Legal residency status and its relationship with health indicators among Syrian refugees in Lebanon: a nested cross-sectional study
Notice bibliographique
Résumé
Abstract Background Failure to possess or renew legal residency permits increases the burden on a vulnerable refugee population. It risks detention or deportation, and hinders access to basic services including healthcare. This study aimed to examined the association between legal residency status and health of Syrian refugees living in Lebanon. Methods Data were from two independent nested cross-sectional studies collected in 2022 through telephone surveys. In the first study, all Syrian refugees aged 50 years or older from households that received humanitarian assistance were invited to participate. The second included all adult Syrian refugees residing in a suburb of Beirut. The exposure was self-reported possession of a legal residency permit in Lebanon. The self-reported health outcomes were mental health status, COVID-19 vaccine uptake, and access to the needed healthcare services. Separate adjusted logistic regression models examined the association between lacking a legal residency permit and each health outcome. Results The first sample included 3357 participants (median age 58 years (IQR:54-64), 47% female), of whom 85% reported lacking a legal residency permit. The second sample included 730 participants (median age 34 years (IQR:26-42), 49% female), of whom 79% lacked a legal residency permit. In both studies, lacking a legal residency permit increased the odds of having poor mental health [adjusted odds ratio (aOR):1.62 (95%CI:1.2-2.2); aOR:1.62 (95%CI:1.01-2.60)], and decreased the odds of COVID-19 vaccine uptake [aOR:0.64 (95%CI:0.53-0.78); aOR:0.51 (95%CI:0.32-0.81)]. In the sub-sample who needed primary healthcare, lacking a legal residency permit decreased the odds of access to primary healthcare in the second study only (aOR:0.37 (95%CI:0.17-0.84)). Conclusions The majority of Syrian refugees from these two samples reported lacking a legal residency permit in Lebanon. This was associated with poor mental health and lower uptake of COVID-19 vaccination, potentially originating from fear of detention or deportation. These findings call for urgent action to support access to legal documentation for refugees in Lebanon. Key Messages What is already known on this topic Refugees are a vulnerable population and face varied challenges, such as marginalization and high levels of poverty. The lack of legal residency increases the risk of detention or deportation and may impact access to essential public services and healthcare. What this study adds This study showed that the majority of Syrian refugees in Lebanon lacked legal residency permits and this impacted receipt of the COVID-19 vaccination during the pandemic and their mental health. How this study might affect research, practice or policy These findings highlight the need for actions to support access for legal documentation for refugees and enable equitable access to vaccination campaigns and health and mental health services for this vulnerable population.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».