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- Risk factors for non-communicable diseases in refugees, asylum seekers, and subsidiary protection beneficiaries resettled or relocated in Portugal between 2015 and 2020Publication . Pinto de Oliveira, Ana; Conceição, Cláudia; Fronteira, InêsAbstract: Non-communicable diseases, previously thought of as a problem of high-income countries, now coexist in low- and middle-income countries, including the countries of origin for many refugees traveling to Europe. We aimed to describe the prevalence of risk factors for non-communicable diseases among refugees, asylum seekers, and subsidiary protection beneficiaries resettled or relocated in Portugal between 2015 and 2020 and compare these to the prevalence of risk factors in the 12 months before they left their country of origin. A cross-sectional study was conducted between 2019 and 2020 of all refugees, asylum seekers, and subsidiary protection beneficiaries attending a Lisbon, Portugal refugee center. Behavioral and biological risk factors were assessed using the WHO STEPwise modified questionnaire. A descriptive statistical analysis was conducted, which included 80 respondents, mainly men, with an average age of of 30.3 ± 9.8 years. The prevalence of several behavioral risk factors for non-communicable diseases among refugees, asylum seekers, and subsidiary protection beneficiaries was higher at the time of the study than in the 12 months before leaving the country of origin. Differences between men and women were noted in tobacco (49.1% vs. 25.9%) and alcohol use (43.4% vs. 18.5%) in the receiving country. Overweight and obesity also showed differences by gender (7.5% vs. 11.1% and 39.6% vs. 48.1%). The prevalence of suicidal ideation and suicidalplanning was high, and varied from 6.3% and 20% in the country of origin to 16.3% and 38.5% respectively in the receiving country, however the prevalence of suicide attempts was lower in the receiving country (66.7%) compared to the country of origin (100.0%). Information on health and social determinants is critical to identify priorities and increase access to access to gender-specific health and community level interventions, including mental health, to reduce risk factors associated with refugee relocation and resettlement.
- Exploring the perspectives of professionals involved in refugee and asylum seekers’ reception and integration on access and utilization of healthcare: a qualitative studyPublication . Pinto de Oliveira, Ana; Loesch, Regina; Conceição, Cláudia; Fronteira, InêsBackground In recent years, the number of displaced persons due to conflict, persecution, and environmental crises has significantly increased, leading to a large influx of refugees and asylum seekers in European countries, including Portugal. While the Portuguese National Health Service guarantees universal access to healthcare, numerous barriers still hinder the effective access and use of health services by refugee populations, particularly for the prevention and management of non-communicable diseases. This qualitative study aimed to explore the perspectives of professionals involved in refugee reception and integration regarding barriers to accessing and utilizing healthcare, with a particular focus on non-communicable diseases. Methods A qualitative study informed by phenomenological principles was conducted. Semi-structured interviews were conducted with individual participants from December 2022 to March 2023, transcribed verbatim, and analysed using reflexive thematic analysis, informed by phenomenological principles. Results Thirteen professionals from healthcare, reception, and integration sectors participated. Participants described a high burden of non-communicable diseases, particularly mental health conditions, alongside common risk factors such as unhealthy diets, sedentary lifestyles, and psychosocial distress. Barriers to healthcare access included cultural and linguistic challenges, bureaucratic complexity, and socioeconomic constraints. Facilitators - though less mentioned - included the involvement of cultural mediators, flexible service delivery, and intersectoral collaboration. Both refugees and professionals were described as adopting informal strategies to navigate systemic barriers. Conclusion This study provides insight into how professionals perceive refugees and asylum seekers’ health needs and their access to healthcare in Portugal. Findings highlight the interplay of structural, linguistic, cultural, and socioeconomic factors shaping healthcare utilisation, informing the development of more equitable and culturally responsive health strategies.