Integration as a way to reducing health inequalities among forced migrants: A collaborative and knowledge building project.

Health among immigrants develops over time in Norway. Health and integration are linked in different ways: good health can lead to integration, but integration can also lead to better health. These connections can nevertheless go in both directions: poor integration can lead to poor health, which in turn can make integration difficult. This study examines the development of health among refugees from Syria who have now lived in Norway for four years and tries to find out how these dynamics change over time. After an improvement in most health parameters in the first year, we see that certain outcomes get worse again after a few years and we study how this is connected to integration and self-perceived discrimination, among other factors. We have also carried out a pilot of an intervention that has included immigrants with a health professional background in academic professional environments. We are in the process of finding out whether such interventions can be carried out on a larger scale and what effect integration into meaningful activities provides for better health for participants and improves cultural competence in the academic environments. We expect the results to be published within the next year.

Health professionals with refugee origins, either must endure long waits to get their education approved or may never obtain it due to administrative barriers. On the other hand, the health sector in Norway, lacks a culturally competent workforce and students lack sufficient exposure to cultural diversity as part of their education. Inclusion is a key European political priority and the new National Curriculum Regulations for Norwegian Health and Welfare Education obliges educational institutions to include cultural competence in their programs. To address these challenges, the Western Norway University of Applied Sciences and University of Bergen are committed to improve diversity among teachers and students. However, there is neither a clear strategy nor available evidence on how this inclusion might impact migrants, their families, or the institutions themselves. This research action brings together two of the largest Norwegian projects working for a healthier integration of refugees: CHART (Changing Health and health care needs Along the Syrian Refugees’ Trajectories to Norway) study and the REFUGE (Resettlement in Uprooted Groups Explored) study. We hypothesise that; the relationships between health and integration are circular rather than linear and present integration as key to improve health and wellbeing for forced migrants. Our study will harness the on-going collaboration across institutions with different roles, competences and capacities, including migrant themselves, towards a better understanding of the intertwined links between health and integration, paving the way for co-creation, implementation and evaluation of an innovative intervention. Our proposal is thus a potential driver for further measures promoting welfare, health and integration of migrants.