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Refugee Health and Well-Being: Psychological, Behavioral and Biochemical Insights
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Refugee Health and Well-Being: Psychological, Behavioral and Biochemical Insights

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Global Health".

Deadline for manuscript submissions: closed (31 March 2025) | Viewed by 9650

Special Issue Editor

Dr. Samina Salim

E-Mail Website
Guest Editor
Department of Pharmacological and Pharmaceutical Sciences, College of Pharmacy, University of Houston, Houston, TX 77204, USA
Interests: neurobehavioral; real-life domains of health; social and human phenomena; neuro-socioecological

Special Issue Information

Dear Colleagues,

At present, forcible displacement and unavoidable migration have resulted in nearly 80 million displaced people, 26 million of whom are refugees. This is the highest since the second World War broke out. Conflict, instability and civil war in Sub-Saharan and West African countries, conflict in Syria, war on terror in Afghanistan, the Rwanda and Rohingya genocide and more recently the crisis in Ukraine have resulted in massive displacement of men, women and children from their home countries. The traumatic experiences of war and conflict and ethnic, cultural and socioeconomic complexities, combined with the struggles of resettlement, make refugees highly susceptible to several health risks such as obesity, diabetes, mental health (including depression and post-traumatic stress disorder), tuberculosis, nutritional deficiencies, parasitic infections, chronic hepatitis B infection, cancer, etc. To better understand the health risks and examine the structural health disparities faced by refugees, psychological, behavioral and basic science research is critical in understanding these important aspects. Importantly, refugee health research is critical for various important reasons, (a) in increasing the scientific understanding of complex human diseases, (b) in promoting a greater understanding of racial and ethnic contexts of health and (c) in helping to mitigate structural health disparities faced by refugees in their host environments.

Dr. Samina Salim
Guest Editor

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Keywords

  • refugees
  • migration
  • mental stress
  • displacement trauma
  • behavior
  • psychological health
  • cancer
  • population health

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Published Papers (6 papers)

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Research

20 pages, 2918 KiB  
Article
The Relationship Between Food Insecurity and Mental Health Among Syrians and Syrian Refugees Working in Agriculture During COVID-19
by Clara Calia, Afnan El-Gayar, Ann-Christin Zuntz, Shaher Abdullateef, Esraa Almashhor, Liz Grant and Lisa Boden
Int. J. Environ. Res. Public Health 2025, 22(4), 549; https://doi.org/10.3390/ijerph22040549 - 2 Apr 2025
Viewed by 49
Abstract
The COVID-19 pandemic has disproportionately impacted vulnerable populations, such as internally displaced Syrians and Syrian refugees (SSRs) in Middle Eastern host countries, through a syndemic interplay of health, social, and economic challenges. Movement restrictions disrupted their livelihoods resulting in increased food insecurity. A [...] Read more.
The COVID-19 pandemic has disproportionately impacted vulnerable populations, such as internally displaced Syrians and Syrian refugees (SSRs) in Middle Eastern host countries, through a syndemic interplay of health, social, and economic challenges. Movement restrictions disrupted their livelihoods resulting in increased food insecurity. A mixed-methods approach was used to address the research question: “What is the relationship between Food Insecurity (FI), Mental Health (MH), and COVID-19 among displaced SSRs working in agriculture”? One hundred SSR participants working in agriculture were recruited from northern Syria and neighbouring countries to participate in a Household Survey. The survey data were analysed using correlation and regression analysis. Additionally, interviews with Household Survey researchers were conducted and thematically analysed. Increasing food insecurity was significantly correlated with worse mental health outcomes among SSR participants (rs = −0.24, p = 0.018). No moderation effects were found with COVID-19 measures or household responses to the pandemic. However, smaller food portions and storing food were positively correlated with poor mental health and food insecurity. The COVID-19 pandemic exacerbated food insecurity and mental health challenges among displaced Syrians and refugees, particularly during Ramadan in 2020, highlighting the compounded effects of overlapping crises and the need for further research into resilience strategies. Full article
(This article belongs to the Special Issue Refugee Health and Well-Being: Psychological, Behavioral and Biochemical Insights)
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18 pages, 1681 KiB  
Article
Family and Peer Support Facilitates Recall and Retelling of Traumatic Memories in War Refugee Children and Adolescents
by Arianna Barazzetti, Stefano Milesi, Francesca Giordano, Maria Chiara Noto and Attà Negri
Int. J. Environ. Res. Public Health 2025, 22(3), 328; https://doi.org/10.3390/ijerph22030328 - 23 Feb 2025
Viewed by 395
Abstract
War refugees are more likely to present psychological disorders, such as PTSD. Memory impairments often hinder their ability to recall and integrate traumatic events. This study investigated the memory capacity of 133 Syrian refugee children and adolescents in Lebanon and examined the moderating [...] Read more.
War refugees are more likely to present psychological disorders, such as PTSD. Memory impairments often hinder their ability to recall and integrate traumatic events. This study investigated the memory capacity of 133 Syrian refugee children and adolescents in Lebanon and examined the moderating role of resilience in the relationship between exposure to negative events, post-traumatic stress reactions, and traumatic events recollection. Participants completed the Childhood War Trauma Questionnaire (CWTQ), Post-Traumatic Symptom Reactions Checklist for Children (PTSR-C), and Child and Youth Resilience Measure-28 (CYRM-28). They also performed a timeline exercise, part of Narrative Exposure Therapy, in which they organized and described their positive and negative life memories. Results showed that memories of traumatic events were lower than potentially traumatic events that participants had witnessed. This difference increased as post-traumatic stress increased. Moreover, potentially traumatic events experienced predicted post-traumatic stress reactions, and these predicted negative memories recalled. Participants’ resilience moderated the association between post-traumatic reactions and remembered traumatic memories showing that only for children and adolescents with higher resilience post-traumatic symptoms predicted trauma-related memories. The results highlight meaning making and sharing capacities of natural relational contexts (family, peers, etc.) as potential key processes to be promoted to overcome and process traumatic events. Full article
(This article belongs to the Special Issue Refugee Health and Well-Being: Psychological, Behavioral and Biochemical Insights)
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13 pages, 1827 KiB  
Article
Sex Disparities in Smoked and Smokeless Tobacco Use Among Displaced Populations in Mizoram, India: A Cross-Sectional Study
by Yashika Sharma, Ruth Masterson Creber, Julia Lalmuanpuii, Sakie Zawtha, Beichotha Zawtha, Helimay Chairi, Rodani Zawkhai, Stacey Dai, So Hyeon Bang and Natalie Benda
Int. J. Environ. Res. Public Health 2025, 22(3), 318; https://doi.org/10.3390/ijerph22030318 - 20 Feb 2025
Viewed by 383
Abstract
Displaced populations face an elevated risk for tobacco use, especially smokeless tobacco (SLT), due to its affordability and acceptability in regions like Mizoram State (India) and Chin State (Myanmar). Despite this, limited research exists on tobacco use patterns and contributing factors among displaced [...] Read more.
Displaced populations face an elevated risk for tobacco use, especially smokeless tobacco (SLT), due to its affordability and acceptability in regions like Mizoram State (India) and Chin State (Myanmar). Despite this, limited research exists on tobacco use patterns and contributing factors among displaced populations. This study aimed to examine smoked tobacco and SLT use among displaced communities in Mizoram, India. We collected data across nine villages using mobile health technology. We conducted logistic regression models to examine the cross-sectional associations between sex and tobacco use. Age was explored as a potential moderator. The analytic sample consisted of 2226 participants, with a mean age of 43 (±16.2) years, 63.1% of whom were women. Approximately 70% of the participants reported using tobacco, with SLT being the most common form (46.3%). Women were 57% less likely to use tobacco than men, but women aged 55 and older had twice the odds of using tobacco compared to men in the same age group. Additionally, women had nearly 71 times higher odds of using SLT compared to smoked tobacco than men. The findings underscore the need for culturally sensitive interventions targeting SLT use among women. Future research should explore the drivers of this disparity to guide public health strategies. Full article
(This article belongs to the Special Issue Refugee Health and Well-Being: Psychological, Behavioral and Biochemical Insights)
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10 pages, 322 KiB  
Article
Describing the Eye Health of Newly Arrived Refugees in Adelaide, South Australia
by Kate Murton, Antonietta Maldari, Joanne Thomas, Jan Williams, Marcel Nejatian, Hessom Razavi and Lillian Mwanri
Int. J. Environ. Res. Public Health 2024, 21(7), 869; https://doi.org/10.3390/ijerph21070869 - 2 Jul 2024
Viewed by 1591
Abstract
This study describes the eye health of newly arrived refugees attending a state-funded health service in Adelaide, South Australia, helping to address the paucity of data on the eye health of refugees. Patients attending the Refugee Health Service undergo comprehensive assessment by an [...] Read more.
This study describes the eye health of newly arrived refugees attending a state-funded health service in Adelaide, South Australia, helping to address the paucity of data on the eye health of refugees. Patients attending the Refugee Health Service undergo comprehensive assessment by an on-site optometrist with accredited interpreters if they have eye symptoms, personal or family history of eye disease, or visual impairment (using World Health Organization definitions). A retrospective audit of this service was performed to obtain patient demographics, presenting best-corrected distance visual acuity (better-seeing eye), diagnoses, and management. In 2017–2018, 494 of the 1400 refugees attending the service underwent an optometry assessment (age range 1–86 years, mean age 33.1 ± 18.6 years, 53% female). Regions of origin included the Middle East (25%), Bhutan (24%), Afghanistan (22%), Myanmar (15%), and Africa (14%). Of the 124 cases of visual impairment, 78% resolved with corrective lenses and 11% were due to cataracts. Ophthalmology follow-up was required for 56 (11%) patients, mostly for cataracts (22 patients). Newly arrived refugees have high rates of visual impairment from refractive error and cataracts. Integration of optometry and state-based refugee health services may improve the timely detection and treatment of these conditions. Full article
(This article belongs to the Special Issue Refugee Health and Well-Being: Psychological, Behavioral and Biochemical Insights)
12 pages, 358 KiB  
Article
Breast Cancer Beliefs and Screening Practices among Syrian Refugee Women and Jordanian Women
by Fatin Atrooz, Sally Mohammad Aljararwah, Chiara Acquati, Omar F. Khabour and Samina Salim
Int. J. Environ. Res. Public Health 2023, 20(4), 3645; https://doi.org/10.3390/ijerph20043645 - 18 Feb 2023
Cited by 1 | Viewed by 2655
Abstract
Despite significant declines in breast cancer (BC) incidence in the West, this disease is widespread in Jordan, where cancer detection occurs at much advanced stages. This is particularly concerning for Syrian refugee women resettled in Jordan, who are less likely to undergo cancer [...] Read more.
Despite significant declines in breast cancer (BC) incidence in the West, this disease is widespread in Jordan, where cancer detection occurs at much advanced stages. This is particularly concerning for Syrian refugee women resettled in Jordan, who are less likely to undergo cancer preventative procedures because of poor health literacy and lack of health services access. The present work assesses and compares breast cancer awareness and breast cancer screening behaviors among Syrian refugee women and Jordanian women residing close to the Syrian–Jordanian border city of Ar-Ramtha. A cross-sectional survey was conducted using a validated Arabic version of the Breast Cancer Screening Beliefs Questionnaire (BCSBQ). A total of 138 Syrian refugee women and 160 Jordanian women participated in the study. Results indicate that 93.6% of Syrian refugee women and Jordanian women ≥ 40 years of age reported never having undergone a mammogram. Syrian refugee women and Jordanian women reported low attitudes toward general health checkup (mean score for Syrian refugees 45.6 vs. 42.04 among Jordan women; p = 0.150). Barriers for BC screening were higher among Syrian refugees (mean score = 56.43) than Jordanian women (mean score = 61.99, p = 0.006). Women with higher education were more likely to report fewer barriers to screening (p = 0.027). The study documents a significant lack of BC screening awareness among Syrian refugee women and Jordanian women, indicating that future work is needed to alter current attitudes towards mammograms and early detection measures especially for Syrian refugee women and Jordanian women residing in rural areas of Jordan. Full article
(This article belongs to the Special Issue Refugee Health and Well-Being: Psychological, Behavioral and Biochemical Insights)
14 pages, 664 KiB  
Article
Understanding Mental Health Status of Syrian Refugee and Jordanian Women: Novel Insights from a Comparative Study
by Fatin Atrooz, Sally Mohammad Aljararwah, Tzuan A. Chen, Omar F. Khabour and Samina Salim
Int. J. Environ. Res. Public Health 2023, 20(4), 2976; https://doi.org/10.3390/ijerph20042976 - 8 Feb 2023
Cited by 13 | Viewed by 3142
Abstract
(1) Background: War and displacement are well-known predictors of negative mental health outcomes among affected populations. This is especially relevant for refugees of war, particularly women, who often repress their mental health needs due to family responsibilities, social stigma, and/or cultural pressures. In [...] Read more.
(1) Background: War and displacement are well-known predictors of negative mental health outcomes among affected populations. This is especially relevant for refugees of war, particularly women, who often repress their mental health needs due to family responsibilities, social stigma, and/or cultural pressures. In this study, we compared the mental health status of urban Syrian refugee women (n = 139) with local Jordanian women (n = 160). (2) Methods: Psychometrically validated Afghan Symptom Checklist (ASC), Perceived Stress Scale (PSS), and Self-Report Questionnaire (SRQ) examined psychological distress, perceived stress, and mental health, respectively. (3) Results: According to independent t-tests, Syrian refugee women scored higher than Jordanian women on the ASC [mean score (SD): 60.79 (16.67) vs. 53.71 (17.80), p < 0.001], PSS [mean score (SD): 31.59 (8.45) vs. 26.94 (7.37), p < 0.001], and SRQ [mean score (SD): 11.82 (4.30) vs. 10.21 (4.72), p = 0.002]. Interestingly, both Syrian refugee and Jordanian women scored higher than the clinical cutoff in the SRQ. Regression analyses indicated that more educated women were less likely to score high on the SRQ (β = −0.143, p = 0.019), particularly in the anxiety and somatic symptoms subscale (β = −0.133, p = 0.021), and were less likely to exhibit symptoms of ruminative sadness (β = −0.138, p = 0.027). Employed women were more likely to exhibit high coping ability than unemployed women (β = 0.144, p = 0.012). (4) Conclusions: Syrian refugee women scored higher than Jordanian women in all used mental health scales. Access to mental health services and enhancing educational opportunities would help mitigate perceived stress and may enhance stress-coping abilities. Full article
(This article belongs to the Special Issue Refugee Health and Well-Being: Psychological, Behavioral and Biochemical Insights)
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