Table 4.

Description of studies on employment and physical health.

Authors Date	Country	Study design	Study population	Measure of employment	Measure of health	Statistical Analysis	Main findings of employment and health	Quality
Azaroff, 2004	USA	Cross sectional Survey	N = 160 Refugees (Cambodia, Laos)	Work hazards: Open-ended questions Employment conditions: Working hours and employment type	Health problems Work-related symptoms	Descriptive statistics Prevalence Ratio	Prevalent workplace hazards reported included exposures to chemicals; inadequate ventilation; prolonged sitting or standing and awkward postures; unguarded machinery; long work hours. 26% of the respondents reported work-related backache and 9% reported work-related skin rashes. Working over 40 hours yielded a prevalence ratio of 1.4 (95% CI 1.1, 1.7) for reporting a work-related health symptom, and working a late shift had a prevalence ratio of 1.5 (95% CI 1.0, 2,3) for reporting a work-related sign.	Low
Jen, 2018	USA	Longitudinal study	Iraqi refugees N = 298 at baseline N = 290 refugees Y1 follow up N = 282 at Y2 follow up	Employment status	Body Mass Index (BMI) Non-communicable Disease (NCD): composite score of self-reported NCD	Linear regression	Unemployment at year 2 was associated with a higher number of non-communicable diseases (B = 0.35, SE = 0.13, p < 0.0001) and increased NCDs from baseline (B = 0.23, SE = 0.13, p < 0.01). Unemployment was not significantly associated with BMI or changes in BMI over the 2 years (p > 0.05)	Moderate
Kraeh, 2016	South Korea	Cross sectional survey	N = 394 North Korean Refugees	Employment status	Physical health: Resting heart rate Psychological adjustment: Korean version of CES-D	Linear regression	Employment status had a significant effect on psychological adjustment (B = 0.12, SE = 0.06, p = 0.028) and resting heart rate (B = −4.63, SE = 1.66, p = 0.006). Further analyses, found a significant indirect effect of employment status on resting heart rate via socio-cultural adjustment and psychological adjustment.	Moderate
Ruiz, 2018	UK	Cross sectional Survey	N = 2360 Refugees N = 279,634 UK born	Employment status Hours worked (weekly)	Self-reported health problem	Linear regression models	69% of refugees with health problems reported that this limits the kind or amount of work they can engage in compared with half of the natives and other migrants with health problems. Refugees are 14% more likely than non-refugees to report a health problem that limits the type of work they can do and 17% more likely to report a health problem that limits the amount of work they can engage in.	High
Sundquist, 2003	Sweden	Cross sectional survey	N = 333 Refugees	Job demand: High/Low Decision latitude: High/Low Job strain: Yes/No Support: Low/Heigh	Self-reported long-term illness.	Logistic regression	Refugees experiencing both high job demands and low decision latitude had an increased risk (OR = 1.74; 95% CI: 1.42–2.13) of long-term illness. There was no interaction between migration status and high job strain. However, refugees with low social support at work had nearly twice (OR = 1.91, 95%CI (1.44–2.54)) as high a risk of long-term illness as Swedes with high-level work-related social support	Moderate
Van Hanegem, 2011	Netherlands	Longitudinal study	N = 40 Asylum seekers	Employment status	Severe acute maternal morbidity (SAMM)	Risk Ratio	Unemployment was one of the specific risk indicators for asylum seekers to experience SAMM (RR = 3.1, 95% CI 1.5–6.6)	Moderate
Zhang, 2021	USA	Cross-sectional survey	N = 218 Burmese and Bhutanese refugees	Employed as essential worker: Y/N	COVID 19 infection	Logistic regression	Being an essential worker was associated with COVID 19 infection (OR = 5.25; 95% CI, 1.21–22.78). The prevalence of COVID-19 was 13.6% among essential workers and 2.3% among nonessential workers.	Moderate

Abbreviations: Composite International Diagnostic Interview (CIDI), Center for Epidemiological Studies-Depression (CES-D), EuroQol-visual analogue scales (EQ-VAS), General Anxiety Disorder Assessment (GAD-7), General Health Questionnaire (GHQ), Hospital Anxiety and Depression Scale (HADS), Hopkins Symptom Checklist-25 (HSCL-25), Hamilton Anxiety Rating Scale (HAM-A), Hamilton Depression Rating Scale (HAM-D), The Manchester Short Assessment of Quality of Life (MANSA), Mini International Neuropsychiatric Interview (MINI), PTSD Checklist for DSM-5 (PCL-5), the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5), Posttraumatic Symptom Scale (PTSS) Perceived Stress Scale (PSS), Patient Health Questionnaire (PHQ), Posttraumatic Diagnostic Scale (PDS), Refugee Health Screener (RHS), World Health Organization Quality of Life Brief Version (WHOQOL-BREF), World Health Organization Disability Assessment Schedule (WHODAS).