A residence permit is good for your health
Work, discrimination, and the limitations and difficulties in daily life affect the health and the utilization of care by immigrants and refugees, according to research by the Netherlands Institute for Health Services Research (NIVEL) and the Academic Medical Centre (AMC) for which Majda Lamkaddem received her doctorate on May 30, 2013 from the University of Amsterdam.
Ethnic diversity is continuing to increase in the Western world. In the Netherlands, immigrants and refugees make use of the same healthcare facilities as the indigenous Dutch population. How is their overall physical and mental health, and how often do they go to the doctor? Majda Lamkaddem looked at the utilization of care and the physical and mental health of groups of immigrants and refugees in the Netherlands, in particular Dutch people with Moroccan, Turkish, Surinamese and Antillean origins and refugees from Iran, Somalia and Afghanistan.
Work
Lamkaddem investigated the role of various social and environmental factors at various points in time. The work situation, discrimination, and limitations and difficulties in day-to-day life appear to have a major effect on the health and utilization of care among these groups. “The work situation in particular seems to be very important. The health of people from ethnic minority groups is also a product of economic and cultural factors, as well as factors from the physical and social environments. Discrimination appears to be a barrier against using healthcare. Work does seem to improve mental health, and health in general.”
Residence permit
One striking feature of the research is the effect that a residence permit has on health. When refugees get a residence permit, they become healthier. The explanation for this is primarily practical, according to the graduate student: “Health is also determined by the conditions in which you live. People don’t get healthier because they have a residence permit, but because their living conditions then improve. They can get work, rent a house, and finally become part of society. And that makes them feel healthier.”
PTSD
About 15% of refugees exhibit symptoms of post-traumatic stress disorder (PTSD), which is over twice the average figure for the Netherlands. This percentage remains unchanged over a period of seven years. There are various ways of explaining this, says Majda Lamkaddem. “When the first measurements were made, only 21% of people with PTSD had been in contact with the mental healthcare services. These turned out to be the refugees with PTSD who have a significantly better chance of improvement. Contact with the mental healthcare services in the Netherlands therefore had a positive effect. The majority remained untreated though, and on top of that the symptoms of PTSD in some of the refugees only become visible after a longer period.”
Contact
Majda Lamkaddem, phone 0031 (0)20 566 7443 or m.lamkaddem@amc.uva.nl
Funding
GGD Nederland (Association of Community Health Services)
ZonMw
Cooperating partner
Department of Social Medicine, AMC - University of Amsterdam