Refugee Crisis Associated With Increased CVD Rates

There are more than 80 million refugees—forcibly displaced individuals who have been “forced to flee [their] country because of persecution, war, or violence”—in the world as of 2020, creating challenges for healthcare management, including addressing cardiovascular disease (CVD). Although the US government has made efforts to address these challenges, individuals in the refugee, immigrant, and migrant communities continue to experience poor access to healthcare, according to an article published in Heart.

Results of an analysis of 2010 to 2016 US National Health Interview Survey results showed that members of these communities from South America, Asia, and Africa are affected disproportionately by risk factors for CVD including hypertension, diabetes, and hyperlipidemia.

According to the United Nations High Commissioner for Refugees, forcibly displaced individuals can struggle to obtain appropriate healthcare in a new country. Healthcare access in the refugee population may be inadequate due to a combination of social determinants of health, ranging from low income and lack of insurance to racial and ethnic background and limited or no English language proficiency.

Immigrants, according to authors, are also more likely to be unaware of CVD risk factors—resulting in less motivation to seek treatment or modify lifestyle factors that can impact negative outcomes.

CVD is the leading cause of death worldwide, according to the World Health Organization, representing 31% of the total disease burden, of which refugees and other displaced persons bear a disproportionately higher load—even compared with individuals subject to torture, persecution, and other human rights violations. A 2021 study of Syrian refugees treated in Jordanian hospitals showed that “chronic war-related stressors” and other traumatic events contributed significantly to the development and severity of myocardial infarction and coronary artery diseases.

In addition to sociodemographic factors, resettlement into the US can be a factor affecting refugee health as well. As refugees begin to integrate into the culture of their surroundings, a “more sedentary Western lifestyle” in conjunction with already unequal access to healthcare contributes to CVD in these communities.

“[Refugees, immigrants, and migrants] are predisposed to countless stressors, which influence their decision to migrate,” the authors wrote. “Given their disposition and the social/global determinants of health that limit their ability to be treated with preventive medicine, [they] will continue to be diagnosed with one or more of these lifestyle diseases.”

“Simple, inexpensive interventions, such as community education and preventive campaigns among healthcare providers can significantly impact…overall health,” they concluded. “

Reference

Santana J, Lemma A, O’Connor MH, Kelli H. Understanding risk factors and preventive measures of cardiovascular disease in refugee communities. Heart. Published online July 21, 2021. doi: 10.1136/heartjnl-2021-319435