Factors Associated with Self-Reported Chronic Diseases of Syrian Refugees in Turkey

Mehmet Balcilar; Canan Gulcan

doi:10.5334/aogh.3794

Factors Associated with Self-Reported Chronic Diseases of Syrian Refugees in Turkey

Annals of Global Health

Volume 88 (2022): Issue 1

By: Mehmet Balcilar and Canan Gulcan

Open Access

|Jul 2022

Abstract

Background: Syria’s civil conflict, which began in 2011, led millions of Syrians to migrate to countries all over the world, including Turkey. Considering the fact that war-caused migrations may affect the citizens of the host countries and immigrants from diverse perspectives, It is important to make scientific research on the outcomes of migration after the Syrian civil war.

Objective: This paper investigates the relationship between chronic diseases, such as, cardiac disease, diabetes, and hypertension, and covariates, including socioeconomic status, war-related conditions, risky health behaviours, health services use, and health literacy, using survey data on 7 202 Syrian refugees from 4 068 households living out of camp settlements in Turkey.

Methods: Logistic regressions were employed to examine the relationship between the chronic diseases and covariates, which include socioeconomic status, war-related conditions, risky health behaviours, health services use, and health literacy.

Findings: The results reveal that pre-migration income, health behaviours, such as, tobacco consumption, body mass index, daily activity, health-care use, and health literacy are the most important factors for one or more chronic diseases.

Conclusion: Considering the effects of risk factors on chronic diseases among Syrian refugees, it is critical to take preventive steps for negative outcomes.

References

Syria emergency. The UN Refugee Agency. Accessed September 25, 2021. https://www.unhcr.org/syria-emergency.html.
Search in Google Scholar Back to article
Registered Syrian Refugees. The UN Refugee Agency. Accessed September 25, 2021. https://data2.unhcr.org/en/situations/syria/location/113.
Search in Google Scholar Back to article
Mipatrini D, Balcılar M, Dembech M, Ergüder T, Ursu P. Survey on the health status, services utilization and determinants of health: Syrian refugee population in Turkey. World Health Organization. Regional Office for Europe; 2019.
Search in Google Scholar Back to article
World Health Organisation. Health Literacy Toolkit for low- and Middle-Income Countries. A Series of Information Sheets to Empower Communities and Strengthen Health Systems. Geneva: World Health Organization; 2015.
Search in Google Scholar Back to article
Wångdahl J, Lytsy P, Mårtensson L, Westerling R. Poor health and refraining from seeking healthcare are associated with comprehensive health literacy among refugees: a Swedish cross-sectional study. Int. J. Public Health. 2018; 63(3): 409–419. DOI: 10.1007/s00038-017-1074-2
Open DOI Search in Google Scholar Back to article
Andrus MR, Roth MT. Health literacy: a review. Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy. 2002; 22(3): 282–302. DOI: 10.1592/phco.22.5.282.33191
Open DOI Search in Google Scholar Back to article
de Melo Ghisi GL, da Silva Chaves GS, Britto RR, Oh P. Health literacy and coronary artery disease: A systematic review. Patient Educ. Couns. 2018; 101(2): 177–184. DOI: 10.1016/j.pec.2017.09.002
Open DOI Search in Google Scholar Back to article
Schillinger D, Grumbach K, Piette J, Wang F, Osmond D, Daher C, et al. Association of health literacy with diabetes outcomes. Jama. 2002; 288(4): 475–482. DOI: 10.1001/jama.288.4.475
Open DOI Search in Google Scholar Back to article
Baker DW, Parker RM, Williams MV, Clark WS. Health literacy and the risk of hospital admission. J Gen Intern Med. 1998a; 13(12), 791–798. DOI: 10.1046/j.1525-1497.1998.00242.x
Open DOI Search in Google Scholar Back to article
Baker DW, Wolf MS, Feinglass J, Thompson JA, Gazmararian JA, Huang J. Health literacy and mortality among elderly persons. Arch. Intern. Med. 2007b; 167(14): 1503–1509. DOI: 10.1001/archinte.167.14.1503
Open DOI Search in Google Scholar Back to article
Decoda Study Group, Nyamdorj R. BMI compared with central obesity indicators in relation to diabetes and hypertension in Asians. Obesity. 2008; 16(7), 1622–1635. DOI: 10.1038/oby.2008.73
Open DOI Search in Google Scholar Back to article
Haire-Joshu D, Glasgow RE, Tibbs TL. Smoking and diabetes. Diabetes Care. 1999; 22(11): 1887–1898. DOI: 10.2337/diacare.22.11.1887
Open DOI Search in Google Scholar Back to article
Mardin FD. Right to health and access to health services for Syrian refugees in Turkey. MiReKoc Policy Brief Ser, 1; 2017.
Search in Google Scholar Back to article
Shelley D, Yerneni R, Hung D, Das D, Fahs M. The relative effect of household and workplace smoking restriction on health status among Chinese Americans living in New York City. J Urban Health. 2007; 84(3): 360–371. DOI: 10.1007/s11524-007-9190-6
Open DOI Search in Google Scholar Back to article
Cheng L, Liu H, Zhang Y, Shen K, Zeng Y. The impact of health insurance on health outcomes and spending of the elderly: evidence from China’s new cooperative medical scheme. Health Econ. 2015; 24(6): 672–691. DOI: 10.1002/hec.3053
Open DOI Search in Google Scholar Back to article
Cutler DM, Lleras-Muney A, Vogl T. Socioeconomic status and health: dimensions and mechanisms (No. w14333). NBER; 2008. DOI: 10.3386/w14333
Open DOI Search in Google Scholar Back to article
Lowry R, Kann L, Collins JL, Kolbe LJ. The effect of socioeconomic status on chronic disease risk behaviours among US adolescents. Jama. 1996; 276(10): 792–797. DOI: 10.1001/jama.276.10.792
Open DOI Search in Google Scholar Back to article
Antonovsky A. Social class, life expectancy and overall mortality. Milbank Q. 1967; 45(2): 31–73. DOI: 10.2307/3348839
Open DOI Search in Google Scholar Back to article
Winkleby MA, Jatulis DE, Frank E, Fortmann SP. Socioeconomic status and health: how education, income, and occupation contribute to risk factors for cardiovascular disease. Am. J. Public Health. 1992; 82(6): 816–820. DOI: 10.2105/AJPH.82.6.816
Open DOI Search in Google Scholar Back to article
Dray-Spira R, Lert F, Marimoutou C, Bouhnik AD, Obadia Y. Socio-economic conditions, health status and employment among persons living with HIV/AIDS in France in 2001. AIDS Care. 2003; 15(6); 739–748. DOI: 10.1080/09540120310001618595
Open DOI Search in Google Scholar Back to article
Liberatos P, Link BG, Kelsey JL. The measurement of social class in epidemiology. Epidemiol. Rev. 1988; 10(1): 87–121. DOI: 10.1093/oxfordjournals.epirev.a036030
Open DOI Search in Google Scholar Back to article
Nair SC, Satish KP, Sreedharan J, Ibrahim H. Assessing health literacy in the eastern and middle-eastern cultures. BMC Public Health. 2016; 16(1): 831. DOI: 10.1186/s12889-016-3488-9
Open DOI Search in Google Scholar Back to article
Hosmer, Jr. DW, Lemeshow S, Sturdivant RX. Applied logistic regression (Vol. 398). John Wiley & Sons; 2013. DOI: 10.1002/9781118548387
Open DOI Search in Google Scholar Back to article
Carnethon MR, Yan L, Greenland P, et al. Resting heart rate in middle age and diabetes development in older age. Diabetes Care. 2008; 31(2): 335–339. DOI: 10.2337/dc07-0874
Open DOI Search in Google Scholar Back to article
McEniery CM, Wilkinson IB, Avolio AP. Age, hypertension and arterial function. Clin. Exp. Pharmacol. Physiol. 2007; 34(7): 665–671. DOI: 10.1111/j.1440-1681.2007.04657.x
Open DOI Search in Google Scholar Back to article
Reckelhoff JF. Gender differences in the regulation of blood pressure. Hypertension. 2001; 37(5): 1199–1208. DOI: 10.1161/01.HYP.37.5.1199
Open DOI Search in Google Scholar Back to article
Manfredini R, De Giorgi A, Tiseo R, et al. Marital status, cardiovascular diseases, and cardiovascular risk factors: a review of the evidence. J. Women’s Health. 2017; 26(6): 624–632. DOI: 10.1089/jwh.2016.6103
Open DOI Search in Google Scholar Back to article
Johnson NJ, Backlund E, Sorlie PD, Loveless CA. Marital status and mortality: the national longitudinal mortality study. Ann. Epidemiol. 2000; 10(4): 224–238. DOI: 10.1016/S1047-2797(99)00052-6
Open DOI Search in Google Scholar Back to article
Haines L, Coppa N, Harris Y, Wisnivesky JP, Lin JJ. The impact of partnership status on diabetes control and self-management behaviors. Health Educ Behav. 2018; 45(5): 668–671. DOI: 10.1177/1090198117752783
Open DOI Search in Google Scholar Back to article
Greenland P, Knoll MD, Stamler J, et al. Major risk factors as antecedents of fatal and nonfatal coronary heart disease events. Jama. 2003; 290(7): 891–897. DOI: 10.1001/jama.290.7.891
Open DOI Search in Google Scholar Back to article
Kaplan RM, Kronick RG. Marital status and longevity in the United States population. J Epidemiol Community Health. 2006; 60(9): 760–765. DOI: 10.1136/jech.2005.037606
Open DOI Search in Google Scholar Back to article
Balcilar M, Nugent JB, Xu J. Adversities in Syria and their relation to their physical and mental health conditions as Syrian refugees in Turkey. Scott. J. Political Econ. 2021; 69: 37–59. DOI: 10.1111/sjpe.12295
Open DOI Search in Google Scholar Back to article
Diabetes. World Health Organization. Accessed September 27, 2021. http://www.who.int/health-topics/diabetes#tab=tab_1.
Search in Google Scholar Back to article
Hu G, Lindströ J, Valle TT, et al. Physical activity, body mass index, and risk of type 2 diabetes in patients with normal or impaired glucose regulation. Arch Intern Med. 2004; 164: 892–896. DOI: 10.1001/archinte.164.8.892
Open DOI Search in Google Scholar Back to article
Caballero B. Introduction. Symposium: Obesity in developing countries: biological and ecological factors. J Nutr. 2001; 131(3): 866S–870S. DOI: 10.1093/jn/131.3.866S
Open DOI Search in Google Scholar Back to article
Al-Ibrahim MS, Gross JY. Tobacco use. 3rd edition. Clinical Methods: The History, Physical, and Laboratory Examinations; 1990.
Search in Google Scholar Back to article
Krauss RM, Winston M, Fletcher BJ, Grundy SM. Obesity: impact on cardiovascular disease. 1998; 98(14): 1472–1476. DOI: 10.1161/01.CIR.98.14.1472
Open DOI Search in Google Scholar Back to article
Gatimu SM, Milimo BW, San Sebastian M. Prevalence and determinants of diabetes among older adults in Ghana. BMC Public Health. 2016; 16(1): 1174. DOI: 10.1186/s12889-016-3845-8
Open DOI Search in Google Scholar Back to article
Hamasaki H. Daily physical activity and type 2 diabetes: a review. World J. Diabetes. 2016; 7(12): 243. DOI: 10.4239/wjd.v7.i12.243
Open DOI Search in Google Scholar Back to article
Franks P, Clancy CM, Gold MR, Nutting PA. Health insurance and subjective health status: data from the 1987 National Medical Expenditure survey. American Journal of Public Health. 1993; 83(9): 1295–1299. DOI: 10.2105/AJPH.83.9.1295
Open DOI Search in Google Scholar Back to article
Tayfur I, Günaydin M, Suner S. Healthcare service access and utilization among Syrian refugees in Turkey. Annals of Global Health. 2019; 85(1). DOI: 10.5334/aogh.2353
Open DOI Search in Google Scholar Back to article
Bailey SC, Brega AG, Crutchfield TM, et al. Update on health literacy and diabetes. Diabetes Educ. 2014; 40(5): 581–604. DOI: 10.1177/0145721714540220
Open DOI Search in Google Scholar Back to article
Pandit AU, Tang JW, Bailey SC, et al. Education, literacy, and health: Mediating effects on hypertension knowledge and control. Patient Educ. Couns. 2009; 75(3): 381–385. DOI: 10.1016/j.pec.2009.04.006
Open DOI Search in Google Scholar Back to article
Spiegel PB, Checchi F, Colombo S, Paik E. Health-care needs of people affected by conflict: future trends and changing frameworks. The Lancet. 2010; 375(9711): 341–345. DOI: 10.1016/S0140-6736(09)61873-0
Open DOI Search in Google Scholar Back to article
Alawa J, Zarei P, Khoshnood K. Evaluating the provision of health services and barriers to treatment for chronic diseases among Syrian refugees in Turkey: a review of literature and stakeholder interviews. International Journal of Environmental Research and Public Health. 2019; 16(15): 2660. DOI: 10.3390/ijerph16152660
Open DOI Search in Google Scholar Back to article