Impact of early postmigration health and quality of life on later health and service use among Syrian refugees in Norway: a prospective cohort study

BACKGROUND: Previous studies indicate initial health improvements following resettlement for refugees, but the long-term trajectories remain unclear. This study explores health outcomes and healthcare use among Syrian refugees in Norway, focusing on the impact of early health and quality of life (QOL) on future outcomes. METHODS: This prospective cohort study used data from the Changing Health and health care needs Along the Syrian Refugees' Trajectories to Norway and Integration for Health projects. Baseline factors, self-rated health (SRH) and QOL, were collected 1 year after arrival. Health outcomes and healthcare use were assessed at 1 and 4 years (2019-2023) post-resettlement. Changes over time were analysed with generalized estimating equations, and associations with baseline factors were assessed using generalized linear models, presenting relative risks (RR) with 95% confidence intervals. RESULTS: A total of 132 individuals participated in both follow-ups. Chronic pain prevalence increased from 28% to 51% (RR 1.80, 1.46-2.23), with similar increases in non-communicable diseases, symptoms of poor mental health and chronic impairments. Use of emergency (RR 2.06, 1.50-2.82) and specialist care (RR 3.47, 2.62-4.60) also increased, while general practitioner visits and hospitalizations remained stable. Good SRH and higher QOL at baseline were associated with better health outcomes and reduced healthcare use over time. CONCLUSION: Refugees reporting good SRH and higher QOL during the early postmigration period experienced more favorable health outcomes and decreased healthcare use later on. Our findings raise the subject of the possibility of capitalizing on early interventions to support refugee health and ease the burden on healthcare systems over time.