UC San Diego

Objective: The Middle East and North Africa (MENA) region is a climate change “hot spot” and is also a major contributor to the global refugee crisis. Refugees are also burdened with greater prevalence of hypertension, and climate-sensitive exposures have been shown to exacerbate this condition. Little research exists regarding MENA refugees’ knowledge surrounding the climate exposures they face along their refugee journeys and the impacts of such climate-sensitive exposures on their health, including hypertension. Methods: Data was collected between July 2022 and January 2023 in a follow-up sample of participants from a larger parent study. Interviews gauged hypertensive Syrian and Iraqi refugee participants for all intermediary locations along their refugee journey. Qualitative questions were subsequently asked to explore participants’ knowledge and attitudes towards the impact of climate-related hazards on their health, including hypertension. The qualitative interviews were transcribed and analyzed using inductive thematic analysis. Additionally, data on climate-related disasters were retrieved from the Emergency Events Database (EM-DAT) and used to identify specific exposures during the refugees’ journeys. Results: Study included 67 participants, (14 Syrians and 53 Iraqis, of which 37 were female) with an average age of 58.5 (SD 9.96) years and 9.03 (SD 3.83) years average length of stay in the US. Overlaying the EM-DAT disaster data with the refugees’ migratory journeys, we identified six participants that were present during a climate-related disaster in their place of origin, prior to beginning their migratory journey. We did not find participants who were exposed to disasters during their stay in transition locations. Qualitative results from the 67 interviews yielded six themes: 1) Weather extremes during the migration journey, 2) US weather is heaven; prior was hell, 3) Poor climate in refugee camps, 4) US surpasses transition countries’ environmental quality standards, 5) War trauma, not environmental hazards, cause chronic disease, and 6) Environmental conditions in the resettlement sites impacted health. Conclusion: MENA refugees face harsh climate exposures during their resettlement journey and in their countries of origin, which impacts their health. It is crucial that we build the availability and quality of resources to address the climate crisis in the MENA region, one of the most vulnerable regions to climate disasters.