum seekers and permit holders from Afghanistan, Iran and Somalia. We re-interviewed 172 people from this group during the period 1 June 2010 – 1 July 2011. At this T2, all respondents had a residence permit: 104 had a permit during T1 as well, while 68 received a residence permit during the intervening period. We analysed the changes in health and health care utilisation of this 2nd cohort, and the differences between recent and longstanding permit holders.

Results

The prevalence of self-reported diabetes and hypertension increased among longstanding permit holders (from 8% to 21% and from 13% to 24%, respectively). The prevalence of chronic disorders decreased among new permit holders; on average, they reported 3.0 chronic disorders, i.e. 0.7 less than at T1. The prevalence of mental problems also diminished for this group, but nevertheless remained high (16% post-traumatic stress disorder, 40% anxiety or depression). Excess weight and obesity were also prevalent. The number of contacts with several health care providers, including GPs, increased during the period between the two measurements, especially for new permit holders.

Conclusion

Refugees continue to have psychological symptoms, even in the years after receiving a residence permit. They are at high risk of developing a post-traumatic stress disorder. Refugees, particularly older ones) may also be at high risk of developing cardiovascular diseases. Therefore, continuous attention to the psychosocial welfare of refugees and more research into the cardiovascular risk profile of refugees are needed.

Conflict of interest and financial support: disclosure forms provided by the authors are available along with the full text of this article at www.ntvg.nl, search for A5604; click on ‘Belangenverstrengeling’ (‘Conflict of interest’). Financial support for this article: T1 of the study ‘Gevlucht – gezond?’ in 2003-2004 was subsidised by the ZonMw Prevention program (project no. 2100.0097); T2 of the study in 2010-2011 was subsidised by the Netherlands Regional and Municipal Health Service.