This article has been peer reviewed and accepted for publication. It is in production and has not been edited, so may differ from the final published form.
The influence of the social determinants of health on access to health care services among refugees in Australia
Summary: Refugees in Australia are not fully utilising the health care system for several reasons and this may be impacting on their overall health outcomes. This qualitative systematic review aimed to examine the influence of the social determinants of health on refugees’ access to health care services in Australia. Methods: Electronic databases were searched using terms relating to refugees, social determinants, health care services, barriers, enablers, influencers and Australia. Only peer reviewed studies published in English since 2006, which focused on refugees and which specifically discussed social determinants influencing refugees access to health care services in Australia were included. The studies were critically analysed using standard Critical Appraisal Skills Programme Tools. Results/discussion: Eight studies were included in the review. Findings reveal multiple factors influence refugees’ access to health care in Australia and these can be conceptualised within a social-ecological model of health; that is, they operate across individual, interpersonal, environment, organisational and policy levels. The novel finding of this review was the re-occurrence of similar influences across multiple and varying health care service settings in Australia, and in the application of a social-ecological model to understand the breadth of these influences. Conclusions/implications: The prevalence and re-occurring nature of the social determinants of health suggests that refugees are experiencing multilayered barriers to accessing health care in Australia. All levels of a social-ecological model must be addressed in any attempt to break down these barriers. This will require a multifaceted approach with involvement from key stakeholders across multiple sectors.
PY16147 Accepted 09 September 2017
© La Trobe University 2017