BMC Public Health Research article Comparison of self-reported health & healthcare utilisation between asylum seekers and refugees: an observational study Magzoub Toar1, Kirsty K O'Brien2 and Tom Fahey*1,2 BioMed Central Open Access Address: 1Department of General Practice, Royal College of Surgeons in Ireland Medical School, Beaux Lane House, Mercer Street Lower, Dublin 2, Ireland and 2HRB Centre for Primary Care Research, Department of General Practice, Royal College of Surgeons in Ireland Medical School, Beaux Lane House, Mercer Street Lower, Dublin 2, Ireland Email: Magzoub Toar - mtoar@hotmail.com; Kirsty K O'Brien - kirstyobrien@rcsi.ie; Tom Fahey* - tomfahey@rcsi.ie * Corresponding author Published: 30 June 2009 BMC Public Health 2009, 9:214 doi:10.1186/1471-2458-9-214 This article is available from: http://www.biomedcentral.com/1471-2458/9/214 Received: 22 January 2009 Accepted: 30 June 2009 © 2009 Toar et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Background: Adult refugees and asylum seekers living in Western countries experience a high prevalence of mental health problems, especially post traumatic stress disorder (PTSD), depression and anxiety. This study compares and contrasts the prevalence of health problems, and potential risk factors as well as the utilisation of health services by asylum seekers and refugees in the Irish context. Methods: Cross sectional study using validated self reported health status questionnaires of adult asylum seekers (n = 60) and refugees (n = 28) from 30 countries, living in Ireland. Outcome measures included: general health status (SF-36), presence of PTSD symptoms and anxiety/ depression symptoms. Data on chronic conditions and pre or post migration stressors are also reported. The two groups are compared for utilisation of the health care system and the use of over the counter medications. Results: Asylum seekers were significantly more likely than refugees to report symptoms of PTSD (OR 6.3, 95% CI: 2.2–17.9) and depression/anxiety (OR 5.8, 95% CI: 2.2–15.4), while no significant difference was found in self-reported general health. When adjusted by multivariable regression, the presence of more than one chronic disease (OR 4.0, 95%CI: 1.3–12.7; OR 3.4, 95% CI: 1.2– 10.1), high levels of pre migration stressors (OR 3.6, 95% CI: 1.1–11.9; OR 3.3, 95% CI: 1.0–10.4) or post migration stressors (OR 17.3, 95% CI: 4.9–60.8; OR 3.9, 95% CI: 1.2–12.3) were independent predictors of self reported PTSD or depression/anxiety symptoms respectively, however, residence status was no longer significantly associated with PTSD or depression/anxiety. Residence status may act as a marker for other explanatory variables; our results show it has a strong relationship with post migration stressors (χ2 = 19.74, df = 1, P < 0.001). In terms of health care utilisation, asylum seekers use GP services more often than refugees, while no significant difference was found between these groups for use of dentists, medication, hospitalisation or mental health services. Conclusion: Asylum seekers have a higher level of self reported PTSD and depression/anxiety symptoms compared to refugees. However, residence status appears to act as a marker for post migration stressors. Compared to refugees, asylum seekers utilise GP services more often, but not mental health services. Page 1 of 10 (page number not for citation purposes)