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Prevalence of Chronic Disease and Insurance Coverage among Refugees in the United States

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Abstract

Little is known about the health status of refugees beyond the immediate post-arrival period in the US. Using data from the 2003 New Immigrant Survey, a nationally representative survey of immigrants who had recently become legal permanent residents, we determined the prevalence of chronic conditions and health insurance coverage among adult refugees who had lived in the US for at least 1 year (n = 490). We compared their health status with that of other immigrants (n = 3,715) using multivariable logistic regression. The median duration of US residency was 5.6 and 8.0 years among refugees and other immigrants, respectively. Refugees were more likely than other immigrants to report at least one chronic condition (24.7 vs. 15.6 %, P < 0.001). After adjusting for sociodemographic differences, the odds of the following conditions remained significantly higher among refugees: arthritis (adjusted odds ratio [AOR] = 1.67, 95 % confidence interval [CI] = 1.07, 2.61), heart disease (AOR = 2.49, 95 % CI = 1.30, 4.74), stroke (AOR = 5.87, 95 % CI = 1.27, 27.25), activity-limitation due to pain (AOR = 1.96, 95 % CI = 1.31, 2.93), and any chronic condition (AOR = 1.37, 95 % CI = 1.03, 1.81). Although similar percentages of refugees (49.0 %) and other immigrants (47.4 %) were uninsured, 46.5 % of refugees with chronic conditions lacked health insurance. Refugees have a high burden of chronic disease and would benefit from expanded insurance coverage for adults with preexisting conditions.

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Notes

  1. Data from the Department of Homeland Security’s Immigration Yearbook were used to determine the number of people admitted to the US as refugees, asylees, or humanitarian parolees from 1999 to 2009.

  2. Data from the Department of Homeland Security’s Immigration Yearbook were used to determine country of origin for all new refugees and asylees from 2000 to 2009.

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Author information

Authors and Affiliations

  1. Department of Pediatrics, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA

    Katherine Yun

  2. Department of Pediatrics, University of California, San Francisco School of Medicine, San Francisco, CA, USA

    Elena Fuentes-Afflick

  3. Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA

    Mayur M. Desai

  4. The Children’s Hospital of Philadelphia, 34th and Convention Center Blvd, CHOP North, Suite 1539, Philadelphia, PA, 19104, USA

    Katherine Yun

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  1. Katherine Yun
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Correspondence to Katherine Yun.

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Yun, K., Fuentes-Afflick, E. & Desai, M.M. Prevalence of Chronic Disease and Insurance Coverage among Refugees in the United States. J Immigrant Minority Health 14, 933–940 (2012). https://doi.org/10.1007/s10903-012-9618-2

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