Disparities in vulnerable populations: Canadian determinants of health as key indicators of refugee health status

Background:

In 2007, nearly 33 million persons were displaced worldwide (UNHCR, 2008). Over 500,000 Burundians have refugee status, many surviving in Tanzanian refugee camps since 1972 (USCRI, 2006). Due to the increased volume of refugees and their inability to repatriate, the United States has become a site for the resettlement of Burundian refugees. Even in the U.S., these refugees often experience limited access to health and social services. Based on the Canadian Public Health Expansion's key social determinants of health (Raphael, 2008), it was anticipated that the Burundian refugees would fair better compared to their experiences in the refugee camp.

Methods:

As part of the community-based participatory research project, Healing Transitions: Program Interventions for Youth Refugees and Families, Burundian refugees were recruited by snowball sampling in a mid-sized resettlement community. Using a translator, 5 men's (n = 22) and 2 women's (n = 15) focus groups were conducted and audio-recorded, transcribed into Kirundi, and then translated into English for qualitative analysis. Qualitative themes were analyzed and compared with the Social Determinants.

Results:

Burundians were found to fair poorly in all social and environmental determinant areas. Furthermore, the Burundians also indicated that they faired better in their own country and have suffered greater health disparities in resettlement than in the camps; they also indicated their desire to return to Africa.

Conclusions:

These results indicate the need for interventions that work to improve health conditions and focus on empowering those being resettled. Culturally relevant and community-based interventions through Healing Transitions are discussed.