Health Burdens and Labor Participation Among Refugees in Norway

The study highlights the need for better collaboration and increased involvement of healthcare personnel during the IP to address refugees' health issues and improve their labor market outcomes.

Background: Refugees often face poorer health outcomes and labor integration compared with non-immigrants. Understanding their health status during the mandatory Introduction programme (IP) is crucial for improving their labor participation and overall health.
Methods: This longitudinal study utilized health registry data of 60,325 refugees who completed the IP between 2005 and 2018 in combination with 2020 measures of work participation and income from SSB. Sociodemographic variables and health diagnoses (psychological and musculoskeletal) during and after the IP were included in the analyses. Logistic and multiple linear regression models were used to assess the impact of health burdens on later labor outcomes.
Results: During the IP, 20.2% of refugees received psychological diagnoses, and 42.6% received musculoskeletal diagnoses. Post-IP, these figures increased to 26.7% and 55.4%, respectively. Refugees with diagnoses during the IP were less likely to be employed and had lower incomes in 2020 compared with refugees without diagnoses during the IP. However, musculoskeletal diagnoses post-IP were associated with higher employment and income.
Conclusions: Health burdens are prevalent among refugees during the IP, significantly impacting later labor participation. Psychological and musculoskeletal diagnoses during the IP are linked to lower employment rates and incomes. The findings underscore the importance of continuous and comprehensive healthcare for refugees, emphasizing the need for primary care practitioners to be knowledgeable about refugee health issues and collaborate with refugee services in adapting the IP to the refugees’ needs. The study suggests integrating health-promoting activities into the IP to better support refugees' health and improve their chances of successful labor market integration; addressing both psychological and musculoskeletal health issues is crucial for enhancing refugees' overall well-being and economic integration.