Health status of refugees settled in Alberta: changes since arrival.

OBJECTIVE This paper sought to examine which pre- and post-migration factors might be associated with changes in refugees' health status. METHODS Using linear regression, the associations between pre- and post-migration factors and changes in self-rated mental and physical health status were examined in 525 refugees from the 1998 Settlement Experiences of Refugees in Alberta study. RESULTS Having spent time in a refugee camp and having held professional/managerial jobs in one's home country were associated with a greater decline in mental health status since arrival in Canada. Having completed a university degree in one's home country was associated with a greater decline in physical health status. Being employed was associated with greater improvements in mental health status. Perceived economic hardship was associated with greater declines in physical health status. A higher number of settlement services received during the first year in Canada was associated with greater improvements in both mental and physical health status. Longer residence in Canada was associated with greater declines in physical health status but not in mental health status. CONCLUSION While little can be done to alter refugees' pre-migration experiences, public policies can affect many post-migration experiences in order to mitigate the negative health consequences associated with resettlement. Results of this study point to the need for continued provision of settlement services to assist refugees with job training, labour market access, and credential recognition, as well as counseling for refugees who experienced the trauma of living in a refugee camp.