Asylum Seekers Enter U.S. With Unexpectedly Large Symptom Load

Business News —
Stress, CVD, pain symptoms highly prevalent in those evaluated in New York City

by
Nicole Lou, Senior Staff Writer, MedPage Today
December 5, 2024

Asylum seekers revealed a high burden of symptoms of psychological stress, cardiovascular disease (CVD), and somatic pain after arrival in the U.S., according to a retrospective cross-sectional study.

Based on records of medical, psychological, and gynecological forensic medical evaluations conducted at the Weill Cornell Center for Human Rights, the prevalence of symptoms of psychological stress was 94%, CVD symptoms 47%, and somatic pain 50% among 453 individuals applying for asylum.

“Furthermore, among the CVD+ population, with a median age of just 30 years, the worrisome symptoms of palpitations, presyncope/syncope, stroke, and chest pain were present in a concerning 33%, 25%, 20%, and 16% of participants, respectively,” reported Gunisha Kaur, MD, anesthesiologist and human rights researcher at NewYork-Presbyterian/Weill Cornell Medical Center in New York City, and colleagues in Nature Mental Health.

“We would not have expected the rates of these illnesses or conditions to be this high in such a young, otherwise healthy population,” said Kaur in a press release.

Still, Kaur and her collaborators suggested that their findings might actually underestimate the true prevalence of these symptoms in asylum seekers, as Weill Cornell’s initial forensic medical evaluations had not been specifically designed to detect symptoms of psychological stress, CVD, or somatic pain.

Kaur and colleagues said they plan to further investigate the occurrence of these symptoms in this population and any potential interventions that could mitigate them.

“Now that we know these diseases are unexpectedly prevalent, we should be addressing this upfront. Increased rehabilitation and decreased healthcare costs benefit not only these individuals, but the communities in which they reside,” Kaur said in a statement.

Asylum seekers are legally defined as people who have left their country and are seeking protection from persecution and serious human rights violations in another country. They are still waiting for a decision on their asylum claim as they wait to become recognized as a refugee.

Asylum seekers “are a particularly vulnerable subset of the world’s displaced population owing to a variety of psychosocial factors, including housing uncertainty, employment restrictions and lack of access to healthcare — in addition to the stress of their legal status being uncertain for years,” study authors noted.

“While their application is adjudicated in their host country, asylum seekers may experience immigration detention, family separation, the persistent threat of deportation, and other post-migration psychological stressors,” they added.

Outside the scope of the study were migrants, who are neither asylum seekers nor refugees, but are understood to be people living outside their country of origin due to work, study, or personal motivations.

The study relied on data from Kaur’s institution spanning the years 2010 to 2020. Asylum seekers were eligible for inclusion in the study if they had a legal affidavit accompanying their medical record.

Ultimately, there were 453 individuals included. Median participant age was 30 years and the cohort was roughly split between the sexes.

Kaur’s group found that 46% of asylum seekers reported both CVD and stress symptoms, while 31% reported CVD, stress, and pain symptoms. Stress symptoms and pain symptoms were each predictors of comorbid CVD symptoms.

Those screening positive for stress symptoms most frequently had anxiety (89%), depression (85%), sleep disturbance (82%), and low energy (72%).

For the CVD symptom group, common symptoms were shortness of breath (45%), fatigue (33%), palpitations (33%), presyncope/syncope (25%), stroke symptoms (20%), and chest pain (16%).

As for those reporting pain, headache (52%), musculoskeletal pain (39%), and abdominal pain (34%) were the most commonly encountered.