Health status and care utilization among Afghan refugees newly resettled in Calgary, Canada between 2011-2020

Abstract

AbstractBackgroundThe United States and Canada have resettled over 120,000 Afghan refugees since August 2021, but sociodemographic and health status data remains sparse with investigations often limited to refugee entrance exams, standardized health screenings, or acute health settings.MethodsThis retrospective community-engaged cohort study investigated Afghan patients who received care between January 1, 2011 and December 31, 2020 at an interdisciplinary specialized refugee clinic in Calgary, Canada that provides care to newly arrived refugees. Two reviewers independently extracted and manually verified sociodemographic factors, medical diagnoses, and clinic utilization variables from patients’ electronic medical records, then coded patient diagnoses into ICD-10 codes and chapter groups. Diagnosis frequencies were calculated and stratified by age group and sex. We corroborated these findings with Afghan refugee co-investigators.FindingsAmong 402 Afghan refugee patients, 228 were adults (mean age 34·2 [SD 13] years), and 174 were children (mean age 7·5 [SD 5·4] years). We identified 1535 total individual diagnoses and classified them into 382 unique ICD-10 codes. Patients had a median 2 diagnoses each [IQR 0-6], 4 clinic visits across primary, specialty and multidisciplinary care annually, and an 11% appointment no-show rate. Among adults, the most frequent diagnoses were abdominal pain (26·3%, 60/228), mechanical back pain (20·2%, 46/228), and H. pylori infection (19·3%, 44/228). Among children, the most frequent diagnoses were upper respiratory tract infection (12·1%, 21/174),Giardia(10·3%, 18/174), and short stature (7·5%, 13/174).InterpretationRecently resettled Afghan refugees in Canada were relatively young, experienced diverse health characteristics, and had multi-specialty care engagement in their first two years after arrival. These findings may guide specialized healthcare provision to this inadequately characterized but growing population of refugee arrivals in North America and elsewhere.FundingResearch grants from the M.S.I. Foundation and University of Calgary O’Brien Institute for Public Health