Millions of individuals and families have been permanently resettled in host countries after having fled their homes in order to seek safety from war or persecution. These resettled refugees may experience extreme hardship prior to and during flight, and may continue to experience difficulties upon resettlement, all of which can negatively influence health status. However, many also exhibit strength and resilience. Understanding the myriad social and environmental factors that affect (and are affected by) health status for any population can be difficult in general, and there are many additional contextual factors to consider when working with refugees in particular. This dissertation contributes to knowledge of refugee health status in two ways. The first is to provide an integrated model for the social determinants of health a tool that can be used to organize what is already either theorized or known, and what is lacked, about the health of a population of interest. This framework is applied to resettled refugees as both an example and as a way of structuring the extant knowledge for this population. The second is to produce evidence about the health status of resettled refugees via three empirical studies. One uses a large existing dataset from the UK, employing latent growth curve modeling to investigate changes in health status over time after resettlement. The other two utilize local data from Nashville, TN collected in partnership with a refugee-serving non-profit organization. One series of research questions focuses on relationships between adjustment to life in the US and health status, drawing on focus groups with Somali residents (n=12). Another series investigates the relationship between life stressors (including traumatic events and chronic stressors) and health status, drawing from survey data collected from Somali residents (n=145). Overall, it is clear that some refugees do quite well upon resettlement, but that there is also great need among others, especially for emotional problems. Approaches to estimating and alleviating the health burdens require attention to cultural issues.
| Identifer | oai:union.ndltd.org:VANDERBILT/oai:VANDERBILTETD:etd-07172014-213543 |
| Date | 22 July 2014 |
| Creators | Lunn, Laurel Marie |
| Contributors | Craig Anne Heflinger, Marybeth Shinn, Sonya Sterba, William Turner |
| Publisher | VANDERBILT |
| Source Sets | Vanderbilt University Theses |
| Language | English |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | http://etd.library.vanderbilt.edu/available/etd-07172014-213543/ |
| Rights | restrictone, I hereby certify that, if appropriate, I have obtained and attached hereto a written permission statement from the owner(s) of each third party copyrighted matter to be included in my thesis, dissertation, or project report, allowing distribution as specified below. I certify that the version I submitted is the same as that approved by my advisory committee. I hereby grant to Vanderbilt University or its agents the non-exclusive license to archive and make accessible, under the conditions specified below, my thesis, dissertation, or project report in whole or in part in all forms of media, now or hereafter known. I retain all other ownership rights to the copyright of the thesis, dissertation or project report. I also retain the right to use in future works (such as articles or books) all or part of this thesis, dissertation, or project report. |
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