A new World Health Organization study of refugee and migrant flows in Europe found that these groups have a lower risk of almost all forms of cancer but are more vulnerable to communicable diseases including vaccine-preventable diseases and antimicrobial resistance.
The report attributes the disease risk to “issues such as poor health services and vaccination coverage in their country of origin, exposure to overcrowding and poor sanitation facilities in transit or at reception, and the likelihood of living in poor conditions with difficulty in accessing healthcare initially in the destination country.”
Changes in lifestyle and the “adoption of unhealthy behaviors, such as sedentary lifestyles and poor diet” for displaced persons stuck in camps can also contribute to health issues, and “mental health conditions are particularly sensitive to any uncertainty over legal status, residency, work permits and the broader social perspectives in the host country.”
Researchers found that the migrants’ increased risk of non-communicable diseases, such as cardiovascular diseases and stroke, correlated to the amount of time that they were living in a European host country.
“Refugees and migrants have a lower risk for all neoplasms except cervical cancer, for which they are also more likely to be diagnosed at a later stage in their disease than the host populations in the Region,” said the report. “In general, refugees and migrants in the Region have a higher incidence, prevalence and mortality rate for diabetes than the host population, with higher rates seen in women than men depending on the country of origin.”
Researchers noted that “risk factors for mental health problems may be experienced during all phases of the migratory process and in settling in the host country,” but it was hard to nail down just how many refugees and migrants were suffering from mental illness.
“For example, the reported prevalence of depression in the refugee and migrant population varied from 5% to 44%, compared with a prevalence of 8–12% in the general population. Poor socioeconomic conditions, such as unemployment or isolation, are associated with increased rates of depression in refugees after resettlement,” said the report. “Migration was also found to be a risk factor for children’s mental condition, and unaccompanied minors experience higher rates of depression and symptoms of PTSD compared with other refugee and migrant groups.”
There is also an increased prevalence of sexually transmitted disease along transit routes and in destination countries when refugees and migrants fall victim to sexual violence.
The study took into account the 90.7 million international migrants in the WHO’s European Region, 53 countries with a total population of nearly 920 million people.
“There are indications that there is a very low risk of transmitting communicable diseases from the refugee and migrant population to the host population in the WHO European Region,” the WHO report continues. “It is possible that refugees and migrants arriving from countries with a high prevalence of tuberculosis (TB) might reflect a similar prevalence. However, the proportion of refugees and migrants among a country’s TB cases varies from more than 90% to less than 1%, reflecting the prevalence in the host country.”
“The same is true for HIV. A significant proportion of those refugees and migrants who are HIV positive acquire infection after they have arrived in the Region, and they are more likely to be diagnosed later in their HIV infections. Infections with hepatitis B virus (HBV) and hepatitis C virus (HCV) are more common among refugees and migrants arriving from countries with high endemic disease, but prevalence of these infections among refugee and migrant populations varies across the Member States of the Region. Tropical and parasitic infections that are not normally seen in Europe may enter the Region via refugees, migrants and travelers originating from or visiting areas of higher endemicity.”