TORONTO, January 24, 2017 - In little more than a year, Canada has welcomed nearly 40,000 Syrian refugees in hopes of providing an opportunity for a better life. For these hopes to become a reality, ensuring the long-term health of Syrian refugees is key, particularly because earlier research with refugees has shown that their initial optimism tends to fade over time as they experience challenges in a new country, affecting mental and physical health.
CAMH’s Dr. Branka Agic is a researcher on three of the first studies on the health of Syrian refugees in Canada. For the past year, she’s been tracking immediate health needs to help local decision-makers plan appropriate health services. Now, she’s extending this research to understand how needs change in the crucial period between the first and second year after arrival.
As Manager of CAMH’s Health Equity Office, Dr. Agic draws on her own experience in her work on refugee and immigrant health. Trained as a medical doctor in her native Sarajevo, she fled her home during the Bosnian War and came to Canada in 1994, completing a PhD in Public Health at the University of Toronto. Her CAMH role involves research and education, and she is a project lead on CAMH’s Refugee Mental Health Project, an evidence-based online course for health-care, settlement and social services providers.
From left: Dr. Branka Agic and Anna Oda from CAMH’s Health Equity Office
A unique opportunity
“In general, we know very little about the health services use and needs of newly arrived refugees in Canada,” says Dr. Agic. “This was a unique opportunity because we had a large cohort coming within a short period of time.”
“The goal is to use our findings to improve services because we expect more Syrian refugees will settle here,” she says. “We’re also learning what needs to change so we can develop a model of health services that can be adapted for different groups of refugees.”
After the honeymoon period
As the first Syrian newcomers enter their second year in Canada, Dr. Agic and her research colleagues at the University of Toronto, the Wellesley Institute and York University are starting to examine how refugees’ mental and physical health needs change a year after arriving. Supported by the federal Social Sciences and Humanities Research Council, the initiative builds on a 2016 study that captured the early health needs of 400 Syrian refugees (see “Learning about immediate needs,” below). The researchers are following up with 200 individuals from the first study.
“In the first six months to one year after arriving in a new country, refugees often experience a honeymoon period – people come full of hope for a better life,” says Dr. Agic. However, outlooks can change over time as the realities of living in a new country set in, and refugees tend to report poorer self-perceived health after two years.
For some refugees, contributing factors may include a change in financial security, as federal income support for refugees ends a year after settlement. “In the long term, the social determinants of health – including access to housing, access to jobs and experiences of racism or other forms of discrimination – are the most important post-migration factors affecting the health of refugees,” says Dr. Agic.
As in the earlier study, the research team is interviewing Syrian refugees about their perceived mental and physical health needs and their use of health services, using quantitative measures. The team is also conducting focus groups to hear about refugees’ experiences in their own words.
In Canada, resettled refugees arrive as government-assisted or privately sponsored refugees or under the Blended Visa Office-Referred (BVOR) Program. Canada’s private sponsorship program is unique in the world. The study is also examining if health needs differ for government-assisted refugees versus private-sponsored refugees, an area for which no research exists.