Association of Immigrant and Refugee Status With Risk Factors for Exposure to Violent Assault Among Youths and Young Adults in Canada

Saunders, Natasha; Guan, Jun; Macpherson, Alison; Lu, Hong; Guttmann, Astrid

doi:10.1001/jamanetworkopen.2020.0375

Cited by 9 publications

(18 citation statements)

References 32 publications

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“…Ethnic, racial and religious discrimination are commonly reported by racialized immigrant groups in Canada [ 23 ] and is associated with a greater risk of experiencing assault [ 24 , 25 ], including hate crimes [ 30 ]. Our findings of higher rates of assault among refugees is consistent with prior research in Ontario [ 31 ]. The large negative relationship between education and assaults is in keeping with prior research examining family violence and violence against women in immigrant populations [ 32 ].…”

Section: Discussionsupporting

confidence: 92%

Association of source country gender inequality with experiencing assault and poor mental health among young female immigrants to Ontario, Canada

et al. 2021

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Background Gender inequality varies across countries and is associated with poor outcomes including violence against women and depression. Little is known about the relationship of source county gender inequality and poor health outcomes in female immigrants. Methods We used administrative databases to conduct a cohort study of 299,228 female immigrants ages 6–29 years becoming permanent residence in Ontario, Canada between 2003 and 2017 and followed up to March 31, 2020 for severe presentations of suffering assault, and selected mental health disorders (mood or anxiety, self-harm) as measured by hospital visits or death. Poisson regression examined the influence of source-country Gender Inequality Index (GII) quartile (Q) accounting for individual and country level characteristics. Results Immigrants from countries with the highest gender inequality (GII Q4) accounted for 40% of the sample, of whom 83% were from South Asia (SA) or Sub-Saharan Africa (SSA). The overall rate of assault was 10.9/10,000 person years (PY) while the rate of the poor mental health outcome was 77.5/10,000 PY. Both GII Q2 (Incident Rate Ratio (IRR): 1.48, 95% Confidence Interval (CI): 1.08, 2.01) and GII Q4 (IRR: 1.58, 95%CI: 1.08, 2.31) were significantly associated with experiencing assault but not with poor mental health. For females from countries with the highest gender inequality, there were significant regional differences in rates of assault, with SSA migrants experiencing high rates compared with those from SA. Relative to economic immigrants, refugees were at increased risk of sustaining assaults (IRR: 2.96, 95%CI: 2.32, 3.76) and poor mental health (IRR: 1.73, 95%CI: 1.50, 2.01). Higher educational attainment (bachelor’s degree or higher) at immigration was protective (assaults IRR: 0.64, 95%CI: 0.51, 0.80; poor mental health IRR: 0.69, 95% CI: 0.60, 0.80). Conclusion Source country gender inequality is not consistently associated with post-migration violence against women or severe depression, anxiety and self-harm in Ontario, Canada. Community-based research and intervention to address the documented socio-demographic disparities in outcomes of female immigrants is needed.

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Section: Discussionsupporting

confidence: 92%

Association of source country gender inequality with experiencing assault and poor mental health among young female immigrants to Ontario, Canada

et al. 2021

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“…This could be further delineated by the high proportion of stabbing and gunshot injuries among refugees constituting 12.6% of all injuries compared to 3.7% among the local population. The increased risk of assault injuries among refugee communities has been previously documented [ 21 ], and may be explained by multiple factors including poverty and possible criminal gang involvement [ 44 , 45 ]. Refugees, having been subject to trauma, instability and displacement stressors, are exposed to accumulated mental disturbances, leading to an increased tendency toward assault and violence [ 46 - 48 ].…”

Section: Discussionmentioning

confidence: 99%

Physical trauma and injury: A multi-center study comparing local residents and refugees in Lebanon

et al. 2021

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Background Refugees are susceptible to various types of injury mechanisms associated with their dire living conditions and settlements. This study aims to compare and characterize the emergency department admissions due to physical trauma and injuries among local residents and refugees in greater Beirut. Methods This epidemiological study analyzes injury incidence and characteristics of patients presenting to Emergency Departments of 5 sentinel hospitals between 2017 and 2019. Using the WHO Injury Surveillance Guidelines and Pan-Asia Trauma Outcomes Study form, an injury data surveillance form was designed and used in hospital settings to collect data on injuries. Chi-square test analysis was performed to compare differences in injury characteristics between local residents and refugees. Regression models were constructed to assess the effect of being a refugee on the characteristics of injuries and outcomes of interest. Results A total of 4847 injuries (3933 local residents and 914 refugees) were reported. 87.4% of the total injuries among refugees were sustained by the younger age groups 0-45 years compared to 68.8% among local residents. The most prevalent injury mechanism was fall (39.4%) for locals and road traffic injury (31.5%) for refugees. The most injured body part was extremities for both populations (78.2% and 80.1%). Injuries mostly occurred at home or its vicinity (garden or inside the camp) for both populations (29.3% and 23.1%). Refugees sustained a higher proportion of injuries at work (6%) compared to locals (1.3%). On multivariate analysis, refugee status was associated with higher odds of having an injury due to a stab/gunshot (odds ratio (OR) = 3.392, 95% confidence interval (CI) = 2.605-4.416), having a concussion injury (OR = 1.718, 95% CI = 1.151-2.565), and being injured at work (OR = 4.147, 95% CI = 2.74-6.278). Refugee status was associated with increased odds of leaving the hospital with injury-related disability (OR = 2.271, 95% CI = 1.891-2.728)] Conclusions Injury remains a major public health problem among resident and refugee communities in Beirut, Lebanon. Refugees face several injury-related vulnerabilities, which adversely affect their treatment outcomes and long-term disabilities. The high prevalence of occupational and violence-related injuries among refugees necessitates the introduction of targeted occupational safety and financial security interventions, aiming at reducing injuries while enhancing social justice among residents.

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“…An important aspect concerning the lives of refugees in highly developed countries is marginalisation, discrimination and racism. In European countries, i.e., Italy, Switzerland and the Netherlands, the risk of immigrants being assaulted was much higher than in Canada or the USA [ 51 ].…”

Section: Resultsmentioning

confidence: 99%

Challenges in the Medical and Psychosocial Care of the Paediatric Refugee—A Systematic Review

Klas

Grzywacz

Kulszo

et al. 2022

IJERPH

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Background: After the invasion of Ukraine, neighbouring countries were forced to find systemic solutions to provide medical care to those fleeing the war, including children, as soon as possible. In order to do this, it is necessary to know the communication problems with refugee minors and find proposals for their solutions. Methods: A systematic review of the literature from 2016 to 2022 was conducted according to PRISMA criteria. Results: Linguistic diversity and lack of professional readiness of teachers are the main constraints hindering the assistance of refugee children in schools. Problems during hospitalization include lack of continuity of medical care and lack of retained medical records. Solutions include the use of the 3C model (Communication, Continuity of care, Confidence) and the concept of a group psychological support program. Conclusions: In order to provide effective assistance to refugee minors, it is necessary to create a multidisciplinary system of care. It is hoped that the lessons learned from previous experiences will provide a resource to help refugee host countries prepare for a situation in which they are forced to provide emergency assistance to children fleeing war.

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Association of Immigrant and Refugee Status With Risk Factors for Exposure to Violent Assault Among Youths and Young Adults in Canada

Cited by 9 publications

References 32 publications

Association of source country gender inequality with experiencing assault and poor mental health among young female immigrants to Ontario, Canada

Association of source country gender inequality with experiencing assault and poor mental health among young female immigrants to Ontario, Canada

Physical trauma and injury: A multi-center study comparing local residents and refugees in Lebanon

Challenges in the Medical and Psychosocial Care of the Paediatric Refugee—A Systematic Review

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