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Out of Sight, Out of Mind. Reviewed by Franzisca Zanker

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Refuge in the Levant and Eastern Mediterranean: Spaces of containment or places of choice?

Migrant necropolitics in no man’s land camps, governing the displaced: race and ambivalence in global capitalism. by ali bhagat., cross-effects of cultural and gay capitals in access to refugee status on the grounds of sogi in france: study of the formal and informal preparations of west african men for asylum trials, bargaining (in)visibility: rohingya refugees and the politics of visibility in india, ongoing oppressions and resistances: a review of des allers vers , a video installation by elisa larvego., liminality and transactional sex among queer refugees: insights from lebanon, turkey, greece, and switzerland.

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‘Being free’: Indigenous youth and future making in the wake of forced migration

Rohingya women as refugees: examining displacement, refugeehood and ‘bare life’, implications of refugee crisis on public sector healthcare organizations: empirical observation from myanmar’s rohingya refugees in bangladesh, samira surfs . rukhsanna guidroz and illustrated by fahmida azim, mismanagement and misinterpretations in asylum interviews: perspectives from south africa and sweden, stuck in a whirlpool the role of hope and despair in dealing with risks during afghan migration journeys, more than a number: exploring the impact of age(ing) on refugees’ experiences of arrival, self-generated asylum evidence: scripting, staging and desperation in the assessment process, withholding the letter: transgender asylum seekers, legal gender recognition, and the unhcr mandate, the politics of crisis-making. forced displacement and cultures of assistance in lebanon by estella carpi, extrajudicial border enforcement against lgbtiq+ asylum seekers, the language politics of uncertainty: on the temporal consequences of germany’s newcomer integration policy, frontiers of belonging: the education of unaccompanied refugee youth annika lems, correction to: building an ethical research culture: scholars of refugee background researching refugee-related issues, private sponsorship prefigured: religious groups and canada’s cold war refugee policy, displacing territory: syrian and palestinian refugees in jordan, quest for refuge: reception responses from the global north, ed. by octávio sacramento, elizabeth challinor, and pedro gabriel silva, the ‘inherent vulnerability’ of women on the move: a gendered analysis of morocco’s migration reform, bridging distance: transnational and local family ties in refugees’ social support networks, correction to: refugee mobilization in the nepal–india borderlands: porosity as opportunity, border abolitionism: migrants’ containment and the genealogies of struggles and rescue by martina tazzioli, time and power in azraq refugee camp: a nine-to-five emergency. by melissa gatter, direct and vicarious administrative burden: experiences of uk public services as homes for ukraine host, ‘if i knew how to speak english…’: how language shapes refugee mothers’ perceptions of past, present, and future in canada, ways of belonging: undocumented youth in the shadow of illegality francesca meloni, bringing care in: the meaning of care in refugee solidarity movements, recognizing the agency of forced migrants with diverse sexual orientations, gender identities and expressions, and sex characteristics, the 2021 unhcr-ie sogi global roundtable on protection and solutions for lgbtiq+ people in forced displacement: toward a new vision for lgbtiq+ refugee protection, not idle: the gymnastics of refugee activism in—and out of—the aid apparatus, three approaches to the 1951 convention: the case for a dialectical approach, twail, archives, and refugee law, the borders of migrant and refugee activism in south africa, fadh, sharaf and respectable passing as new frameworks for understanding transmasculinity in the mena region: case studies of transmasculine refugees in lebanon, shifting paradigms, not identities: lgbtiq+ refugees queering temporalities in denmark, later is a cis-hetero patriarchal time zone: narratives of resistance to lgbtqi+ inclusion amongst humanitarian practitioners, refugee journalism in indonesia: self-representation, resistance, and writing across borders, the convent camp: sacred places in palestinian refugee history, chronicles of disappearance: palestinian encampment in the bekaa valley (1948–1951), sayed’s journey to encampment: examining sites and scenes of economic migrant displacement in mandate palestine, undocumented bordering practices: protagonism and spaces of making, refugee mobilization in the nepal–india borderlands: porosity as opportunity, psychological research evidence in refugee status determination, towards a shared practice of encampment: an historical investigation of unrwa and the unhcr to 1967, what becomes a refugee camp making camps for european refugees in north africa and the middle east, 1943–46, capturing the border in refugee solidarity camp visits and city tours in germany: theorizing relationality through the border as horizon in refugee/migrant solidarity activism as citizenship politics, ‘my family needed me’: exploring caring dimensions and care circulation among older venezuelans on the move in peru, understanding the politics of refugee law and policy making: interdisciplinary and empirical approaches, fragile solidarities: contestation and ambiguity at european borderzones, ‘on the border, i learned how to advocate’: borderlands as political spaces for burmese women’s activism, ‘doing’ legal history in refugee law: a snapshot of bangladesh’s engagement with non-refoulement, drivers of loneliness among older refugees, borderland porosities: migratory journeys and migrant politics in lebanon and turkey, boundary-making and political activism in protracted exile: second-generation tibetan refugees in india, older refugee perspectives on death, remembrance, and burial: the east timorese in indonesia, the role of age at migration in socio-cultural integration: testing mediating mechanisms among recent refugees, data-driven futures of international refugee law, challenging the ‘youth gaze’: building diversity into refugee and asylum reception and integration programmes, institutional analyses of refugee protection, ethnographic approaches and international refugee law, older refugees and internally displaced people in african countries: findings from a scoping review of literature, retracted: environmental conflict between internally displaced persons and host communities in iraq, email alerts.

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Public health crisis in the refugee community: little change in social determinants of health preserve health disparities

1 Department of Learning Sciences, Adult Literacy Research Center, Georgia State University, Atlanta, GA 30303, USA

M H O’Connor

2 Center for Community Engagement at Clarkston, Prevention Research Center, Georgia State University, Atlanta, GA 30303, USA

A Owen-Smith

3 School of Public Health, Georgia State University, Atlanta, GA 30303, USA

Structural inequities and lack of resources put vulnerable refugee communities at great risk. Refugees flee their country of origin to escape persecution and flee from war, famine and torture. Resettled refugee communities become particularly vulnerable during times of crisis due to limited English proficiency and poor social determinants of health (SDOH), which create barriers to attaining and sustaining health and wellbeing for themselves and their families. The purpose of this case study was to evaluate SDOH among a refugee community in the Southeastern United States. We surveyed the community twice during a 1-year period to assess various elements of SDOH. Among a primarily African and Southeast Asian refugee community, 76% reported difficulty paying for food, housing and healthcare during the first round of surveys. During the second round of surveys at the beginning of the Coronavirus pandemic, 70% reported lost income; 58% indicated concern about paying bills. There was little change during the 12-month study period, showing that SDOH are an enduring measure of poor health and wellbeing for this vulnerable refugee community.

Introduction

Refugee and immigrant communities are vulnerable to adverse health conditions often caused by poor social determinants of health (SDOH). This population generally consists of larger families living in dense quarters, low-paid front line workers in a variety of industries, limited English skills, poor access to and use of healthcare services, high degrees of financial and food insecurity, low rates of health insurance and high degrees of stress. A problem particular to these predominantly limited English proficient (LEP) populations is providing information that both comes from a trusted source and is culturally and linguistically appropriate. Without meaningful access to information, LEP populations have little chance to improve their health and wellbeing. In particular, lack of accessible and meaningful health education and promotion exacerbates the poor SDOH that are experienced by residents in the community.

The purpose of this study is to share insights on the SDOH in a population of multi-ethnic refugees in the southeast United States both during a 1-year period that includes the beginning of the Coronavirus pandemic. We contend that this refugee community has significant poor SDOH and that those barriers to health and well-being have only continued or gotten worse at the beginning of the pandemic. We examined barriers to health and wellbeing, particularly limited English proficiency, financial insecurity and knowledge of resources. Reducing these barriers could ameliorate many of the disparities for improving SDOH for this vulnerable refugee community.

Approximately 3 million refugees have been resettled in the United States since the passage of the Refugee Act of 1980, which provides refugees with legal, financial and social support to assist them through the U.S. Resettlement Program [ 1 ]. Refugees leave their country of origin, often fleeing from war, famine and torture or due to a well-founded fear of persecution for reasons of race, religion, nationality and affiliation to a particular social or political group. The U.S. resettlement system is funded with federal funds funneled from the Office of Refugee Resettlement to a network of NGOs, social service agencies and faith-based organizations and is designed to expedite self-sufficiency of new arrivals within a 6-month timeframe [ 2 ]. The focus on rapid integration often leaves refugees without the long-term support frequently resulting in financial instability, lack of health insurance and lack of basic needs for children among some populations of refugees [ 3 ]. Low birth weight, poor educational outcomes, high rates of mental and physical illness and behavioral risks plague the refugee community and are compounded by the perceived stigma of immigration status in the United States [ 4–7 ]. Despite the economic research indicating that refugees contribute more than they receive in benefits and social services [ 7 ], policy has not supported the expansion of longer-term integration resources that could alleviate many of the disparities persisting in refugee communities. Many refugees serve as frontline workers, families tend to be large and housed in small quarters, language and literacy issues are common and most live below the poverty line [ 8–11 ]. All of these factors contribute to the persistent health disparities experienced by refugees [ 3 ].

There is currently a dearth of evidence about the unique social and health-related needs of refugees in the United States. Broadly speaking, most current epidemiologic research focuses on health outcomes of immigrants (individuals that come into a new country, region or environment with the purpose of settling in that area with or without persecution) not refugees [ 12 ]. Some data about refugees explore perceptions of health providers or single ethnic community needs, yet little is known about the barriers and facilitators to health care for refugees in general, particularly those living in diverse communities [ 12 ].

Healthy People 2020 defines social determinants of health (SDOH) as falling into five categories: economic stability, education, social and community context, health and health care, neighborhood and built environment [ 13 ]. SDOH focus on community-level economic and social conditions rather than on individual needs, and are structural in nature. Social determinants are directly related to poor health status; individuals who live in communities with limited access to health facilities, educational opportunities and low-quality housing experience greater health disparities [ 3 ]. Individual needs interact with SDOH in both simple and complex ways. For example, lack of available transportation is a community-level circumstance; on the individual level, the specific SDOH problem may be limited access to bus stop locations. Not being able to get to transportation, or perhaps not even knowing where transportation is, creates a social condition that affects both individual- and community-level health.

Clarkston, a city in DeKalb County, Georgia, is a ‘superdiverse’ community where more than 17 000 refugees who speak 60 different languages have settled since 2004. A superdiverse community is one where there has been significant demographic change that includes many different nationalities and cultures [ 14 ]. The CDC-funded Prevention Research Center (PRC) at Georgia State University is headquartered in Clarkston and works with community organizations, state and local government, community partners and residents to develop, implement and evaluate culturally and linguistically appropriate interventions to address the determinants of health for refugees and to disseminate this work at the community, state and national levels.

Study sample

To evaluate SDOH in the community during a 1-year period, we collaborated with several partner health clinics and refugee resettlement agencies to recruit study participants. Some participants were called by researchers to assess interest and consent. Other participants responded by using a web-based link, and others were recruited and consented at the health clinics or refugee agencies. Our community partners were interested in understanding barriers and facilitators to healthcare access including SDOH; these data had never been collected in the Clarkston community. Data were collected in Spring 2019 ( n  = 136 participants) and Spring 2020 ( n  = 128 participants). Interpreters were available to assist with informed consent and survey administration with primary language needs being Swahili, Arabic and Burmese. The University Institutional Review Board approved this study. There was no crossover between the study participants, that is, each study sample was composed of unique individuals ages 18 and older who resided in the Clarkston area and who self-reported as refugees or asylees.

When working with communities to mobilize around health and wellbeing, community engagement is an essential public health practice [ 15 ]. Community engagement includes partnerships between academic institutions, community-based organizations, health agencies and community members that provide a network for thoughtful communication and discussions. Community engagement serves as an invaluable and integral tool through which relevant needs assessment data and information can be gathered through input from key stakeholders and members in the community. Data and information gathered are used to understand community health assets, challenges and areas that can be improved. Needs assessment data can be used to carefully map out a strategy to improve health and make positive and sustainable changes that community leaders and members can implement. Surveys were created using community engagement guidelines.

At both time points, we took into account methodological considerations to ensure the surveys were adapted appropriately for research with refugees [ 16 ]. We were unable to use a straight forward probability technique (stratified, random, cluster), instead using convenience sampling guided by service providers (health clinics, refugee agencies). Refugee service providers have built-in trust and social relations with refugee adults in the community, and thus removed potential reluctance of refugees to participate in the study. Based on our prior experiences in the community and on prior studies, we knew that we were most likely to have more participation with a gatekeeper (health clinic, refugee agency) who would provide our researchers access [ 16–18 ].

Two cross-sectional surveys were created and allow us to conduct a case study of community needs at two-time points. In both cases, we were concerned with gathering information from both English speaking and limited English proficient respondents, therefore, we used interpreters to reach our subjects for both consent and data gathering [ 16 ]. The latter survey was also offered online in English or over the telephone in a variety of languages due to COVID-19 restrictions on face to face human subjects research.

The first survey was informed by findings of a multi-disciplinary community-wide summit held in November 2018 which focused on refugee health and wellness. One significant gap identified was the lack of data on residents in the community. Development of the second instrument was informed by a request from community health clinic partners for specific issues, and utilized a community-engaged approach by closely working with and responding to community partner organizations and health clinics. In both surveys, we focused on English proficiency, stress and SDOH. English proficiency was measured by both self-report of ability to read, write and speak English and the need for interpreter services to complete the survey. Stress was measured through self-report of feeling scared, anxious or unable to sleep. SDOH was measured by assessing financial security and household size. Other data were collected in both surveys but are not relevant to this particular report. See Table I for measures collected in both studies.

Description of survey measures

Data collection and analysis

Data were collected either orally face to face, through a web-link or through a telephone-based survey. Web-based respondents were consented on the first page of the electronic survey. Telephone interviews were ∼20 min long, and participants consented verbally prior to the interview beginning. Face to face surveys were ∼30 min long, and participants signed informed consent forms. Multilingual study assistants were used, as needed, to provide interpretation for participants who took part either face to face or by phone and requested to speak in their native language. Question responses were either factual (e.g. age), multiple choice (e.g. where do you get health care services with a list of choices) or ordinal using a Likert-style scale (e.g. how would you describe your health with four answers ranging from poor to very good). Univariate and bivariate descriptive analyses were conducted using SPSS V25 including means, frequency and Pearson correlations.

With regard to English proficiency, 78% of our participants preferred a language other than English to complete the survey ( n  = 247). Additional results from Spring 2019 show that over half (57.4%) of participants self-reported marginal reading, writing and speaking skills in English ( n  = 128). With regard to levels of stress, 66% of all participants over the two surveys indicated having high levels of daily stress. SDOH results for all participants indicate high levels of financial insecurity (82%), 31% living in high-density households (6 or more people) and almost 70% of the population did not know where to get benefits like unemployment or financial assistance (See Table II ).

Social determinants of health—data collected Spring 2019 and Spring 2020 (n = 247)

In Spring 2019, results show significant relationships between high levels of stress and poor health status ( r =0.371, P <0.05) and between high levels of stress and financial insecurity ( r =0.444, P <0.05; Table III ). A significant relationship between high levels of stress and more detailed financial insecurity were revealed during the Spring 2020 data collection with food insecurity (this week, r =−0.252, P <0.05 and next week, r =−0.239, P<  0.05) and between high levels of stress and financial insecurity (inability to pay bills this month, r =−0.304, P <0.05 and next month, r =−0.354, P<  0.05; Table III ).

Correlations among stress and financial insecurity—data collected Spring 2019 and Spring 2020

Among a community composed of primarily African and South Asian refugees, our findings from community assessments on SDOH highlight the vulnerability refugees face on a daily basis. One clear concern is the inability to navigate resources for benefits assistance in the Clarkston refugee community which is validated in other studies conducted among migrant populations [ 19 , 20 ], demonstrating significant and persistent barriers to meeting individual needs. Not meeting individual needs is a social risk that exacerbates other existing poor SDOH in a vulnerable community affected by health inequities.

There is little research specific to multi-ethnic refugee communities; hence, we wanted to provide some basic documentation of the conditions which likely contribute to disparities in health and social determinants in this population. Participants had limited English proficiency, lived in high-density housing, had significant levels of daily stress and did not know how to access needed resources—all important predictors of poor health status and low quality of life [ 3 , 21–24 ]. Although the community is home to a wide range of service providers including safety-net clinics, social service agencies and faith-based organizations, the services provided can be hard to access, poorly funded, not available all the time and confusing to refugees—our first study shows that a large percentage of refugees do not know where to get help with food assistance, money problems, legal assistance or housing, combined with a large percentage of the second sample not knowing where to go to get benefits like unemployment assistance. Language is another key barrier to improving SDOH; English proficiency is a key facilitator to improving access to health, healthcare, understanding rights regarding housing and unemployment, accessing community resources and helping children navigate through school and beyond.

Our planned Spring 2020 data collection pivoted to both continue to understand SDOH and to understand how this community was uniquely impacted by the Coronavirus pandemic. Community partners wanted to understand where the pandemic would have the most serious impact. We established and validated the fragility of the population in terms of English proficiency, access to benefits, and stress. These are essential needs; disparities documented in Spring 2019 were just as severe with participants having financial insecurity, high levels of stress and poor knowledge of how to access benefits and help; all important predictors of health problems and low quality of life [ 3 , 21–26 ].

In fact, our studies show the depth of structural inequities, unemployment, ability to maintain daily sustenance and lack of knowledge on or ability to access resources which exacerbate existing health disparities within this population. Structural inequities in the healthcare system such as a lack of insurance or access to technology for poor families have a direct impact on health outcomes [ 19 ]. The refugee community has also been disproportionately impacted by the pandemic living in multigenerational and dense housing where social distancing is not an option, working in frontline jobs with limited access to health information and PPEs, significant loss of income and food security, no reliable access to technology and a general lack of knowledge about how and where to access benefits.

There is limited research on individual-level social, economic and environmental factors affecting this vulnerable population. These data are critical to developing sustainable interventions to improve individual- and community-level health. Funding and support services for refugee resettlement is largely devoted to the first 6 months post-arrival including immediate housing and employment needs [ 2 , 7 ]. There is little that supports ongoing integration such as adult education, language classes or skills training to enhance employment opportunities. The majority of refugees remain in low-wage jobs without health insurance, with limited English proficiency, lacking the social mobility necessary to escape the cycle of poverty in the community. The intersection between individuals at high risk and poor community-level SDOH resources reinforces the challenges refugees face in improving their health and well-being [ 4 , 6 , 10 , 11 ].

Recommendations

Based on our findings and other similar published research on SDOH in migrant populations [ 10 , 11 , 27 , 28 ], several critical recommendations are suggested to achieve equitable improvement in refugee health and well-being. Recommendations must begin by focusing on reducing barriers to community health services and other resources, and improving SDOH for the 3 million refugees already living in communities throughout the US. First, there must be an expansion of and improvement in the quality and number of language and literacy services for refugees immediately upon arrival. Limited English skills keep refugees locked in a socioeconomic stratum that prevents them from accessing healthcare, education and the jobs they need to improve their lives. Refugees are also less able to maximize social service benefits (nutrition services, health insurance, childcare, mental health services, substance abuse program, etc.) due to limitations in language skills. Second, to ensure successful resettlement transitions for refugees, host communities should be provided adequate resources. US health indicators lag behind many other countries because of the underinvestment in ongoing social services. This pandemic has highlighted an even greater need for behavioral health services, food access, technology access and financial security among others. Third, education and training for health professionals should include intercultural competence skills for patient-centered care and provide culturally and linguistically appropriate health education and promotion materials to refugee patients [ 29 ]. Training and supports are needed for community health workers (CHW) from within each ethnic community. CHW are integral to refugee health and wellbeing [ 28 ]. These individuals can assist with navigation by providing maps of their communities with locations and descriptions of support services such as health care, transportation options, after-school care, childcare, job training, language classes, legal assistance and others. Additionally, training for CHW can also assist clinicians with patient navigation for specialty care referrals, benefit applications and prescription education to improve patient compliance and access to health services. Finally, there is a need to establish a national coordinated data collection effort to understand the diversity, needs and approaches to resettling and integrating refugees throughout the United States. Data collection and surveillance of health and SDOH in the refugee population will strengthen the infrastructure and capacity to more fully understand needs of the population and respond to new concerns.

Action is needed on many fronts to eliminate the existing systemic disparities for all vulnerable populations in the United States. [ 23–26 , 30–32 ]. The Coronavirus pandemic has proven to be especially virulent in communities like Clarkston, and it will require a significant change not just in the healthcare system but in the local, state and federal policy approaches to democratize health, education, social services and all of the determinants of health and well-being to mitigate its impact. Culturally and linguistically appropriate approaches to collaboration and delivery of care are needed for clinicians. Community organizations need more resources and better infrastructure for collaboration. Meaningful connection to technology for lower resourced communities must become a standard for the delivery of health information, education, access to benefits and employment opportunities. In the wake of a pandemic, public and individual health systems have been exposed to the vulnerabilities of communities most at risk because of structural inequities, refugees being one of those groups. The lessons learned from our studies are significant to all communities where social determinants of health contribute to poor health outcomes.

Strengths and limitations

Limitations in our surveys include self-report responses which could indicate response bias as well as the use of available rather than trained language interpreters. We were not able to study the same group of respondents in both surveys nor did we ask all of the same questions in which eliminates an ability to compare all pre-responses and post-responses; this manuscript focuses on reporting measures that were collected at both time points. We used a non-probability method of sampling, which resulted in data limitations and inability to generalize. However, these findings have important strengths and are valuable to understanding the needs of this refugee community. These data have never been collected in this community, and findings both corroborate and challenge years of anecdotal evidence; one critical finding from the first study, for example, is that despite numerous refugee agencies and community organizations created to assist refugees, a large number of respondents did not know where to get help with a host of issues including legal, housing, financial, food insecurity and job training. Based on these findings, we created a geo-coded map of these types of resources in Clarkston which is hosted by the Atlanta Regional Commission and used throughout the community today. Results from the second survey indicated, for example, that despite a high level of food insecurity, few refugees used a food pantry to supplement their groceries. Questions arise as to whether that is due to the type of foods available at a food pantry which may not be familiar to refugee or suitable for refugee diets, or whether refugees do not know how to access a food pantry. Our studies are critically important in informing data-driven interventions to improve the health and well-being of this refugee community.

Centers for Disease Control and Prevention (U48DP006393).

Conflict of interest statement

None declared.

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Higher education for refugees: relevance, challenges, and open research questions

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• Volume 3 , article number  177 , ( 2023 )

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Reflecting the increased public, political, and professional interest in higher education for refugees, research activity in this area has increased significantly in recent years. The growing body of literature provides new academic insights and crucial information for both policy and practice. This integrative literature review discusses 104 papers published between 2016 and 2019, contributing to the state of the research by offering a structured synopsis of the key themes and findings of this relatively new field. It first presents structural changes in the research literature, such as an increased focus on Germany and Turkey after the influx of asylum applications in 2015/16. It also outlines the high relevance of higher education for refugees, which is often discussed as the foundation of success in the host country. Further, the paper provides a synopsis of the personal, institutional, and structural challenges faced by refugees as they aim to realize their higher education goals, and an overview of structural challenges for institutions aiming to support them. In particular, the intersection of multiple challenges and the unaligned interests and needs of policymakers, higher education institutions, and refugees threaten the development of adequate support services. Finally, open questions and implications for further research are identified.

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Introduction

The United Nations High Commissioner for Refugees (UNHCR 2019 ) has reported “the highest levels of displacement on record,” with 70.8 million people worldwide having been displaced, including 25.9 million refugees. Notably, the UNHCR’s estimation of refugee enrolment in higher education institutions (HEIs) increased from 1% in 2019 to 6% in 2023. The UNHCR is striving to increase this number to 15% by 2030—the “15by30 target” (UNHCR 2023 ). This emphasizes the importance of targeted support programs (see also United Nations 2019 ).

Before 2016, studies on tertiary education for refugees were sparse and usually based on “primarily exploratory, qualitative investigations with (sometimes very) small case numbers” (Berg et al. 2018 , p. 82, translated from German). They highlighted some of the key challenges refugee students were facing in obtaining higher education, such as financial challenges (Stevenson and Willott 2007 ), the effect of traumatic experiences (Earnest et al. 2010 ), language proficiency (Shakya et al. 2010 ), interruptions and long breaks in their educational experiences (Morrice 2009 ), the lack of information (Stevenson and Willott 2007 ), and peer support in their communities (Joyce et al. 2010 ; Naidoo 2015 ). Along with growing social and practical interest, however, a growing body of academic literature has begun to investigate aspects of higher education for refugees.

Previous literature reviews have considered the state of research until early 2018 (Berg et al. 2018 ; Mangan and Winter 2017 ; Ramsay and Baker 2019 ), focused on specific groups, such as Syrian students in Germany (Ashour 2021 ) or women who experienced forced migration in resettlement contexts (Burke et al. 2023 ), or considered specific methods of teaching and learning, such as mobile learning applications for refugees (Drolia et al. 2020 , 2022 ). To provide a comprehensive overview of the rapid changes in the field over recent years and provide suggestions and implications for further research, this integrative review (Torraco 2016 ) focuses on the academic literature on higher education for refugees published between January 2016 and December 2019. In particular, the relevance of studying for refugees and the challenges faced by both students and higher education institutions have been identified as central themes in academic publications in this emerging field of research. While the challenges highlighted in previous studies persist, the greater density and diversity of studies offer a more in-depth look at the complex and interconnected difficulties that refugee students experience.

In order to reach UNHCR’s 15by30 target, it will be necessary to not only address individual challenges for refugee students but also structural and institutional issues that create obstacles to their ability to access higher education (Baker and Irwin 2019 ; Luu and Blanco 2019 ; Berg 2020 ). Synthesizing findings from the research field can provide guidance for this. This integrative review thus contributes to the state of the research by providing a synopsis of the key challenges faced by both refugees that aim to enter and succeed in higher education, and higher education institutions that aim to develop and implement targeted support programs.

Regarding the terminology, the terms “refugee” and “asylum seeker” cover a broad variety of living situations in diverse personal, structural, and national contexts. Considering the different definitions and sampling criteria used in the studies reviewed, I generally refer to “refugee students,” meaning students in higher education or preparatory programs who have experienced forced international migration (regarding internally displaced scholars, see Oleksiyenko et al. 2020 ).

This paper provides an integrative review (Torraco 2016 ) of the current literature on higher education for refugees. Because the body of literature has expanded rapidly since 2016, the narrow time frame is meant to survey recent developments in the field. This review is followed by a discussion of research gaps and a synthesis of open research questions and implications for further research. The following key questions structured the search and review process:

How has the field of research on higher education for refugees changed along with growing public and academic interest?

What are the central topics, results, and research questions that remain unaddressed?

How can further research build on and advance studies of higher education for refugees?

Literature research and selection criteria

The literature discussed in this review was identified and selected through several steps. The first step was to conduct a database search, which took place in May 2019. In addition to the large interdisciplinary database Scopus and the social science database GESIS, the following databases with an educational focus were searched: the Educational Resources Information Center (ERIC), Education Source, and peDOCS. Based on combinations of English and German keywords, the search was narrowed to focus on peer-reviewed articles that had been published in or after 2016. Table 1 provides an overview of all keyword combinations.

The second step was to conduct a similar search of additional databases, including Academia.edu, Google Scholar, and ResearchGate. Due to filter settings, this search was not limited to peer-reviewed articles. A final database search was conducted in January 2020.

For papers to be included in this review, they had to focus on study preparation or higher education for refugees. The first round of selection was based on the abstracts of the publications. I then excluded literature reviews on higher education for refugees and project reports. Ultimately, 104 journal articles, chapters, and books were included in this review. They will henceforth be referred to as “papers.” Table 2 provides a comprehensive overview of all the papers included. Furthermore, they are marked with asterisks in the reference list.

After the literature selection process, all papers were summarized to provide a preliminary overview of the material. During this step, I received crucial support from a group of students and Prof. Dr. Streitwieser, a fellow researcher in the field. The summaries were completed using a template I prepared, which included the following sections: topic, research question, location, relevance, methods, theoretical framework, and central findings. All summaries contained brief notes and selected quotations for all sections for which this was applicable.

I then familiarized myself with all papers and created a synoptic table to sort them according to their topic, method, sample, and regional focus. This “descriptive evaluation of each study” (Wright et al. 2007 , p. 26) allowed for a general comparison of the literature. I aimed to survey the main characteristics of and issues in this newly emerging field to identify implications for further research. Throughout the review process, I discussed the papers’ results and quality with students and fellow researchers.

All papers were sorted into descriptive categories, including their publication date, location, empirical method, sample, and main topics. Table 3 shows a notable increase in international publications from 2016 to 2019.

A comparison with previous literature reviews emphasizes this impression: Ramsay and Baker's ( 2019 ) discussion of 46 papers that were published between 1999 and early 2018 included 16 papers published in 2016–2018, in comparison to 30 papers published in the much longer period between 1999 and 2015. Berg et al. ( 2018 ) reviewed 34 empirical studies published between 1990 and early 2018. Seventeen of them were published in 2016–2018, in comparison to 17 papers published between 1990 and 2015.

International research before 2016 mostly focused on English-speaking countries, primarily Australia, Canada, the UK, and the USA (Berg et al. 2018 ). Table 4 shows that—even though Australia and the USA remain among those with the most academic inquiry and output on higher education for refugees—the general regional focus has shifted.

Before 2016, hardly any research had been conducted about refugee students in Germany. This has rapidly changed, with Germany now being the subject of the most country-specific studies in this review. This development seems to be closely related to the war in Syria, which caused a significant influx of new asylum applications in Germany, and the country’s rapid development of structural funding for refugee students. Parallel to this development, the publication numbers indicate increasing academic interest in refugee education in the countries neighbouring Syria, including Turkey and Jordan, and multi-country European studies.

The reviewed publications mainly focus on Europe, Australia, and North America (Canada and the USA). A few papers, however, also take Asian and African countries into account. Strikingly, the search produced no papers investigating the situation of refugee students in either South or Central American countries. In this context, it must be noted that the regional focus of the studies identified was surely influenced by the limitation of using only English and German keywords in my search. However, as many journals ask authors to provide English keywords even if they publish in a different language, one could assume that the search would produce multilingual results. Out of all the publications included, eight were published in German. Two were methodological, while six presented the results of empirical research (five studies conducted in Germany, and one in Austria).

Of the 104 papers included in this integrative review, 80 presented the results of empirical studies. The majority (59) were qualitative studies. Ten studies used mixed methods and nine were based on quantitative or standardized research designs. I was unable to classify the methods used in two of the empirical studies as qualitative, quantitative, or mixed methods due to their contradictory or partial methods sections. Often, the studies presented relatively small samples or case studies of individual support programs, including very small quantitative sample sizes.

There are several possible reasons why qualitative and small-sample studies were common. First, considering the rather small body of previous research, it stands to reason that research projects would either focus on or start with explorative studies to gather the first empirical evidence in the field. Second, programs for refugee students are often HEI-specific and not part of a coordinated national or international approach. Thus, even if all participants of a specific program are included, the sample size might still be limited. Third, identifying and reaching the target population outside of specific support programs poses serious difficulties for researchers. Finally, little quantitative information is available for further analysis because refugees are usually not identifiable in surveys and HEIs do not always provide specific information on them. As Streitwieser and Brück ( 2018 ) have pointed out, in the German context, no data is collected on the legal status of enrolled students.

Seven papers were categorized as conceptual, which I understand as drawing on or developing a theoretical framework to discuss a topic (Callahan 2010 ). Furthermore, seven papers were categorized as desk research. They provided policy overviews or project descriptions with no mention or description of empirical methods. Seven other papers presented descriptions and discussions of individual support programs. Finally, four papers introduced methodological implications or frameworks for research on and with refugee students.

Similar to previous publications (Berg et al. 2018 ), the main topics of most of the papers I reviewed were the situations and experiences of refugee students, institutional contexts, the challenges faced by and support available for refugee students, and the evaluation of these support programs. As the challenges faced by refugee students appear to be the leading topic in the field, I will discuss them in more detail below. Eight of the papers addressed higher education in refugee camps and six focused on online education. Finally, it should be noted that most of the research took the perspective of refugees into account. Of the 80 empirical studies, 60 either solely focused on (38) or included the perspectives of refugees (22) as part of mixed samples. This can be related to researchers’ strong demand to take forced migrants’ first-hand experiences into account (Baker et al. 2019 ; Berg et al 2019a , 2019b ; Reimer et al. 2019 ).

Similar to Ramsay and Baker's ( 2019 ) review of the literature published before early 2018, many of the papers discussed in this review can be placed in the broader field of education studies. In this area, the papers contributed to a wide range of topics such as the recognition of foreign degrees (Dunwoodie et al. 2020 ), program evaluation, academic culture (Baker and Irwin 2019 ), language proficiency (Nayton et al. 2019 ; Park 2019 ), internationalization (Streitwieser 2019 ; Berg 2018 ), equity, inclusion, and widening participation. These studies often focused on the perspectives of refugee students but also included higher education practitioners (Streitwieser et al. 2018a ), domestic and international fellow students (Ergin 2016 ; Grüttner 2019 ), teachers (Schröder et al. 2019 ), policymakers (Jungblut et al. 2018 ; Toker 2019 ), NGO members (Nayton et al. 2019 ), and policy analysts (Unangst 2019 ).

The relevance of support for refugee students

Academia, like freedom, is indivisible. It is enriched by diversity, and so long as some are excluded, all are restricted. How citizenship in the academic space is perceived and experienced is, therefore, a complex and urgent political concern. (Rowe et al. 2016 , p. 68)

Many authors insisted that there is a moral and social obligation to provide higher education opportunities for refugees (Abamosa et al. 2019 , p. 13; Lenette 2016 ) and referred to education as a human right (Naylor et al. 2019 ). They expected a number of benefits from providing this support on the social, institutional, and individual levels.

On a social level, higher education is a crucial enabler of the integration of refugees (Marcu 2018 , p. 18). Furthermore, Rasheed and Munoz referred to it as a method of “peacebuilding” ( 2016 , p. 172), and Avery and Said ( 2017 ) argued that it helped prevent radicalization. In the long term, educated refugees were understood to be important actors who could “support their communities in exile and contribute to the future development of their home countries” (Avery and Said 2017 , p. 107).

On an institutional level, refugees were sometimes understood to support the internationalization of HEIs (Abamosa et al. 2019 ; Berg 2018 ; Streitwieser 2019 ) and enrich their cultural diversity (Theuerl 2016 , p. 178; Unger-Ullmann 2017 , p. 5). By orienting themselves to the needs of refugee students, newly implemented support programs were seen to provide a chance for HEIs to “re-assess the ways in which students can engage and how they can give value to the skills brought by the prospective students” (Sontag 2018 , p. 542).

On an individual level, higher education was described as empowering refugees (Crea 2016 , p. 19), supporting their sense of belonging, psychological well-being (Al-Rousan et al. 2018 ; Bajwa et al. 2019 ; Grüttner 2019 ), and self-esteem (Bajwa et al. 2018 , p. 120), and helping them overcome trauma (Maringe et al. 2017 ). Finally, participation in higher education programs can be seen as “an act of resistance itself” (Villegas and Aberman 2019 , p. 79), which allows refugee students to defy stereotypes and negative ascriptions (Harvey and Mallman 2019 , p. 663f.).

Refugee students were found to be highly motivated to participate in higher education. They were often described as expecting their situations to improve (Schneider 2018 ) and seeing higher education as a facilitator of positive individual development and a social participation, as a chance give back to their communities (Crea 2016 , p. 19), or repay the support they received in their host countries (Hirsch and Maylea 2016 , p. 23).

Overall, researchers have claimed that higher education can potentially "yield better settlement outcomes for refugees to increase social cohesion and, more importantly, help redress some of the personal and social disadvantages and the detrimental public discourse" (Lenette 2016 , p. 2). By providing trustworthy environments and spaces for exchange (Villegas and Aberman 2019 , p. 77) and thereby “humanising” (Fleay et al., 2019 , p. 187) refugees, HEIs can support refugees in building agency, developing critical thinking, and reflecting on their own positions, thereby counteracting social exclusion and marginalization (Avery and Said 2017 ; Bajwa et al. 2018 ; Fleay et al. 2019 ; Lenette 2016 ).

Challenges for refugee students

Similar to publications before 2016, the main research interests of the reviewed studies included challenges for refugee students.

The main challenges identified throughout the papers included language proficiency (Akbasli and Mavi 2019 , p. 10; Harvey and Mallman 2019 ; Park 2019 ), the accessibility of information (Baker et al. 2017 ), finances (AbduRazak et al. 2019 , p. 176; Baker et al. 2017 ; Sheikh et al. 2019 , p. 15), housing in stressful environments and/or remote areas (Akbasli and Mavi 2019 ; Schammann and Younso 2017 , p. 13), difficulties with the acknowledgement of credentials, and issues of mental health. Furthermore, family obligations (Perry and Mallozzi 2017 , p. 511), social isolation, discrimination, acculturation to a new learning environment, legal issues, disrupted educational experiences, and institutional settings inhibited refugees’ access to and success in higher education.

Some authors also argued that cultural differences slowed social and academic integration (Karipek 2017 , p. 125; Tamrat and Habtemariam 2019 , p. 134). In this context, gendered expectations caused additional hurdles, especially for women (Crea and Sparnon 2017 , p. 17; Perry and Mallozzi 2017 , p. 496). Even though many of the challenges discussed have been pointed out in previous studies (Berg et al 2018 ), the great number of new studies creates a more nuanced understanding of the situation of refugee students. It also allows the analysis to avoid exclusively focusing on deficits and include the capabilities and strengths of refugee students.

Several studies investigated the mental health and well-being of refugee students. Mental health challenges stem from both pre- and post-migration phases (Jack et al. 2019 , p. 62) or unclear prospects (Crea 2016 , p. 19), and can result in a lack of stability, increased vulnerability, and inhibited academic performance (Erdoğan and Erdoğan 2018 , p. 275; Sheikh et al. 2019 , 9; 14). Mental health issues and the various time-consuming challenges that prevent quick integration and participation in the host country created a feeling of lost time (Baker et al. 2019b, p. 11). This can frustrate and potentially demoralize refugee students. Furthermore, the non-acknowledgement of their previous knowledge and education (Baker and Irwin 2019 ; Jack et al. 2019 ; Sheikh et al. 2019 ), on the one hand, and social isolation and discrimination, on the other hand (Harvey and Mallman 2019 ; Molla 2019 ; Villegas and Aberman 2019 ), caused the feeling of low self-esteem (Park 2019 , p. 7; Tamrat and Habtemariam 2019 , p. 134). Based on quantitative survey data, Grüttner ( 2019 ) showed that.

mechanisms of social exclusion can hamper learning and study preparation success and thereby threaten the academic careers of international students and integration strategies of refugee students. Personal resources of resilience like resilient coping can strengthen feelings of belonging against the backdrop of perceived xenophobia. (p. 42)

The intersectional challenges faced by refugee students do not only limit their access to traditional higher education. Six of the reviewed papers specifically dealt with online courses for refugee students (Brunton et al. 2017 ; Crea and Sparnon 2017 ; Halkic and Arnold 2019 ; Muñoz et al. 2018 ; Reinhardt et al. 2018 ; Zlatkin-Troitschanskaia et al. 2018 ). Generally, online courses were seen as a potential solution for learners due to being cheaper, more flexible, and independent from the availability of local tertiary education (Crea and Sparnon 2017 ; Muñoz et al. 2018 ). However, the studies showed low completion rates (Halkic and Arnold 2019 ) and pointed out that the challenges of accessing higher education in general (e.g., language barriers, finances, housing, time management) also impacted refugee students’ ability to participate in online education (Brunton et al. 2017 , p. 17f.; Halkic and Arnold 2019 , p. 17).

Finally, the “diversity of the target groups” (Halkic and Arnold 2019 , p. 17) caused difficulties in creating online education offers that fit the diverse backgrounds and needs of the population (Reinhardt et al. 2018 , p. 217f.; Zlatkin-Troitschanskaia et al. 2018 , p. 171). Therefore, online courses were, rather, seen as a helpful tool to “form realistic expectations about higher education study” (Brunton et al. 2017 , p. 17) and potentially “improve prospective flexible learners’ preparation for higher education study through the provision of active developmental supports, early in the study life cycle” (Halkic and Arnold 2019 , p. 17). However, to foster long-lasting solutions, individual, institutional, and structural challenges need to be addressed and overcome.

Institutional challenges for refugee students

Recent studies have also increasingly investigated institutional settings that add to refugees’ challenges in entering and obtaining higher education in three ways.

First, challenges in entering and obtaining higher education are enhanced by unclear or absent higher education policies for refugees. This places the responsibility on individual institutions (Villegas and Aberman 2019 , p. 73) and creates a confusing situation. Furthermore, in some cases, refugee policies were “focused primarily on workforce development and career training, rather than on the academic track of post-secondary education” (Luu and Blanco 2019 , p. 9).

Second, repressive asylum policies and the multisector entanglement of higher education, welfare, legal, and asylum policies create challenges for refugees because “these areas need to be taken into account simultaneously, but what is more challenging is that they are often not well in tune with one another” (Schammann and Younso 2017 ; Sontag 2019 , p. 72; Détourbe and Goastellec 2018 ; Klaus 2020 ).

Third, HEIs’ unawareness or ignorance of refugees can result in unfitting institutional contexts. This includes the “[a]voidance of the notion of refugees” (Maringe et al. 2017 , p. 6) and the “[a]bsence of a culture of care and support [in an] academic environment [that] is built around notions of the survival of the fittest” (ibid.). Institutional rules and regulations about university transition are based on assumptions about students, cultural capital, language proficiency (Park 2019 , p. 8), aspirations, linear life courses, and knowledge of academic practices and education systems (Baker and Irwin 2019 ; Stevenson and Baker 2018 , p. 96f.). This results in institutional environments that do not consider and therefore do not or cannot adequately address the backgrounds, experiences, and needs of refugee students.

To give an example, some HEIs offer refugees guest access to their classes. This is meant to provide them with insight into academic practices and language. However, studies have found that refugee students have little interest in programs without official degrees (Crea and Sparnon 2017 , p. 15; Schammann and Younso 2017 ). Klaus ( 2020 , p. 136) described this as a quick solution, not a serious endeavor to fully include refugee students in academic life.

Challenges for institutions

Even though research on members of HEIs, including students and staff, has found that they generally have a robust motivation to support refugees, some studies have argued that HEIs themselves face structural challenges when trying to provide such support. They often lack trained staff and have difficulties finding enough specialists (Maringe et al. 2017 ), such as competent language teachers, instructors with intercultural training (Crea and Sparnon 2017 ), or qualified providers of psychological support (Steinhilber 2019 ), to address the complex and diverse needs of refugee students (Schröder et al. 2019 , p. 72). Additionally, some papers described faculty members’ insecurities about how to address students who have experienced forced migration or deal with practical questions (e.g., determining the validity of documents; Schammann and Younso 2017 , p. 12; Toker 2019 ; Lenette 2016 ).

The lack of information and guidelines is closely linked to political frameworks and the availability of policy solutions. Considering the situation in the USA, Luu and Blanco ( 2019 ) stated that “[t]he perspective on refugees espoused by the Trump Administration is symptomatic of a larger discourse that vilifies and dehumanises refugees” (p. 4). Political discourse and policy frameworks are of great importance to HEIs that aim to support refugee students because they determine the existence and availability of official guidelines, target group-specific policies (Abamosa et al. 2019 , p. 4), policy solutions or suggestions about topics such as the acknowledgement of documents, and—last but not least—public funding. Public and non-profit HEIs, especially, have difficulty fully funding their programs, which makes public funding a crucial factor (Nayton et al. 2019 ).

Discussion and research implications

The amount of research and literature on tertiary education for refugees has grown massively, especially since 2016. In this review, I have discussed 104 papers, including 80 empirical studies, that were published between January 2016 and December 2019.

As in literature published before 2016, there is a primary focus on the challenges faced by refugee students and the majority of the papers are qualitative case studies or conceptual papers, emphasizing the importance of higher education opportunities for refugees (Shakya et al. 2010 ; Earnest et al. 2010 ; Joyce et al. 2010 ; Stevenson and Willott 2007 ). Nonetheless, a new focus on formal study preparation (Schröder et al. 2019 ), a slight increase in quantitative and mixed methods approaches, and the appearance of studies on new countries and regions all indicate the increasing importance of this research field and create a more nuanced picture.

It can be assumed that due to the narrow time frame considered, many of the studies were conducted simultaneously. In combination with the little previously published literature on the topic, this results in a somewhat repetitive body of work, with many studies focusing on challenges for refugee students. In the following section, I will summarize some potential open questions and research topics to further differentiate and substantiate this newly growing field.

Multi-level and multi-perspective studies

I recommend enhancing the growing methodological and theoretical diversity to create insights into various aspects, cases, and perspectives. This would include moving beyond (single) case studies and emphasizing comparative, multi-perspective, and multi-level studies. On the one hand, such research could investigate the premises and conditions of successful preparation for, access to, and participation in higher education for refugee students and identify expedient support strategies for various contexts that fit the needs and lived experiences of refugee students. Furthermore, such research could look into the broad activities of individual HEI staff members, students, or volunteers (Webb et al. 2019 ; Resch et al. 2021 ; Sevenson and Willott, 2007 ). It could develop strategies to understand the value of the knowledge they have obtained and preserve it, while also considering ways to formalize this support so it does not need to be offered on private time (Berg et al. 2022 ). On the other hand, it could enhance the understanding of the diverse living situations of refugees and the institutional contexts that shape them, thus broadening education research.

Beyond the deficit discourse

As Ramsay and Baker ( 2019 ) argue in their literature review, research on refugee students should “go beyond a lens of issues and problems” (p. 57). Similar points are made in the discussion sections of many of the reviewed papers. Still, relatively few works investigated the capital and knowledge refugees bring, which should be valued and thematized (Harvey and Mallman 2019 ; Shapiro 2018 ). Studies in this area could include the benefits HEI expect from supporting refugee students but should also critically investigate the norms, limits, and adaptability of academic culture (Baker and Irwin 2019 ), as well as ways to create agency for refugees (Grüttner et al. 2018 ).

Teaching and learning strategies

Several studies mention the use of unfamiliar teaching and learning styles as a challenge faced by refugee students. However, the studies reviewed do not further investigate the learning strategies that refugee students use. As Parkhouse et al. ( 2019 ) have pointed out, well-prepared teachers can be crucial for the success of students from marginalized communities. Higher education staff members, including counsellors and teachers, often show little diversity and are insufficiently qualified to deal with intercultural issues (Schammann and Younso 2017 ). Further research that aims to provide a more detailed understanding of refugees as academic learners (Ives and Castillo-Montoya, 2020) and teaching styles in intercultural higher education could have valuable strategical and practical implications, along the lines of Warriner et al. ( 2019 ) conceptual approach to teaching academic English in schools.

Organisational responses and contexts

Many studies around higher education for refugees investigate the experiences of refugee students (Bajwa et al. 2017 ; Joyce et al. 2010 ) or introduce, investigate, or evaluate case studies about higher education programs (Bacher et al., 2020 ; Naidoo 2015 ). However, very few apply organizational theory to understand institutional reactions and frameworks that shape the higher education system and, more specifically, programs for refugees (one exception is Webb et al. 2019 ). A closer investigation of institutional rationale, decision-making processes, and potential organizational changes could clarify the exact context of higher education for refugees. This could also include a more detailed investigation of concepts, aspects, and strategies related to integration and participation and how well they meet the needs of refugee students. Unangst and Crea ( 2020 ) introduced an approach to bridge the contrast between subjective identities and generalized support programs: Intersectional programmes could consider a variety of intersectional identity markers to offer a range of supports. Additionally, as not all endeavours to support refugee students originate from HEIs, it seems important to investigate all relevant public and private institutions, their actions, and their objectives. This could present interesting overlaps with studies of civic engagement.

The impact of the Covid-19 pandemic

As the world adapts to the “new normal,” it becomes increasingly clear that the Covid-19 pandemic not only affected all aspects of everyday life, including higher education, but also exacerbated the situation of at-risk populations globally. Further research will need to consider and measure the impact of the pandemic, including its consequences for refugee education. In different contexts, different outcomes can be expected, from backlash to questions of survival to a shift towards online education. The outcomes for (student) mobility, migration, social security, the organization of higher education, and many other factors that influence refugee (higher) education have yet to be determined.

Data availability

The data that support the findings of this study were used under license for the current study, and so are not publicly available. All data are cited in the paper and can be accessed via their respective publishers.

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Acknowledgements

I especially want to thank Dr. Bernhard Streitwieser. He strongly supported the conceptualization of this paper and actively participated in the research and analysis of the discussed literature. I thank Renny Osuna and Olivia Laska for both their literature research and summaries. Further, I thank Thierry Adrien, Jen Bhiro, Lexus Bivins, Alexandra Croteau, Lydia Delamatta, Michelle Fleuriot, Jisun Jeong, Hailey Klein, Samira Sariolghalam, Kelber Tozini, Siyu Wan and Sebastian Zühl for their summaries.

Open Access funding enabled and organized by Projekt DEAL. The article is based on research funded by the German Federal Ministry of Education and Research [01PX16015].

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Berg, J. Higher education for refugees: relevance, challenges, and open research questions. SN Soc Sci 3 , 177 (2023). https://doi.org/10.1007/s43545-023-00769-6

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Migrants and refugees: Improving health and well-being in a world on the move

* E-mail: [email protected]

Affiliation Public Library of Science, San Francisco, California, United States of America and Cambridge, United Kingdom

• Richard Turner, 
• on behalf of the PLOS Medicine editors

Published: July 30, 2019

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Citation: Turner R, on behalf of the PLOS Medicine editors (2019) Migrants and refugees: Improving health and well-being in a world on the move. PLoS Med 16(7): e1002876. https://doi.org/10.1371/journal.pmed.1002876

Copyright: © 2019 Turner, on behalf of the PLOS Medicine editors. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Funding: The authors received no specific funding for this work.

Competing interests: The author's individual competing interests are at http://journals.plos.org/plosmedicine/s/staff-editors . PLOS is funded partly through manuscript publication charges, but the PLOS Medicine Editors are paid a fixed salary (their salaries are not linked to the number of papers published in the journal).

Provenance: Written by editorial staff; not externally peer-reviewed

The PLOS Medicine Editors are Thomas McBride, Clare Stone, and Richard Turner.

At the 72nd World Health Assembly, held during May 20–28 of this year in Geneva, Switzerland, a very welcome global action plan was agreed upon, which seeks to establish a “framework of priorities and guiding principles… to promote the health of refugees and migrants” [ 1 ]. Indicating the pressing need for leadership by WHO and other actors, over the period from 2000 to 2017, the number of international migrants is estimated to have risen by 49%, to 258 million people [ 2 ]. The WHO document also notes that the number of forcibly displaced people has reached its highest-ever level, at an estimated 68.5 million individuals, including 25.4 million refugees—the majority hosted in low- and middle-income countries. Furthermore, approximately 10 million stateless people lack basic human rights to freedom of movement, education, and healthcare. Scattered across the planet, such enormous numbers of people dwarf the individual populations of many countries, yet, all too often, no government or international agency can offer adequate protection or health provision to this virtual state of refugees and migrants.

Migration, whether voluntary or otherwise, covers a wide range of situations. People may move within their own country or to another country for economic or family reasons, and, even in familiar surroundings or in transit, individuals will have health needs that may not be addressed, and they can also be vulnerable to exploitation or violence. Where there is armed conflict or persecution, the degree of danger and vulnerability is substantially greater. One distressing example is the Syrian conflict, which has involved extreme and prolonged violence and led to the harm and displacement of large numbers of people since 2011. UNHCR, the UN Refugee Agency, estimates that, as of June 2019, 5.6 million people have been displaced to Turkey, Lebanon, Jordan, and other nearby countries, with 6.6 million people displaced within Syria itself [ 3 ]. Such large and unpredictable movements of refugees create great challenges in protection and provision of shelter, food and water, and medical care.

There is substantial documentation of the numerous and grave health threats faced by migrants, refugees, and asylum seekers. Migrant workers who have relocated internationally are at risk of occupational injuries and ill health, for instance, highlighting the need for employers and host country governments to strengthen employment rights and healthcare provision [ 4 ]. Migrants and refugees can be vulnerable to serious outbreaks of infectious diseases, such as cholera, in emergency settings [ 5 ]. In a transit or destination country, people could be affected by diseases prevalent in their country of origin, such as tuberculosis, and by noncommunicable diseases, for example, that reflect the situation in countries of transit and destination. Mental ill-health, including posttraumatic stress disorder in relevant groups of people, is a particular concern for migrants and refugees and their health providers [ 6 ]. In many settings, barriers of language, culture, or law prevent migrants from accessing essential services. As discussed in an article by Cathy Zimmerman and colleagues published as part of the “Migration & Health” Collection in PLOS Medicine in 2011, migration can be viewed in terms of distinct phases, from predeparture to potential return to a person’s country of origin, with opportunities for health monitoring and intervention through suitable services at each stage [ 7 ].

Some of the drivers of the growing phenomenon of human migration include population expansion, increased availability of long-distance travel, and greater access to economic opportunities for those willing and able to move. Alongside these factors, it would be naïve not to acknowledge the potential impact of migration on the populations and infrastructure of destination countries—witness the heated debate in the United States over its long and tortuous border with Mexico and the people who attempt to cross that divide. Owing to the prominent, large-scale challenges presented in many countries by the fluid and unpredictable nature of migration, regrettable political constituencies have emerged that can marginalize and stigmatize migrants and refugees. Based as they are on the nonsensical idea that one person merits appropriate access to healthcare and other services but another person does not, these political entities are, though dangerous and destructive, vulnerable to those who can mobilize principled and just arguments. Generally, stable governments can be expected to provide the necessary resources and plan the provision of suitable infrastructure and health services for those who have migrated to their jurisdiction, and where they do not, support from international agencies must be made available.

International agreements set out clear responsibilities for protection of and provision for refugees and asylum seekers, whereas the situation for other migrants is less clear—indicating the potential importance of the new WHO plan in driving the activities of host states and appropriate international bodies. Priorities of the WHO plan include deploying public health interventions to improve migrant health alongside promotion of essential health services and occupational health provision. Strengthening health monitoring and information systems is recommended, as is accelerated progress toward universal health coverage. There should be attention toward mainstreaming migrant and refugee health, the plan notes, and to overcoming misconceptions about these groups of people. We look forward to seeing the impact of the plan in practice.

Seeking to raise awareness of the health threats faced by migrants and refugees and to promote research, service, and policy innovation in this area, the editors of PLOS Medicine are planning a Special Issue on the topic to be published early in 2020. Paul Spiegel, director of the Johns Hopkins Center for Humanitarian Health, who will be a Guest Editor for the issue, comments that “migration is a global phenomenon that will likely increase due to improved communication and modes of transport as well as, unfortunately, due to climate change. Health is a human right, and we must all work together to provide appropriate health services to migrants that are equitable, affordable and take into account services available to nationals.” A call for papers has been issued separately setting out the detailed scope for the Special Issue, and we look forward to considering your research papers dedicated to understanding and improving the health and well-being of refugees and migrants in all settings.

• 1. World Health Organization. World Health Assembly Update, 27 May 2019 [press release]. 2019 May 27. Available from: https://www.who.int/news-room/detail/27-05-2019-world-health-assembly-update-27-may-2019 . [cited 2019 Jun 28].
• 2. World Health Organization. Promoting the Health of Refugees and Migrants: Draft Global Action Plan, 2019–2023. Geneva, Switzerland: World Health Organization; 2019 [cited 2019 Jun 28]. Available from: https://apps.who.int/gb/ebwha/pdf_files/WHA72/A72_25-en.pdf .
• 3. UNHCR. Syria emergency. Available from: https://www.unhcr.org/uk/syria-emergency.html . [cited 2019 Jun 25].
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The RSC carries out multidisciplinary, policy-relevant research on the causes and consequences of forced migration, with an emphasis on understanding the experiences of forced migration from the point of view of affected peoples.

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Refugee –related research themes & questions for students

(for more information, please contact Dr. Susan McGrath (link is external) at [email protected] (link sends e-mail) )

This list of research themes and questions has been developed by the Refugee Research Network (RRN) at the Centre for Refugee Studies (CRS) at York University to encourage the generation and mobilization of research on refugees in Canada.  While the questions came out of Canadian experience, we hope there will be enough material that can be adapted in other contexts.

These priority areas of research are drawn from two reports generated by the practitioner community. The first, entitled: A Sector-Based Research Agenda: Issues Affecting Government-Assisted Refugees in Canada , was published on November 15, 2010, and compiled by Chris Friesen (ISS of BC) and Jennifer Hyndman (CRS). This research agenda focuses on government-assisted refugees and emerged in consultation with representatives from service providers across Canada. The second, entitled: Refugee Integration: Key concerns and areas for further research , was published on December 23, 2011, by the Canadian Council for Refugees (link is external) . The report emerged through a consultation with settlement practitioners, private sponsors, academics, and other stakeholders to identify priority concerns regarding refugee integration.

We invite faculty and students to work with us in responding to this community-generated research agenda. The field of refugee studies is interdisciplinary and all interested scholars are encouraged to engage with this project – whether from the professional programs, the arts, or the social sciences. While some of the research questions listed below may already have been addressed by researchers, the issues raised by the practitioner community would seem to indicate that the knowledge produced may not have been sufficiently disseminated. A useful response in these cases would be to develop comprehensive literature reviews and make them widely available online. Alternatively, there are questions that have not been extensively researched and could be studied in term papers or major research papers.

Students who participate in the project will have their peer-reviewed literature reviews and research papers posted on the RRN website ( www.refugeeresearch.net (link is external) ) as a resource and have an opportunity to submit their work for presentation at community-based and academic consultations and conferences. Travel support will be provided by the RRN to a number of students who have their research accepted for presentation at these events. In addition, students will receive training in developing research summaries from the Knowledge Mobilization Unit at York, where they will learn how to write about their work for non-academic audiences.

Researchers are expected to put the welfare of refugees first in any studies they undertake and to respect the principle of ‘do no harm’ that Mary B. Anderson (1999) outlined in her work on humanitarianism aid some years ago, i.e. no research should be undertaken if it has potentially harmful consequences in policy or practice to refugee welfare[1] . Our goal in compiling this community-generated research agenda is to improve the experiences of refugees and the policies and practices that support them. We acknowledge and understand that research can be put to unintended uses; as a result, it is important for students working on these questions to consider the potential impacts of the knowledge they produce.

• Settlement outcomes
• What are the settlement outcomes for refugees (e.g. labour market participation, use of provincial income support, impact of language requirement for citizenship, impact of religion/spirituality)?
• What factors contribute to barriers/successes and how can longitudinal settlement outcomes be measured?
• How should integration be measured? (E.g. alternative approaches to outcome measurement with regards to employment success and other integration factors; considering refugees’ ‘sense of belonging’ as measure of integration.)

By immigration category & length of time in Canada

• What are the differences in a) eligibility for, b) availability of, and c) uptake of settlement assistance services among GARs, PSRs, Refugees Landed in Canada, and non-refugee immigrants, across the provinces?
• How do the differences between refugee categories (i.e. inland refugees, GARs, and PSRs) impact settlement and integration experiences?
• Are there differences in integration experiences between different groups? (E.g. first and second generation refugee families; refugee children and children from other categories of immigration.)
• What are the consequences for inland refugee claimants of waiting for their claims to be processed? (Anecdotal evidence suggests that hardships experienced in the initial years in Canada can have profound and long-lasting consequences for integration.)
• What are the impacts of temporary status experienced by refugee claimants and those coming from protracted refugee situations?
• How do refugees find their first job?
• How does immigration status on arrival interact with other factors to influence access to employment over time? (Longitudinal study following first 5 years after arrival.)
• What is the impact of access to provincial employability programs on arrival?
• How do language, discrimination, education, and other factors influence access to employment upon arrival and over time?
• Do refugees face particular issues with respect to credential recognition and accessing appropriate employment? (E.g. are there psychological barriers to “starting again” that may prevent some refugees from getting their credentials recognized?)
• What might be some innovative ways for refugees with work experience in their home countries to use their skills? (Anecdotal evidence suggests that many refugees have transferable skills that go unrecognized.)
• What are the experiences of older adult refugees in relation to access to employment and labour market integration? (E.g. issues related to limited use of English/French. fragile health.)
• What are some alternative methods for measuring employment success?
• Do refugees face discrimination in the labour market?

Health, mental health, and trauma-related issues

• What are the mental health issues of GARs (government assisted refugees) and what treatment models and/or approaches are culturally appropriate?
• What are some affordable alternative ways of maintaining mental health? (E.g. social groups, physical activity, nutrition, etc.)
• Are there barriers to the uptake of mental health services by refugees? (E.g. issues around concepts of mental health; stigmatization of mental health.)
• What physical health issues do refugees face? (Including HIV/AIDS.)
• What are the health needs of older adult refugees and of refugees with disabilities?
• What are the impacts of health issues on social and economic integration?

Language training programs

• What are some of the barriers that refugees face in accessing existing language training programs?
• What are some of the shortcomings of existing language training programs for refugees? (E.g. lack of adaptation of language training for people who are illiterate or have low levels of education; lack of job-specific language training.)

Housing issues

• Do refugees face barriers in terms of access to housing?
• Does discrimination based on refugee status play a role in the housing market?
• What are the housing experiences of refugees outside of major urban centres?
• What is the impact of regionalization and of specific settlement areas on individuals and families?
• What is the relationship between place and housing experiences? (E.g. big city, small community; type of neighbourhood.)
• Is there a role for cooperative models of housing for refugee settlement?

Other economic issues that affect settlement

• How does refugees’ repayment of transportation loans impact their settlement and integration outcomes? (E.g. employment, language acquisition, high school completion rates. Particular attention to impacts on individual refugees versus families, as well as on youth.)
• What are the impacts on integration of refugees with family members abroad to whom they have financial responsibilities?

Settlement program coordination & evaluation

• Does centralization of settlement services in urban centres form a barrier to integration? (E.g. differences in access to settlement services outside of urban centres or where services are centralized; comparison of experiences between smaller communities and larger cities.)
• Can an evaluation framework be developed that addresses outcomes, is agreed upon by service providers and funders, and does not require the reallocation of resources from programs?
• Do particular pilot programs or experiments lead to improved outcomes for refugees? (E.g. Local Immigration Partnerships as good model of coordination.)
• Could alternative models of settlement program coordination be used?
• Do different provincial jurisdictions have an impact on access to settlement services and mainstream social welfare services?
• How well are various services coordinated within regions?
• Government Assisted Refugee (GAR) youth
• How well are GAR youth settling in Canada over time? How do family and integration-related factors/needs impact GAR youth’s settlement and high school completion rates?
• How do single/lone parents raising refugee youth who have daycare needs and are attending regular school fare?
• What are GAR youth’s experiences with accessing employment? (E.g. lack of access to employability programs.)
• Do refugee youth have unique education needs and if so, what are they and how can they be addressed?
• Need for longitudinal studies to follow youth progress over time.
• Resettlement Assistance Program (RAP) funding
• Does the limited RAP funding structure reflect the different needs of refugees, especially the (perceived) higher medical requirements of GARs who arrived after new selection criteria were implemented under the 2002 Immigration and Refugee Protection Act (IRPA)?
• Is there a way to allocate settlement resources that corresponds to different levels of need for post-IRPA refugees?
• How effectively does RAP income support the settlement and integration of GARs? (Does it set them up for failure?)
• Cost-of-living or livelihood studies would be helpful – in large cities where costs are higher, a large study that documents food bank access would be relevant.
• Family reunification
• What is the impact of delayed family reunification on refugees? How do family dynamics change (including gender relations) and does this impact settlement?
• How do delays in reunification affect single/lone parents who face the double stress of raising children alone and supporting a spouse abroad?
• What are the integration experiences of refugees arriving with their families and how do those compare to those of refugees arriving alone and awaiting reunification?
• What has been the impact of the moratorium on applications for sponsorship of parents and grandparents?
• What challenges do refugees face due to family separation? (E.g. mental health issues; economic responsibilities, remittances.)
• Pre-arrival information-sharing
• How effective is pre-departure training for refugees? What is its impact on settlement outcomes?
• What gaps, if any, exist in pre-arrival orientation and information-sharing, and how can they be filled?
• Critical content analysis of orientation abroad materials would be valuable.
• Destination policy
•  What factors should be considered in destining refugees? Which factors drive secondary migration? What factors drive retention?
• How many refugees from one ethnic/national group should be destined to a specific location in order to maximize retention?
• How can better matches be created between destination and refugees’ needs?
• Protracted refugee situations (PRS)
• What are the settlement needs and outcomes of refugees from protracted situations compared to those from shorter term displacements? (Especially in terms of health and mental health needs and outcomes.)
• Do refugees from protracted situations require a special program that addresses their learning needs as these relate to language and professional training? (Development of a ‘Protracted Refugee Benchmark’ to address this?)
• Discrimination & stereotyping
• How can discrimination/prejudice against and stereotypes of refugees be addressed in host communities?
• What tools can be created to educate Canadian communities to dispel stereotypes and help prepare for the arrival of newcomers? (E.g. public awareness campaigns about the situations of claimants awaiting status determination.)
• What approaches can be followed to educate locally elected government representatives on the needs of the refugee population in their jurisdictions?

[1] Anderson, M. B. (1999) Do No Harm: How Aid Can Support Peace or War, Boulder CO: Lynne Rienner Publishers; 3rd Printing edition.

RRN-refugee-related-research-themes-questions-2013.pdf

159 Refugee Essay Topic Ideas & Examples

🏆 best refugee topic ideas & essay examples, 👍 good essay topics on refugee, ⭐ most interesting refugee topics to write about, 📑 good research topics about refugee, ✅ simple & easy refugee essay titles, ❓ refugee essay questions.

• Essay Review on the Refugee by Alan Gratz Despite the different reasons that prompted Isabel and Josef to leave their native country, and the fate of their loved ones that affected the emotional state of the children, they are similar in that the […]
• Canadian Refugees and the Refugee Crisis While some countries, especially in the Middle East and Africa, are the source of the refugees, countries in the west, including the USA and Canada are among the popular destinations.
• Life in the Kenya Refugee Camp The onset of the politically instigated violence in my country meant that circumstances had taken a turn for the worst. Life in the refugee camp is so challenging with so little to smile about as […]
• Social Work & Movements of Refugees and Migrants The profession of social workers acts as an advocate for the human rights of refugees and migrants in education and practice.
• The Refugee Crisis and How to Overcome It While the current situation of Syrian and Iraqi refugees is unprecedented, the problem of refugees, in general, is well-known, and it was studied since the middle of XX century.
• Attitudes Toward Newly Arrived Refugees The crisis demonstrates the evolution of interactions between refugees and host nations and the impact of close geographical proximity on attitudes toward immigrants. The war broke out on the 24th of February 2022, to the […]
• Attitudes Toward Newly Arrived Refugees: Theories and Models Authors distinguish the existence of several approaches to understanding the concept of refugees and the application of world systems theory, integration of theory, and theories of assimilation and citizenship.
• Addressing the Healthcare Language Barrier of Afghan Refugees in California The foundation of the problem lies in the lack of adequate infrastructure in the places where medical services are provided to interpret information for immigrants and refugees.
• The Immigration and Refugee Board of Canada The IRB is comprised of the Immigration Appeal Division, the Immigration Division, and the Refugee Protection Division. The governor-in-council appoints the Chairperson of the IRB who is supported by the vice-chairperson and deputy chairperson.
• Access of Refugees to Healthcare in Nevada The issues were identified only by the resettlement workers, yet the struggle to cope with existing problems and the resettlement process can lead to serious health implications.
• Refugees, Migrants and Asylum-Seekers in Nevada The movement of refugees from one asylum country to another that has agreed to accept them and eventually offer them permanent status is known as resettlement.
• Researching the Concept of Refugee Status It is to make sure that a person is fit to settle as a refugee in a country to legitimize them.
• Refugee Mental Health & Transcultural Psychiatry Because of this, many refugees have resorted to seeking refugee camp mental health services to cope with their situation in a new country and feel less stress.
• Syrian Refugees in Ottawa: Health Promotion Needs This report will highlight the difficulties of neglected facets such as mental health and the crucial role of implementing global proficiency in health professionals and organizations that work with refugees.
• Psychiatry: PTSD Following Refugee Trauma The psychiatrists finally recognized PTSD in the first version of the Diagnostic and Statistical Manual of Mental Disorders after the mass occurrence of similar symptoms in Vietnam veterans.
• America’s Refugee Act’s Bottlenecks The Act replaced the earlier versions of laws touching on the issue of refugees, mainly the Migration and Refugee Assistance Act and the Immigration and Nationality Act.
• Creating Organization to Help Refugee Children Specifically, the legal standards for refugee admission and resettlement will have to be taken into account since they will define the vulnerable population’s accessibility to the services provided by the organization, as well as the […]
• Societal Views on Refugees and Children’s Mental Wellbeing Just like the definition given by UNHCR, the OAU also believes that an individual becomes a refugee when they cross the border of their country of origin to a foreign country.
• How Refugees Affect the Host Country By contrast, a positive effect of refugees, which usually remains unconsidered, is that they contribute to the aggregate demand of the host country.
• “Race, Refugees, and International Law” by Achiume In the article “Race, Refugees, and International Law,” the author describes the definition of the term “race” as the social systems of meaning that attach to elements of morphology and ancestry.
• Democratic Republic of Congo’s Refugee Crisis The refugee crisis in the Democratic Republic of Congo is one example of how refugees suffer because of poor healthcare access and the inability to provide for themselves.
• “Refugee Trauma” Article Critique The main hypothesis of the work could be assumed to be in two things: first, the fact refugees experience trauma that needs specific and specialized approaches to be properly addressed, and second that the Multiphase […]
• Influx of Syrian Refugees in North Jordan To mitigate the tension between the Syrian refugees and the surrounding communities in Jordan, the primary aim of this proposed research study is to investigate tension factors.
• Unintentional Injuries Among Refugee and Immigrant Children The research question is not formulated evidently, but the readers can understand that the authors pose the question about the differences in injury rates as related to the country and status of immigrants and refugee […]
• Maternity Care for Asylum Seekers and Refugees In the process of the study, Judith Nabb focuses on a set of particular issues representing interest to her personally and being relevant in the course of general medical care studies, such as the level […]
• Cultural Perspectives on Health of Sudanese Women Refugees in Australia This study aims of understanding FGM among the Sudanese refugee women in Australia and its impact on the health of the women.
• Immigration and Refugee Law in New Zealand Consequently, the refugee policy comes about due to the flow of obligations courtesy of the 1960 UNHCR Convention, that is to say, the provision of refugees’ protection.
• Refugees Issues: Rights and Challenges The specified rights allow refugees to ensure that the factors which have compelled them to escape their native country will not affect them in the environment of the UN.
• Anxiety Among Refugees and the Crucial Need for Professional Interpreters This review appraises three studies examining the issue of anxiety among refugees and the role of professional interpreters in reducing anxiety.
• The Politics of Refugee Protection The paper will first review the background of the literature to explain the issues of migration and provide insight into the functions, roles, and organs of the Council of Europe.
• Egypt and Sudan Refugees and Asylum Seekers Face Brutal Treatment and Human Trafficking In this report by Amnesty International, the issue of the security of refugees and asylum seekers in Shagarab refugee camps, which are located in the eastern parts of Sudan, is raised.
• Rights, Needs, or Assistance? The Role of the UNHCR in Refugee Protection in the Middle East Ultimately, the author seeks to understand the concept of protection as defined by the UNHCR and how such definition plays out in the context of Syrian and Iraqis refugees in the Middle East.
• How to Stop Being Afraid and Welcome Refugees The current strategy of the White House suggests resettling 10,000 Syrians next year in order to help the Old World to overcome the worst refugee crisis since the times of the Second World War.
• ”Refugees From Amerika: A Gay Manifesto” Context Review In the 1950s, the West Coast became one of the pulsing centers of the counterculture, heralded in San Francisco by exponents of the Beat generation, including Lawrence Ferlinghetti and Allen Ginsberg, the latter openly gay.
• African Refugee Life Challenges According to the United Nations Convention Relating to the Status of Refugees, a refugee is a person who “”owing to a well-founded fear of being persecuted for reasons of race, religion, nationality, membership of a […]
• Global Warming and Environmental Refugees Moreover, since environmental refugees have to leave their homelands, the developed countries are responsible for their relocation; thus, have to provide refugees with all the necessary financial and emotional support to ease their adaptation process […]
• Government-Funded Settlement Programs for African Refugees This will come in handy when assessing and evaluating the ability of the service providers, especially the government, to satisfy the needs of the refugees.
• Refugee Crisis: Term Definition In addition to the above mentioned, the Iraqi government had reduced the garrisons in the Kurdistan regions were reduced or abandoned.
• UN, WTO and the Solving the Palestinian Refugee Subject The end of the war was also marked by the creation of a massive number of refugees 10,000 of them Jewish and 711,000 of them Palestinian.
• Refugees as a Tactic in War: History, Types, and Number A refugee is defined as a person who due to a justifiable reason of being persecuted for reasons of race, religion, nationality, membership of a certain social or a political group is out of the […]
• Refugee Women and Their Human Rights According to the researches have been made by UNHCR, 1998, found that 80% of the refugees immigrating to the United States and other countries of second asylum are women or children.
• Stereotypes About Immigrants and Refugees The majority of these stereotypes develop due to the lack of education and understanding of immigration and people’s relocation. For instance, the history of the US heavily focuses on the achievements of white people, while […]
• South Sudan Refugees: Women Empowerment The subject of this work is the study of women’s empowerment in the country in question in order to ensure the greater rights and freedoms of this group.
• Refugees in Iowa Has Changed in 40 Years Iowa played a unique role in the reception of Vietnamese refugees in that it was the only state to actively offer asylum to these people.
• Trump’s Refugee Order: Suppression or Protection There are a lot of other countries where the majority of the population are Muslims, and their citizens are allowed to come to the USA.
• Discrimination Against Refugees in a New Country However, the report argues that the educational interventions are particularly important because of their ability to affect attitudes and the lack of awareness, which appear to be the major reasons for the existence of discrimination.
• Immigration and Refugee Protection Act for Women The main problem facing women asylum seekers within Canada is the failure of decision makers to incorporate gender related claims of women into the interpretation of the existing enumerated grounds and their failure to recognize […]
• Refugees Self-Sufficiency Program in Miami S military invasion of Iraq and Fidel Castro’s reign in Cuba resulted in Thousands of Iraqi and Cuban refugees being resettled in the U.S.
• Challenges Experienced by Syrian Refugees Even though the right to seek asylum and find the protection in different countries is granted to Syrian refugees according to the United Nations Convention Relating to the Status of Refugees, the problem is in […]
• Gulf Cooperation Council and Syrian Refugees However, there is a great number of other facts that should not be omitted and which prove the fact that the GCC countries do not refuse to shelter refugees.
• International Relations: The Palestinian Refugees Problem The best way to solve the crisis is to analyze the problem through an International Relations framework, such as, the application of knowledge gleaned from the study of the international system.
• Syrian Refugee in Toronto However, this process is very complicated and the war in Syria could be taken as the best evidence of the complexity of the situation. The evolution of ISIS resulted in the war on the territory […]
• Refugees and Mental Health They live their lives on the edge because they are unsure of what is going to happen to them and their families.
• United Nations High Commissioner for Refugees Despite the fact that UNHCR has in the recent past executed its duty in the best interest of all the refugees across the globe, the agency faces some setbacks and failures that need to be […]
• Working With Iraqi and Cuban Refugees as a Career Counselor The purpose of this study is to examine the impacts of the lives of Iraqi and Cuban refugees who have arrived the United States.
• Immigrants and Refugees Differences 3 The country of origin may push them as a result of harsh economic conditions, and on the other hand, the destination country may pull them due to better standards of living and promise of […]
• System of Protection for Asylum Seekers and Refugees Internship The system has identified the need to have respect among the refugees in a given camp and between the refugees and the staff that run the protection institutions.
• Refugees and Economic Migrants The refugee migrants are not in a position, or have no willingness, to go back to their country of origin and this is because they have the fear of being persecuted and therefore, these people […]
• Cross-Cultural Communication: Helping Refugees From Syria Good communication is based on the capability of the recipient to listen and comprehend the intention of the speaker and vice versa.
• Palestinian Refugees in Lebanon The purpose of this brief is to outline the current situation and to push for reforms in Lebanon pertaining to the ownership of property, land and housing by Palestinian refugees.
• Indonesia and Its Relationship With Refugees To accomplish this task, a brief history of the country and apartheid, the country’s relationship with asylum seekers and refugees and finally the current situation are succinctly covered.
• Essential Services for Refugees in Auburn, New South Wales To enhance accessibility of health care services, the Refugee Health Plan recognizes complex medical needs of refugees and thus incorporate elements of culture and language as some of the factors that need consideration in the […]
• Briefing Paper on Palestinian Refugees in Lebanon The paper aims to elucidate on the plight of the refugees and the gains that would be attained from application of their full rights as well as some practical solutions to the predicaments.
• Can Art Change How We Think About Refugees? The group had identified that the refugees used art to negotiate their way of becoming part and parcel of the indigenous people of the new home, despite the varying degrees of prejudice and exclusion that […]
• Media Discourse on Refugees in Australia The article is meant to reduce the conflict between the public and the government regarding the issue of asylum seekers and refugees.
• Is It Important to Distinguish Between Immigrants and Refugees? It is really important to distinguish between immigrants and refugees, as representatives of the two groups experience various acculturation processes in different ways.
• The Immigrant and Refugee Community Organization (IRCO) The Immigrant and Refugee Community Organization is a community organization which focuses on issues concerning proper integration of immigrants and refugees into the US society.
• Thailand ‘Interested’ in Refugee Swap Deal With Australia The genre of the text refers to journalistic genre, which means that the main purpose of the text should be to attract the readers and make them read the article until the end.
• Refugees and Asylum Seekers in Australia Deviance is associated to foreigners; the feeling of substantial section of society is that refugees pose a threat to the society and to the moral order.
• The Protracted Sri Lankan Refugee Situation in India: Challenges and Possible Solutions There are a lot of people, government agencies perhaps and international organizations that speak well of the need to help refugees, but at the heart of the matter is a social problem that is difficult […]
• House of Refugee vs. Life-Saving Station: In Search for a Shelter It is quite remarkable that the difference between the two houses comes into the limelight as the correspondent, who clearly incorporates the elements of media as the author perceived it, cunning, two-faced and at the […]
• Refugees Detention in the U.S. and Australia The civil groups argue that most of the detention facilities are in the remote areas and the facilities are of poor quality.
• Refugees And Ordinary Migrants The immigrant countries should grant and approve visas to the refugees to allow them to live in them according to the laws on refugees.
• Differences and Similarities Between Refugees and Economic Immigrants Additionally, the UN recognizes the universal right of refugees to claim asylum and endeavors to communicate the same to their member countries.
• Across the Sands: African Refugees in the Eyes of the World Among the most notorious issues of the present-day political affairs, the one concerning the problem of the African refugees remains on the agenda of the modern politics and culture.
• Artists in Exile: How Refugees From Twentieth-Century War and Revolution Transformed the American Performing Arts, by Joseph Horowitz Knowledge of the type of music in that era is will help in the understanding of the book especially the German way of expressing inner motion.
• Korean Immigrants and Refugees in New York The second phase of Koreans to immigrate to the US occurred in 1950 to 1953, this was after the Korean War.
• Are Refugees, or Diasporic Migrants Are Different From or Similar to the “Ordinary” Labor/Economic Migrants? The aim of the study is to discuss how refugees are different from or similar to the “ordinary” labor or economic migrants.
• The Ramifications of Hosting Refugees in the Society in Case of Kenya In the case of Kenya, the nation I went to, a majority of these camps are located in the Arid and Semi Arid Lands.
• Mental Health Status and Syndrome Patterns Among Young Refugee Children in Germany
• The Difference Between Emigration and Refugee
• Welcoming Refugees and the Cultural Wealth of Cities: Intersections of Urban Development and Refugee Humanitarianism
• Refugee Women During the 21st Century
• Employer Attitudes Towards Refugee Immigrants
• Refugee Resettlement, Redistribution, and Growth
• The Best Practices for Addressing Refugee Adjustment
• Refugee Admissions and Public Safety: Are Refugee Settlement Areas More Prone to Crime
• Borderless Lullabies: Musicians and Authors in Defense of Refugee Children
• Regional Migration Patterns and Homeownership Disparities in the Hmong-American Refugee Community
• Jobs, Crime, and Votes: A Short-Run Evaluation of the Refugee Crisis in Germany
• Refugees and Refugee Crises: Some Historical Reflections
• The European Refugee Crisis: The Struggles of Survival
• Winners and Losers Among a Refugee-Hosting Population
• Getting the First Job – Size and Quality of Ethnic Enclaves for Refugee Labor Market Entry
• Benefits and Costs With High Refugee Population
• Mapping Complex Systems: Responses to Intimate Partner Violence Against Women in Three Refugee Camps
• Harnessing and Advancing Knowledge in Social Enterprises: Theoretical and Operational Challenges in the Refugee Settlement Experience
• Pre-school Teachers’ Stereotypes and Perceptions of Behavior Problems in Newly Arrived Refugee Children
• Racism and the European Refugee Crisis
• Local Labor Markets and Earnings of Refugee Immigrants
• Escape From Violence: Conflict and the Refugee Crisis in the Developing World
• Mental Health Interventions for Refugee Youth
• Estimating Poverty for Refugee Populations: Can Cross-Survey Imputation Methods Substitute for Data Scarcity
• Administrative State Refugee Protection
• Blaming Brussels: The Impact of the Refugee Crisis on Attitudes Towards the EU and National Politics
• Assisting the Least Among Us: Social Work’s Historical Response to Unaccompanied Immigrant and Refugee Youth
• Syrian Refugee Crisis: Global Impacts and Sustainable Solutions
• Americans and the German Jewish Refugee Crisis of the 1930s
• Inclusive Education for Refugee Children With Disabilities
• Belonging: Decision Theory and Refugee
• Refugee Movement: Causes, Impacts, and Solutions
• Entrepreneurship and the Business Cycle: The “Schumpeter” Effect Versus the “Refugee” Effect
• Assessing the Direct and Spillover Effects of Shocks to Refugee Remittances
• Mental Illness and Addiction Among Immigrant, Refugee, and Asylum-Seeking
• Europe’s Refugee and Migrant Crisis: Economic and Political Ambivalences
• Refugee Camps and the Application of Florence Nightingale’s Environmental Theory
• Gratitude and Hospitality: Tamil Refugee Employment in London and the Conditional Nature of Integration
• Assigning Protection: Can Refugee Rights and State Preferences Be Reconciled
• Canada’s Refugee Strategy: How It Can Be Improved
• Does Entrance With Family Influence the Way Minors Leave a Refugee Centre?
• Are Refugee Settlement Areas More Prone to Crime?
• Who Was the First Refugee?
• What Are the Leading Causes of Refugees?
• How Did the ISIS Terror Group and Syrian Refugee Crisis Start?
• What Is the Main Problem With Refugees?
• Who Should Determine Refugee Policy?
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• Which Country Is Most Welcoming to Refugees?
• Are Refugee Flows Associated With International Trade?
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• Which Country Has the Most Refugee?
• Does Halting Refugee Resettlement Reduce Crime?
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• What Is the Importance of Refugees?
• Which Are the Significant Problems of Refugees?
• Is the Syrian Refugee Crisis an Outcome of the Civil War?
• What Countries Do Not Allow Refugees?
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• What Are the Types of Refugees?
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• Does Reduced Cash Benefit Worsen the Educational Outcomes of Refugee Children?
• Is the Syrian Refugee Crisis Becoming a Major Part of Internation?
• Why Do Refugee Burden Sharing Initiatives Fail?
• Is the Syrian Refugee Crisis Today’s Worst Humanitarian?
• Who Is Affected by the Refugee Crisis?
• Racism Paper Topics
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Study explores immigrant challenges and hopes

by Neph Rivera, University of Texas at Arlington

Some refer to the United States as a land of opportunity for those looking to better their lives. A research team headed by a University of Texas at Arlington social worker recently asked a group of immigrants if they agreed.

Led by Saltanat Childress, assistant professor in the School of Social Work, the researchers interviewed 24 Arab-speaking Middle Eastern North African refugees in the United States about their experiences immigrating to the country.

"Our research was driven by the expressed needs and concerns of the community and service providers. There was a strong anecdotal and community-based recognition of the challenges faced by immigrants, particularly around family conflicts and adaptation processes," Dr. Childress said.

The team's findings were published in Families in Society: The Journal of Contemporary Social Services .

During the conversations, two main topics became clear: the challenges these immigrants face daily and the opportunities and hopes they have for a better future here in the U.S.

Their main challenges include the language barrier they face upon entering the country, intimate partner violence and the addressing of stress or mental health problems , with some respondents downplaying the latter as a critical issue.

"Key issues on the instrumental side include language barriers, legal status , affordable housing , employment, transportation, and access to health care and childcare," Childress said. "On the ideological side, cultural adaptation challenges, particularly around gender roles and family dynamics and stigma of mental health issues, add another layer of difficulty to the refugee experience."

Childress says the community, including local organizations, can help support these immigrants early in their journeys in their new homeland.

"One key recommendation is to provide more robust language support for early adaptation stages, and it's possible that all the new automated translation tools can help in this regard," she said. "Additionally, improving access to affordable housing and employment opportunities is crucial."

When it comes to opportunities and hopes, the research team found that common responses included the quality of U.S. governance, support from fellow immigrants and the quality of education for their children.

"The U.S. is seen by many immigrants and refugees as a desirable destination due to its economic opportunities , political and religious freedoms, and the presence of pre-existing communities that provide support," Childress said. "These factors make the U.S. an attractive option for those seeking a better life for themselves and their children."

In the end, Childress says, it will take a team effort to help immigrants succeed in the face of the difficult issues that brought them to the U.S. in search of a fresh start.

"The key message is that refugee populations are full of wonderful, hard-working families that are silently struggling with significant challenges, and it is crucial for the profession, services, and mainstream population to be more aware, informed, and resourced to help them cope with these challenges effectively," Childress concluded.

Provided by University of Texas at Arlington

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Massive biomolecular shifts occur in our 40s and 60s, Stanford Medicine researchers find

Time marches on predictably, but biological aging is anything but constant, according to a new Stanford Medicine study.

August 14, 2024 - By Rachel Tompa

We undergo two periods of rapid change, averaging around age 44 and age 60, according to a Stanford Medicine study. Ratana21 /Shutterstock.com

If it’s ever felt like everything in your body is breaking down at once, that might not be your imagination. A new Stanford Medicine study shows that many of our molecules and microorganisms dramatically rise or fall in number during our 40s and 60s.

Researchers assessed many thousands of different molecules in people from age 25 to 75, as well as their microbiomes — the bacteria, viruses and fungi that live inside us and on our skin — and found that the abundance of most molecules and microbes do not shift in a gradual, chronological fashion. Rather, we undergo two periods of rapid change during our life span, averaging around age 44 and age 60. A paper describing these findings was published in the journal Nature Aging Aug. 14.

“We’re not just changing gradually over time; there are some really dramatic changes,” said Michael Snyder , PhD, professor of genetics and the study’s senior author. “It turns out the mid-40s is a time of dramatic change, as is the early 60s. And that’s true no matter what class of molecules you look at.”

Xiaotao Shen, PhD, a former Stanford Medicine postdoctoral scholar, was the first author of the study. Shen is now an assistant professor at Nanyang Technological University Singapore.

These big changes likely impact our health — the number of molecules related to cardiovascular disease showed significant changes at both time points, and those related to immune function changed in people in their early 60s.

Abrupt changes in number

Snyder, the Stanford W. Ascherman, MD, FACS Professor in Genetics, and his colleagues were inspired to look at the rate of molecular and microbial shifts by the observation that the risk of developing many age-linked diseases does not rise incrementally along with years. For example, risks for Alzheimer’s disease and cardiovascular disease rise sharply in older age, compared with a gradual increase in risk for those under 60.

The researchers used data from 108 people they’ve been following to better understand the biology of aging. Past insights from this same group of study volunteers include the discovery of four distinct “ ageotypes ,” showing that people’s kidneys, livers, metabolism and immune system age at different rates in different people.

Michael Snyder

The new study analyzed participants who donated blood and other biological samples every few months over the span of several years; the scientists tracked many different kinds of molecules in these samples, including RNA, proteins and metabolites, as well as shifts in the participants’ microbiomes. The researchers tracked age-related changes in more than 135,000 different molecules and microbes, for a total of nearly 250 billion distinct data points.

They found that thousands of molecules and microbes undergo shifts in their abundance, either increasing or decreasing — around 81% of all the molecules they studied showed non-linear fluctuations in number, meaning that they changed more at certain ages than other times. When they looked for clusters of molecules with the largest changes in amount, they found these transformations occurred the most in two time periods: when people were in their mid-40s, and when they were in their early 60s.

Although much research has focused on how different molecules increase or decrease as we age and how biological age may differ from chronological age, very few have looked at the rate of biological aging. That so many dramatic changes happen in the early 60s is perhaps not surprising, Snyder said, as many age-related disease risks and other age-related phenomena are known to increase at that point in life.

The large cluster of changes in the mid-40s was somewhat surprising to the scientists. At first, they assumed that menopause or perimenopause was driving large changes in the women in their study, skewing the whole group. But when they broke out the study group by sex, they found the shift was happening in men in their mid-40s, too.

“This suggests that while menopause or perimenopause may contribute to the changes observed in women in their mid-40s, there are likely other, more significant factors influencing these changes in both men and women. Identifying and studying these factors should be a priority for future research,” Shen said.

Changes may influence health and disease risk

In people in their 40s, significant changes were seen in the number of molecules related to alcohol, caffeine and lipid metabolism; cardiovascular disease; and skin and muscle. In those in their 60s, changes were related to carbohydrate and caffeine metabolism, immune regulation, kidney function, cardiovascular disease, and skin and muscle.

It’s possible some of these changes could be tied to lifestyle or behavioral factors that cluster at these age groups, rather than being driven by biological factors, Snyder said. For example, dysfunction in alcohol metabolism could result from an uptick in alcohol consumption in people’s mid-40s, often a stressful period of life.

The team plans to explore the drivers of these clusters of change. But whatever their causes, the existence of these clusters points to the need for people to pay attention to their health, especially in their 40s and 60s, the researchers said. That could look like increasing exercise to protect your heart and maintain muscle mass at both ages or decreasing alcohol consumption in your 40s as your ability to metabolize alcohol slows.

“I’m a big believer that we should try to adjust our lifestyles while we’re still healthy,” Snyder said.

The study was funded by the National Institutes of Health (grants U54DK102556, R01 DK110186-03, R01HG008164, NIH S10OD020141, UL1 TR001085 and P30DK116074) and the Stanford Data Science Initiative.

• Rachel Tompa Rachel Tompa is a freelance science writer.

About Stanford Medicine

Stanford Medicine is an integrated academic health system comprising the Stanford School of Medicine and adult and pediatric health care delivery systems. Together, they harness the full potential of biomedicine through collaborative research, education and clinical care for patients. For more information, please visit med.stanford.edu .

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Study reveals ways in which 40Hz sensory stimulation may preserve brain’s “white matter”

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Early-stage trials in Alzheimer’s disease patients and studies in mouse models of the disease have suggested positive impacts on pathology and symptoms from exposure to light and sound presented at the “gamma” band frequency of 40 hertz (Hz). A new study zeroes in on how 40Hz sensory stimulation helps to sustain an essential process in which the signal-sending branches of neurons, called axons, are wrapped in a fatty insulation called myelin. Often called the brain’s “white matter,” myelin protects axons and insures better electrical signal transmission in brain circuits.

“Previous publications from our lab have mainly focused on neuronal protection,” says Li-Huei Tsai , Picower Professor in The Picower Institute for Learning and Memory and the Department of Brain and Cognitive Sciences at MIT and senior author of the new open-access study in Nature Communications . Tsai also leads MIT’s Aging Brain Initiative. “But this study shows that it’s not just the gray matter, but also the white matter that’s protected by this method.”

This year Cognito Therapeutics, the spinoff company that licensed MIT’s sensory stimulation technology, published phase II human trial results in the Journal of Alzheimer’s Disease indicating that 40Hz light and sound stimulation significantly slowed the loss of myelin in volunteers with Alzheimer’s. Also this year, Tsai’s lab published a study showing that gamma sensory stimulation helped mice withstand neurological effects of chemotherapy medicines, including by preserving myelin. In the new study, members of Tsai’s lab led by former postdoc Daniela Rodrigues Amorim used a common mouse model of myelin loss — a diet with the chemical cuprizone — to explore how sensory stimulation preserves myelination.

Amorim and Tsai’s team found that 40Hz light and sound not only preserved myelination in the brains of cuprizone-exposed mice, it also appeared to protect oligodendrocytes (the cells that myelinate neural axons), sustain the electrical performance of neurons, and preserve a key marker of axon structural integrity. When the team looked into the molecular underpinnings of these benefits, they found clear signs of specific mechanisms including preservation of neural circuit connections called synapses; a reduction in a cause of oligodendrocyte death called “ferroptosis;” reduced inflammation; and an increase in the ability of microglia brain cells to clean up myelin damage so that new myelin could be restored.

“Gamma stimulation promotes a healthy environment,” says Amorim, who is now a Marie Curie Fellow at the University of Galway in Ireland. “There are several ways we are seeing different effects.”

The findings suggest that gamma sensory stimulation may help not only Alzheimer’s disease patients but also people battling other diseases involving myelin loss, such as multiple sclerosis, the authors wrote in the study.

Maintaining myelin

To conduct the study, Tsai and Amorim’s team fed some male mice a diet with cuprizone and gave other male mice a normal diet for six weeks. Halfway into that period, when cuprizone is known to begin causing its most acute effects on myelination, they exposed some mice from each group to gamma sensory stimulation for the remaining three weeks. In this way they had four groups: completely unaffected mice, mice that received no cuprizone but did get gamma stimulation, mice that received cuprizone and constant (but not 40Hz) light and sound as a control, and mice that received cuprizone and also gamma stimulation.

After the six weeks elapsed, the scientists measured signs of myelination throughout the brains of the mice in each group. Mice that weren’t fed cuprizone maintained healthy levels, as expected. Mice that were fed cuprizone and didn’t receive 40Hz gamma sensory stimulation showed drastic levels of myelin loss. Cuprizone-fed mice that received 40Hz stimulation retained significantly more myelin, rivaling the health of mice never fed cuprizone by some, but not all, measures.

The researchers also looked at numbers of oligodendrocytes to see if they survived better with sensory stimulation. Several measures revealed that in mice fed cuprizone, oligodendrocytes in the corpus callosum region of the brain (a key point for the transit of neural signals because it connects the brain’s hemispheres) were markedly reduced. But in mice fed cuprizone and also treated with gamma stimulation, the number of cells were much closer to healthy levels.

Electrophysiological tests among neural axons in the corpus callosum showed that gamma sensory stimulation was associated with improved electrical performance in cuprizone-fed mice who received gamma stimulation compared to cuprizone-fed mice left untreated by 40Hz stimulation. And when researchers looked in the anterior cingulate cortex region of the brain, they saw that MAP2, a protein that signals the structural integrity of axons, was much better preserved in mice that received cuprizone and gamma stimulation compared to cuprizone-fed mice who did not.

A key goal of the study was to identify possible ways in which 40Hz sensory stimulation may protect myelin.

To find out, the researchers conducted a sweeping assessment of protein expression in each mouse group and identified which proteins were differentially expressed based on cuprizone diet and exposure to gamma frequency stimulation. The analysis revealed distinct sets of effects between the cuprizone mice exposed to control stimulation and cuprizone-plus-gamma mice.

A highlight of one set of effects was the increase in MAP2 in gamma-treated cuprizone-fed mice. A highlight of another set was that cuprizone mice who received control stimulation showed a substantial deficit in expression of proteins associated with synapses. The gamma-treated cuprizone-fed mice did not show any significant loss, mirroring results in a 2019 Alzheimer’s 40Hz study that showed synaptic preservation. This result is important, the researchers wrote, because neural circuit activity, which depends on maintaining synapses, is associated with preserving myelin. They confirmed the protein expression results by looking directly at brain tissues.

Another set of protein expression results hinted at another important mechanism: ferroptosis. This phenomenon, in which errant metabolism of iron leads to a lethal buildup of reactive oxygen species in cells, is a known problem for oligodendrocytes in the cuprizone mouse model. Among the signs was an increase in cuprizone-fed, control stimulation mice in expression of the protein HMGB1, which is a marker of ferroptosis-associated damage that triggers an inflammatory response. Gamma stimulation, however, reduced levels of HMGB1.

Looking more deeply at the cellular and molecular response to cuprizone demyelination and the effects of gamma stimulation, the team assessed gene expression using single-cell RNA sequencing technology. They found that astrocytes and microglia became very inflammatory in cuprizone-control mice but gamma stimulation calmed that response. Fewer cells became inflammatory and direct observations of tissue showed that microglia became more proficient at clearing away myelin debris, a key step in effecting repairs.

The team also learned more about how oligodendrocytes in cuprizone-fed mice exposed to 40Hz sensory stimulation managed to survive better. Expression of protective proteins such as HSP70 increased and as did expression of GPX4, a master regulator of processes that constrain ferroptosis.

In addition to Amorim and Tsai, the paper’s other authors are Lorenzo Bozzelli, TaeHyun Kim, Liwang Liu, Oliver Gibson, Cheng-Yi Yang, Mitch Murdock, Fabiola Galiana-Meléndez, Brooke Schatz, Alexis Davison, Md Rezaul Islam, Dong Shin Park, Ravikiran M. Raju, Fatema Abdurrob, Alissa J. Nelson, Jian Min Ren, Vicky Yang and Matthew P. Stokes.

Fundacion Bancaria la Caixa, The JPB Foundation, The Picower Institute for Learning and Memory, the Carol and Gene Ludwig Family Foundation, Lester A. Gimpelson, Eduardo Eurnekian, The Dolby Family, Kathy and Miguel Octavio, the Marc Haas Foundation, Ben Lenail and Laurie Yoler, and the U.S. National Institutes of Health provided funding for the study.

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• Li-Huei Tsai
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