Distress and Resilience in Resettled Refugees of War: Implications for Screening

Michael Hollifield, Eric C. Toolson, Sasha Verbillis-Kolp, Beth Farmer, Junko Yamazaki, Tsegaba Woldehaimanot and Annette Holland
Additional contact information
Michael Hollifield: VA Long Beach Healthcare System, Long Beach, CA 90822, USA
Eric C. Toolson: Department of Biology, The University of New Mexico, Albuquerque, NM 87131, USA
Sasha Verbillis-Kolp: Consultant, 3630 N. Winchell St., Portland, OR 97217, USA
Beth Farmer: International Rescue Committee, 1200 S. 192nd St., SeaTac, WA 98148, USA
Junko Yamazaki: Asian Counseling and Referral Service, Seattle, WA 98144, USA
Tsegaba Woldehaimanot: Asian Counseling and Referral Service, Seattle, WA 98144, USA
Annette Holland: Public Health Seattle & King County, Seattle, WA 98121, USA

IJERPH, 2021, vol. 18, issue 3, 1-15

Abstract: There is little work published about predictors of specific trajectory types of distress in refugees of war during early resettlement in a host country. Data about distress (Refugee Health Screener—15 (RHS-15)) and possible predictors of distress were collected at the domestic medical examination (T1) within 90 days of arrival and the civil surgeon examination (T2) 11–16 months after T1 for refugee groups from three countries (COU). Descriptive, correlative, analyses of variance, and regression techniques were used to determine trajectory type and their predictors. A higher percentage (7.3%) were distressed at T2 than at T1. By group, the Bhutanese became more distressed, the Burmese became less distressed, and Iraqi’s continued to have high distress. A regression model showed gender, loss, post-migration stress, and self-efficacy to be significant predictors of trajectory type (R 2 = 0.46). When the T1 RHS-15 score was added to the model, observed variance increased (R 2 = 0.53) and T1 RHS score accounted for the majority of variance ( r = 0.64, p < 0.001), with post-migration stress accounting for markedly less (? = 0.19, p = 0.03). Loss and self-efficacy became less significant. Loss was, however, a strong predictor of delayed and chronic distress trajectory type. These data suggest that screening for distress should occur at least twice during resettlement to detect those with initial distress and those with delayed distress. Screening should be coupled with identifying other social determinants of health and a comprehensive assessment to determine the need for intervention for secondary prevention (i.e., reducing delayed distress) and treatment (reducing chronic distress).

Keywords: health trajectory; refugee health; war; emotional distress; screening (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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