Abstract
Canada is a country with large populations of immigrants and refugees. These populations face unique health challenges and barriers to accessing health care services. Amendments to the Canadian Immigration and Refugee Protection Act in 2002 have resulted in an increase in refugees with complex medical needs. However, little is known about the health of refugees on arrival and their subsequent health care trajectories.
There is an urgent need for an improved understanding of refugee demographics and health status on arrival, changes in health status over time, utilization of health services, and characteristics associated with optimal health outcomes. This knowledge gap could be addressed through the creation of a longitudinal cohort study of government-assisted refugees (GARs) in British Columbia (BC). The provision of services for GARs in BC lends itself readily to the creation of a prospective GAR cohort. This, combined with access to highly reliable, valid and comprehensive administrative databases available through Population Data BC, would allow for longitudinal follow-up, and ensure low attrition rates.
Establishment of such a cohort would improve knowledge of refugee health and could guide health service providers and policy-makers in providing optimal services to GARs.
Key words: Refugees, cohort studies, longitudinal studies, prospective studies, health services, utilization
Résumé
Le Canada est un pays ayant de grandes populations d’immigrants et de réfugiés. Ces populations sont confrontées à des problèmes et à des obstacles particuliers pour accéder aux services de santé. À la suite des modifications apportées en 2002 à la Loi sur l’immigration et la protection des réfugiés du Canada, il y a eu une augmentation des réfugiés ayant des besoins médicaux complexes. Toutefois, on en sait peu sur la santé des réfugiés à leur arrivée et sur leurs trajectoires subséquentes dans le système des soins de santé.
Il y a un urgent besoin d’améliorer nos connaissances du profil démographique et de l’état de santé des réfugiés à leur arrivée, de l’évolution de leur état de santé au fil du temps, de leur utilisation des services de santé et des caractéristiques associées aux résultats sanitaires optimaux. Ces lacunes pourraient être comblées par la création d’une étude longitudinale de cohorte pour les réfugiés parrainés par le gouvernement (RPG) en Colombie-Britannique (C.-B.). La prestation de services aux RPG dans cette province se prête bien à la création d’une cohorte prospective de RPG. Si en plus on avait accès aux bases de données administratives de Population Data BC–qui sont extrêmement fiables, valides et complètes–cette initiative permettrait d’effectuer un suivi longitudinal et garantirait de faibles taux d’attrition.
L’établissement d’une telle cohorte améliorerait l’état des connaissances sur la santé des réfugiés et pourrait aider les dispensateurs de services de santé et les responsables des politiques à optimaliser les services offerts aux RPG.
Mots clés: réfugiés, études de cohortes, études longitudinales, études prospectives, services de santé, utilization
Footnotes
Conflict of Interest: None to declare.
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