Social Capital and Rural Health for Refugee Communities in Australia

Understanding the Health Literacy Experiences and Practices of Australian-Resettled Myanmar Refugees: Relevance for Nutrition and Dietetics Practice

Background/Objectives: Refugees typically experience poorer health compared with people from non-refugee backgrounds, and health literacy may play a part in this discrepancy. Using the WHO's revised health literacy definitions as a framework, this qualitative study sought to examine the health literacy experiences and practices of Australian resettled refugees from Myanmar from refugee and service provider perspectives. Methods: Four refugee participant focus groups (n = 27) along with one focus group and four interviews with service providers (n = 7) were conducted in Melbourne, Australia, and analysed using deductive content analysis. Results: Our study found that in addition to individual health literacy, community literacy was practiced by Myanmar refugees, thus highlighting the relevance of social support to health literacy. Furthermore, our study found gaps in healthcare service provision and resourcing related to health literacy development and responsiveness by the healthcare system. Conclusions: Our study confirms the relevance of WHO's revised health literacy definitions to Myanmar refugees while also discussing, in the context of nutrition and dietetics practice, the importance of understanding the different aspects of health literacy and how this relates to working with those who are most marginalised to improve their health and wellbeing.

The Resettlement Journey: Understanding The Role of Social Connectedness on Well-being and Life Satisfaction among (Im)migrants and Refugees: A Systematic Review

In the context of rising global migration and/or forced displacement, there is a pressing need to consider the well-being and life satisfaction of (im)migrants and refugees during resettlement. Research highlights the importance of social connectedness for (im)migrants and refugees during the resettlement phase. Yet, a critical gap remains in our understanding of the key characteristics through which social connections exert their influence on well-being and life satisfaction. This systematic review provides a comprehensive overview of the existing international literature on social connectedness and its impact on the well-being and life satisfaction of (im)migrants and refugees in post-migration contexts. Our analysis of 43 studies finds that social connectedness, in the form of social support and social networks, is beneficial for well-being and life satisfaction during resettlement. In addition to social support from individual network ties, community engagement can also enhance well-being by facilitating a sense of belonging. All 43 studies focused on psychological well-being and 69.8% relied on cross-sectional data. The findings of this review emphasise the need for longitudinal studies and standardised measurement tools to capture the dynamic interplay between social connectedness and well-being across various domains (psychological, physical, general/subjective) in migrant populations. We draw on the findings to propose a new conceptual model of the dynamic association between social connectedness and well-being/life satisfaction that seeks to explore these relationships in future empirical studies.

A scoping review on the barriers to and facilitators of health services utilisation related to refugee settlement in regional or rural areas of the host country

BACKGROUND

Healthcare access and equity are human rights. Worldwide conflicts, violence, and persecution have increased the number of people from refugee or refugee-like backgrounds. Because urban areas are already densely populated, governments have aimed to increase refugee resettlement in rural and/or regional areas. Because of the complex healthcare needs of refugees, this creates challenges for healthcare service providers. Identifying barriers to accessing healthcare in rural areas is therefore important to better inform policy settings and programmes that will provide culturally appropriate patient-centred care to the refugee community.

METHODS

This review scoped 22 papers written in English between 2018 and July 2023 from five countries (Australia, New Zealand, Germany, Bangladesh, and Lebanon) in order to provide an overview of the barriers and possible solutions to facilitate refugees' access to healthcare.

RESULTS

The reviewed literature summarised the perceptions of at least 3,561 different refugees and 259 rural health service providers and/or administrators and identified major challenges. These include communication (illiteracy in the resettlement country language and lack of a suitable interpreter), lack of cultural awareness of health services, discrimination, and access difficulties (transportation, availability of health specialist services, cost). As a consequence, it was identified that improving access to affordable housing, employment through credential recognition, competence-level education for children, facilitating language training, and adapting health information would increase resettlement and encourage access to healthcare.

CONCLUSIONS

Refugees face significant barriers to accessing and engaging with healthcare services. This impacts their integration into rural communities and increases the prevalence of psychosocial issues like feelings of loneliness, low self-esteem, a lack of autonomy, and a lack of empowerment over informed decision-making, especially for women, jobless men, and the elderly. These findings support the need for additional support for refugees and healthcare providers to improve language proficiency and cultural competency. Policymakers need to improve the availability and accessibility of employment, housing accessibility, and service mobility. Additionally, more research is needed to assess the efficacy of emerging innovative programmes that aim to close the gap by delivering culturally appropriate patient-centred care to refugee communities in rural areas.

Social Support Networks and Care for People Who Use Harmful Drugs

BACKGROUND

The "problem of drugs" is a complex phenomenon with different social dimensions. Thus, the strategy to care for people who use drugs should consider their social support networks, which are defined here as dimensions that compose the social integration of people.

OBJECTIVE

In this paper, we investigate how social support networks are organized, structured, and constituted according to clients of a mental health service dedicated to treat alcohol and drug abuse.

METHODS

Participant observation was employed in a mental health service for three months, and six interviews and three groups of activities were conducted with local clients.

RESULTS

The results demonstrated that the social network of this group is composed of informal and formal social supports: the former includes family, religious institutions, and work, and the latter was represented by a few institutions. However, there are few supports that contribute to the social inclusion and participation of these clients.

CONCLUSIONS

Care actions should expand social networks, helping to create more solid relationships, considering the macro and micro social-life dimensions. Occupational therapists can contribute to this process by driving their action toward social life, building more social participation strategies, and reconfiguring care and social meaning in everyday life.