Trends in the health status of Ukrainian refugees in Norway according to month of arrival during 2022

Abstract Background: Over 75 000 refugees from Ukraine have come to Norway since February 2022. Previous studies show that the refugees have poor health for several domains, and crude reports suggest that those fleeing Ukraine at later stages have even poorer health. However, more systematic knowledge is lacking. This study aimed to analyse self-reported health in a sample of adult refugees from Ukraine by month of arrival to Norway in 2022. Methods: Data were collected via an online, digital questionnaire, in a cross-sectional study design between 28.10.22–31.01.23. Recruitment was via multiple potential physical and social media contact points, including asylum reception centres, municipalities, non-profit organisations, and Facebook groups for refugees in Norway. The survey included self-reported health outcomes: overall health, oral health, presence of long-term illnesses or disabilities, and a short version of Hopkins Symptom Checklist (HSCL-5). Results: Among 727 respondents, 82% were female, 65% aged 30–49 years, 69% had higher education and 53% had responsibility for children in Norway. 383 arrived February-April (T1), 200 May-August (T2) and 144 September-December (T3). Compared to T1, later periods had higher proportions of males, a younger age distribution and lower proportions with higher education. Proportions reporting poor/very poor overall health, presence of long-term illness, and long-term disability were highest in T3. Oral health and HSCL-5 showed an opposite trend, with lower proportions reporting poorer health among respondents in both later periods. Respondents in T3 were still more likely to report poor/very poor health and long-term illnesses after adjusting for sex, age group and education (adjusted odds ratio, aOR: 2.71 95%CI 1.51–4.89) and 1.74 1.14–2.65, respectively). Conclusions: Respondents arriving later in 2022 generally reported poorer long-term health, but less psychological distress than those arriving earlier. These findings may help to inform planning of health services to refugees from Ukraine, especially in areas receiving large numbers of refugees.