Albahsahli Behnan, Dimitrova Anna, Kadri Nadine, Benmarhnia Tarik, Rousan Tala Al
Herbert Wertheim School of Public Health, University of California, San Diego, USA.
Scripps Institution of Oceanography, University of California, San Diego, USA.
Res Sq. 2023 Oct 3:rs.3.rs-3392999. doi: 10.21203/rs.3.rs-3392999/v1.
Climate change disproportionately harms people of color and low-income communities. Despite their unprecedented numbers, being constantly on the move, and suffering extreme social vulnerability, almost nothing is known about the impact of climate change on the health of refugees. This study uses state-of-the-art mixed methods to examine the differential susceptibility of climate-sensitive exposures and environmental exposures among refugees and their links to perceived health after resettlement.
Arabic-speaking refugees (N=67) from Iraq and Syria previously diagnosed with hypertension who resettled in California were recruited from a community center. Semi-structured interviews were conducted to explore participant's understanding of the impact of climate on health. Survey data were collected to inquire regarding participant's refugee journeys prior to resettlement in the US. Survey data on climate-related disasters was retrospectively geo-referenced through the Emergency Events Database (EM-DAT). Qualitative data was analyzed using inductive thematic analysis.
All participants stayed in at least one temporary resettlement country during their migration journey and 12% has stayed in refugee camps. The most popular resettlement sites were Turkey (most disaster-prone in the region due to frequent floods and earthquakes) and Jordan (one of the most extreme water-scarce globally). Participants reported harsh weather conditions during their migratory journeys including extreme cold in Turkey and extreme heat in Jordan. Many participants noted their exposure to dust throughout their travels, and an inability to deal with harsh weather conditions due to financial insecurity. Participants did not link their diagnosis of hypertension to their experience of extreme weather and would only link it to their exposure to stress from war. Participants did note poorer mental health due to poor weather conditions and a challenge adjusting to the climate conditions in different countries. Few participants reported residing in a refugee camp and described it as ill-equipped for the challenges of climate hazards.
This study reveals the links between structural drivers of climate change and health inequities for refugee populations. Refugees are highly vulnerable to climate-sensitive exposures but remain not fully aware of the potential links between these exposures and health. Learnings from this study will inform clinical and public health interventions, and policies to close the climate gap without leaving this vulnerable population behind.
气候变化对有色人种和低收入社区造成了不成比例的伤害。尽管难民数量空前、不断迁徙且面临极端的社会脆弱性，但关于气候变化对难民健康的影响却几乎一无所知。本研究采用最先进的混合方法，研究难民中对气候敏感暴露和环境暴露的差异易感性，以及这些暴露与重新安置后感知健康之间的联系。
从加利福尼亚州的一个社区中心招募了67名来自伊拉克和叙利亚、先前被诊断患有高血压的讲阿拉伯语的难民。进行了半结构化访谈，以探讨参与者对气候对健康影响的理解。收集了调查数据，以询问参与者在美国重新安置之前的难民历程。通过紧急事件数据库（EM-DAT）对与气候相关灾害的调查数据进行了回顾性地理定位。使用归纳主题分析法对定性数据进行了分析。
所有参与者在迁移过程中至少在一个临时安置国家停留过，12% 的人曾在难民营停留过。最受欢迎的安置地点是土耳其（由于洪水和地震频繁，是该地区最容易发生灾害的地方）和约旦（全球最极端的缺水地区之一）。参与者报告说，在迁徙过程中天气条件恶劣，包括在土耳其遭遇极寒，在约旦遭遇酷热。许多参与者指出，他们在整个旅程中都暴露在沙尘中，并且由于经济不安全而无法应对恶劣的天气条件。参与者没有将他们的高血压诊断与极端天气经历联系起来，而是只将其与战争带来的压力联系起来。参与者确实指出，恶劣的天气条件导致心理健康状况较差，并且难以适应不同国家的气候条件。很少有参与者报告住在难民营，并将其描述为应对气候灾害挑战的设备不足。
本研究揭示了气候变化的结构性驱动因素与难民群体健康不平等之间的联系。难民极易受到气候敏感暴露的影响，但仍未充分意识到这些暴露与健康之间的潜在联系。本研究的经验教训将为临床和公共卫生干预措施以及政策提供参考，以缩小气候差距，不让这一弱势群体掉队。
