Comorbid Mental and Physical Health and Health Access in Cambodian Refugees in the US

Abstract

Little research has been conducted on the prevalence of physical health problems in Cambodian refugees and the relationship between their mental and physical health. We identified the relationship between mental and physical health problems and barriers to healthcare access in Cambodian refugee adults. We used a cross-sectional survey design with a snowball sample of 136 Cambodian refugee adult residents of Connecticut and Western Massachusetts. 61% reported being diagnosed with three or more physical conditions and 73% with depression, posttraumatic stress disorder (PTSD) or both. Language and transportation problems were the primary barriers to accessing care. Participants with probable comorbid PTSD and depression had 1.850 times more physical health problems than those without either condition (p > .001; CI 1.334-2.566). Age moderated this relationship. Participants who had been diagnosed with both depression and PTSD reported a consistent number of health conditions across the age span while those who had no mental health conditions or only one of the two reported fewer health conditions when they were younger and more when they were older. These two groups were significantly different from the group reporting both. There is a significant relationship between chronic comorbid mental and physical health diseases affecting Cambodian refugees resettled in the US Having comorbid depression and PTSD puts Cambodian refugees at risk for physical health problems no matter their age. It is vital that those treating Cambodian genocide survivors identify and treat their prevalent comorbid health conditions. Language and transportation barriers must be addressed to improve access to mental and physical health care in this population.

Assessing Geospatial Barriers in Refugee Resettlement Communities: A Descriptive Exploration about How to Identify the Health and Other Resource Needs of Recently Resettled Refugee Women

“…In a study of Cambodian refugees, researchers found that over 50% reported they were sometimes or always unable to see a doctor due to lack of transportation. 13 Similar findings have been reported by researchers working with a variety of refugee populations. 3,14,15 However, there is evidence to suggest that access to transportation is not the only geographic barrier refugees face in accessing care.…”

The Medical Evaluation of the Newly Resettled Female Refugee: A Narrative Review

“…Refugee patients are at high risk for mental health disease including post-traumatic stress disorder (PTSD) and depression (Taylor et al, 2014;Berthold et al, 2014). It is estimated that refugees experience PTSD at 2-10 times higher rates than the general Western population (Mollica et al, 2004;Fazel, Wheeler & Danesh, 2005).…”

Working With Refugees in the U.S.: Trauma-Informed and Structurally Competent Social Work Approaches

“…More than two decades after resettling in the United States, Cambodians continue to experience high rates of past-year depression (51%) and PTSD (62%), much greater than the 7% and 3% rates for the same conditions found in the general U.S. population (Marshall et al, 2005). Comorbid PTSD and depression continued to be experienced by many Cambodians three decades after resettling in the United States (Berthold, Kong, Mollica, Kuoch, Scully, & Franke, 2014). Additionally, Cambodian refugees have disproportionate rates of selfreported poor health, compared to both the general population and other Asian populations (Wong et al, 2011), with higher than average rates of diabetes and cardiovascular risk factors (Marshall, Schell, Wong, Berthold, Hambarsoomian, Elliott, & Gregg, 2016).…”