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Health status and care utilization among Afghan refugees newly resettled in Calgary, Canada between 2011-2020

Abstract
The United States and Canada have resettled over 120,000 Afghan refugees since August 2021, but sociodemographic and health status data remains sparse with investigations often limited to refugee entrance exams, standardized health screenings, or acute health settings. This retrospective community-engaged cohort study investigated Afghan patients who received care between January 1, 2011 and December 31, 2020 at an interdisciplinary specialized refugee clinic in Calgary, AB, Canada that provides care to newly arrived refugees. 2 reviewers independently extracted and manually verified sociodemographic factors, medical diagnoses, and clinic utilization variables from patients’ electronic medical records, then coded patient diagnoses into ICD-10 codes and chapter groups. Diagnosis frequencies were calculated and stratified by age group and sex. We corroborated these findings with Afghan refugee co-investigators. Among 402 Afghan refugee patients, they were relatively young, experienced diverse health characteristics, and had multi-specialty care engagement in their first two years after arrival. These findings may guide specialized healthcare provision to this inadequately characterized but growing population of refugee arrivals in North America and elsewhere.
Authors: Hannah Smati,Nour Hassan,Mohammad Yasir Essar,Fawzia Abdaly,Shayesta Noori,Rabina Grewal,Eric Norrie,Rachel Talavlikar,Julia Bietz,Sarah L. Kimball,Annalee Coakley,Avik Chatterjee,Gabriel E. Fabreau Publication Date: 6/22/2024

Publication Type: Journal Article

URL:https://www.medrxiv.org/content/10.1101/2024.06.21.24309182v1.full-text
Notes

Community organizations: Mosaic Refugee Health Clinic

Future research / gaps identified:

This study focuses on 1 specific clinic and cannot be generalized to other contexts.

Integration timeline: first 2 years after arrival

Key populations: Afghan refugees resettled in Calgary who are using the Mosaic Refugee Health Clinic

Location: Calgary, AB

Key findings:

1) Among 402 Afghan refugee patients (228 adults, mean age in their 30s; 174 children, mean age 7.5), 1535 total individual diagnoses were identified.

2) The 1535 diagnoses were classified into 382 unique ICD-10 codes.

3) Patients had a median 2 diagnoses each, 4 clinic visits across primary, specialty and multidisciplinary care annually, and an 11% appointment no-show rate.

4) Among adults, the most frequent diagnoses were abdominal pain, mechanical back pain, and H. pylori infection.

5) Among children, the most frequent diagnoses were upper respiratory tract infection, Giardia, and short stature.

Key recommendations:

1) Utilize a culturally sensitive approach to diagnosing and treating mental health and trauma symptoms.

2) Increase accessibility and interpretation services for Dari and Pashto speakers.

3) Develop more opportunities for refugees to access multidisciplinary health professionals such as social workers, psychologists and dieticians.

Open access: Yes


Collections mental-health , physical-health , public-health , refugee-experiences

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