Associations between refugee camp living and duration lived in refugee camps with health outcomes: A cross-sectional analysis of the Annual Survey of Refugees, 2021–2022

Abstract

Introduction Refugees represent a growing, marginalized population who experience significant health disparities. Approximate 20% of refugees live in refugee camps. Quantitative studies examining the health effects of refugees living in refugee camps are limited. We examined whether living in camps (and duration) is associated with worse health among U.S. refugees. Methods We used two years of cross-sectional data from the Annual Survey of Refugees (ASR 2021 and 2022), involving refugees ≥ 16 years old who entered the U.S. between FY 2016 and FY 2021. We tested for associations of living in a refugee camp (and duration) with self-reported physical and mental health using separate logistic regression models. Results In this national sample of 3,005 refugees (mean age = 39.0 years, SD = 12.4 years; 46% women, 30% White, 31% Black, 18% Asian), more than one in three (37%) reported living in a refugee camp – of whom, over 88% lived in a refugee camp for a year or more or their whole life. Living in refugee camps was highest for refugees from Democratic Republic of Congo (75%), Somalia (58%), and Burma (44%). In adjusted analyses, compared to those who did not live in camps, those who lived in camps for ≥1 year had 27% greater odds of poor physical health (aOR: 1.27 [95% CI: 1.02, 1.60]). Association of camp living with mental health became insignificant when adjusted for socio-demographic characteristics. Conclusions Refugees who lived in refugee camps, and for longer duration, may require targeted interventions to mitigate health harms from their refugee camp experience.