The influence of exile and repatriation on mental and physical health. A population-based study.

This study tested the association between psychosocial stressors extracted from a previous qualitative study, and psychological distress, long-term illness and self-rated ill-health among Latin American refugees in Lund, Sweden, and among repatriated Latin Americans. The study was designed as a population-based cross-sectional study. A structured questionnaire from the Swedish Annual Level-of-Living Surveys 1989: 2 was translated into Spanish. Latin American refugees in Lund (n = 338) and those who had lived in Lund and were repatriated to Santiago de Chile (n = 51) and Montevideo, Uruguay (n = 9), were interviewed in their homes in Sweden and in Latin America. The data were analysed unmatched with logistic regression in main effect models. Torture was an independent risk indicator for psychological distress, with an estimated odds ratio of 2.71 (1.45-4.85). There was a significant association between discrimination, not feeling secure in everyday life and psychological distress, with estimated odds ratios of 1.93 (1.02-3.56) and 3.23 (1.62-6.16), respectively. Torture and not feeling secure in everyday life were independent risk factors for long-term illness. Torture, discrimination and not feeling secure in everyday life were significant strong risk factors for ill-health. Repatriated refugees had significantly higher shares of not feeling secure compared with Latin Americans in Sweden. As risk factors of psychological distress and illness, torture, discrimination and not feeling secure proved to be as important as traditional risk factors such as material factors and lifestyle.