There are several million war-refugees worldwide, majority of whom stay in the recipient countries for years. However, little is known about their long-term mental health. This review aimed to assess prevalence of mental disorders and to identify their correlates among long-settled war-refugees. We conducted a systematic review of studies that assessed current prevalence and/or factors associated with depression and anxiety disorders in adult war-refugees 5 years or longer after displacement. We searched Medline, Embase, CINAHL, PsycINFO, and PILOTS from their inception to October 2014, searched reference lists, and contacted experts. Because of a high heterogeneity between studies, overall estimates of mental disorders were not discussed. Instead, prevalence rates were reviewed narratively and possible sources of heterogeneity between studies were investigated both by subgroup analysis and narratively. A descriptive analysis examined pre-migration and post-migration factors associated with mental disorders in this population. The review identified 29 studies on long-term mental health with a total of 16,010 war-affected refugees. There was significant between-study heterogeneity in prevalence rates of depression (range 2.3–80 %), PTSD (4.4–86 %), and unspecified anxiety disorder (20.3–88 %), although prevalence estimates were typically in the range of 20 % and above. Both clinical and methodological factors contributed substantially to the observed heterogeneity. Studies of higher methodological quality generally reported lower prevalence rates. Prevalence rates were also related to both which country the refugees came from and in which country they resettled. Refugees from former Yugoslavia and Cambodia tended to report the highest rates of mental disorders, as well as refugees residing in the USA. Descriptive synthesis suggested that greater exposure to pre-migration traumatic experiences and post-migration stress were the most consistent factors associated with all three disorders, whilst a poor post-migration socio-economic status was particularly associated with depression. There is a need for more methodologically consistent and rigorous research on the mental health of long-settled war refugees. Existing evidence suggests that mental disorders tend to be highly prevalent in war refugees many years after resettlement. This increased risk may not only be a consequence of exposure to wartime trauma but may also be influenced by post-migration socio-economic factors.

To explore the use of health care and community-based services in war-affected regions of Croatia and its relation to mental health.A sample of 719 adults exposed to at least one war-related traumatic event were selected by random-walk technique from ...

Background: American Indian and Alaska Native (AI/AN) communities in the United States experience significant health disparities, compounded by socioeconomic challenges, systemic racism, limited health information access, and mistrust of health research, mainstream healthcare, and federal health organizations. Misinformation on digital media and variable digital health literacy further hinder informed decision-making. Objective: Explore digital health literacy, digital technology use for health information-seeking, and the perceived influence of misinformation on health decision-making among AI/AN populations. Methods: In 2022, 540 AI/AN individuals aged 18 and older were surveyed at two large cultural events. Cross-sectional data were collected on health decision-making, influence of misinformation on decisions, digital health literacy, and perceptions of misinformation on specific health topics. Paired t -tests examined differences in perceived effects of misinformation on health decisions. Results: Although 62.7% of respondents felt confident evaluating online health information, only 35.5% used online information for health decisions. The perceived impact of misinformation on one's own health decisions was significantly lower for oneself (16.2%) than for friends and family (26.9%, p < 0.001) or other AI/AN individuals (25.9%, p < 0.001). Participants also believed AI/AN peoples were less vulnerable to misinformation than others (25.9 vs. 28.7%, p < 0.001). Conclusions: Addressing misinformation and digital barriers in AI/AN communities requires targeted public health initiatives. Strategies should focus on improving access to culturally relevant health information, integrating digital literacy education, and strengthening digital infrastructure with supportive policies. Collaborating with trusted community leaders can enhance culturally aligned health communication and information dissemination.