Academic journal article Canadian Journal of Public Health

How Are New Refugees Doing in Canada? Comparison of the Health and Settlement of the Kosovars and Czech Roma

Academic journal article Canadian Journal of Public Health

How Are New Refugees Doing in Canada? Comparison of the Health and Settlement of the Kosovars and Czech Roma

Article excerpt


Background: In 1999, a group of Kosovars arrived in Hamilton, Ontario, with a coordinated international pre-migration plan, as part of the United Nations Humanitarian Evacuation Program. Since 1997, a substantial number of Roma refugees from the Czech Republic also arrived in Hamilton, with no special pre-migration planning. This study examined whether the organized settlement efforts led to better adaptation and perceived health for the Kosovars, using the Czech Roma as a comparison group.

Methods: Adult members of 50 Kosovar (n=157 individuals) and 50 Czech Roma (n=76 individuals) randomly selected families completed a questionnaire on sociodemographics, health, well-being, and perceived adaptation to Canada. Differences between groups were examined using univariate and multivariate analyses. Comparison was made to the Ontario population where possible.

Results: There were more Kosovars than Czech Roma over the age of 50 (22.1% vs 10.5%, p=0.03). Nearly one quarter (21.7%) of the Kosovars had a score indicating post-traumatic stress disorder (PTSD) on the Harvard Trauma Questionnaire (HTQ), compared to none of the Roma (p<0.001). After adjustment for age and PTSD, the Kosovars were significantly more likely to report fair or poor adaptation to Canada (OR=10.5, 95% Cl=3.6-31.2) and that life is somewhat or very stressful (OR=3.9, 95% Cl=2.1-7.4). Differences for other measures were no longer significant after adjustment.

Conclusions: The health and adaptation of the Kosovars was not better than that of the Czech Roma. Reasons for this finding may include differences in demographics, the presence of PTSD, and differing length of time since arrival in Canada.

As part of its role in the United Nations Humanitarian Evacuation Program,1 Canada received approximately 5,000 refugees from Kosovo in the spring of 1999, 500 of whom arrived in Hamilton, Ontario. The majority of Kosovars destined for Hamilton came directly into community "settlement" houses set up in two local hotels. The refugees received social supports and sponsor groups were assigned to each family. Unlike with the usual arrival of refugees in Canada, there was a coordinated effort by health and other professionals to assist with the health and settlement needs of this large influx of Kosovar refugees. Since 1997, Hamilton has also received approximately 500 Roma refugees from the Czech Republic. In contrast, the Czech Roma were self-selected asylum seekers who applied individually for refugee status. As such, there was no pre-migration organizational planning for this group.

Studies examining refugee health profiles are often conducted in the context of international refugee camps,2,3 and relatively little information pertains to refugee groups in receiving host countries.4 One recognized barrier to settlement is the common presence of mental health difficulties, and often there is little data on the post-arrival physical health and self-perception of health of refugees.4,5 Many host countries have poor criteria for assessing how well refugees have integrated,6 compounding the difficulties in evaluating health. Canada has been a leading country in 'best settlement practices',7 encompassing areas such as language, employment and cultural orientation.

As a result of the special settlement efforts, we hypothesized that the Kosovars would report better adaptation and perceived health compared to other recent refugees. We compared the Kosovars and Czech Roma to generate their respective health profiles and highlight issues that may be helpful for planning future humanitarian efforts.

This paper describes the results of a questionnaire administered to individuals in randomly selected Kosovar and Czech Roma families regarding their health and adaptation to Canada. Comparisons were also made to the Ontario general population, where possible.


Sample selection

The Settlement and Integration Services Organization in Hamilton (SISO), a community-based agency that serves local immigrant and refugee groups, used their records of all Kosovar and Czech Roma families that were active with the organization in the spring of 2001. …

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