title: Comorbid mental and physical health and health access in Cambodian refugees in the US.
abstract: Little research has been conducted on the prevalence of physical health problems in Cambodian refugees and the relationship between their mental and physical health. We identified the relationship between mental and physical health problems and barriers to healthcare access in Cambodian refugee adults. We used a cross-sectional survey design with a snowball sample of 136 Cambodian refugee adult residents of Connecticut and Western Massachusetts. 61% reported being diagnosed with three or more physical conditions and 73% with depression, posttraumatic stress disorder (PTSD) or both. Language and transportation problems were the primary barriers to accessing care. Participants with probable comorbid PTSD and depression had 1.850 times more physical health problems than those without either condition (p > .001; CI 1.334-2.566). Age moderated this relationship. Participants who had been diagnosed with both depression and PTSD reported a consistent number of health conditions across the age span while those who had no mental health conditions or only one of the two reported fewer health conditions when they were younger and more when they were older. These two groups were significantly different from the group reporting both. There is a significant relationship between chronic comorbid mental and physical health diseases affecting Cambodian refugees resettled in the US Having comorbid depression and PTSD puts Cambodian refugees at risk for physical health problems no matter their age. It is vital that those treating Cambodian genocide survivors identify and treat their prevalent comorbid health conditions. Language and transportation barriers must be addressed to improve access to mental and physical health care in this population.
authors.affiliation: School of Social Work, University of Connecticut, 1798 Asylum Ave., West Hartford, CT, 06117, USA, megan.berthold@uconn.edu.
authors.forename: S Megan
authors.initials: SM
authors.lastname: Berthold
authors.forename: Sengly
authors.initials: S
authors.lastname: Kong
authors.forename: Richard F
authors.initials: RF
authors.lastname: Mollica
authors.forename: Theanvy
authors.initials: T
authors.lastname: Kuoch
authors.forename: Mary
authors.initials: M
authors.lastname: Scully
authors.forename: Todd
authors.initials: T
authors.lastname: Franke
mesh_terms: D000328:Adult; D000368:Aged; D002160:Cambodia / Q000208:ethnology; D015897:Comorbidity; D003237:Connecticut; D003430:Cross-Sectional Studies; D003863:Depression / Q000208:ethnology*; D005260:Female; D006297:Health Services Accessibility; D006304:Health Status; D006801:Humans; D008297:Male; D008404:Massachusetts; D008603:Mental Health / Q000208:ethnology*; D008875:Middle Aged; D016012:Poisson Distribution; D012036:Refugees; D057566:Self Report; D013313:Stress Disorders, Post-Traumatic / Q000208:ethnology*; D014104:Torture / Q000523:psychology