Iraqi Refugee Health Profile
Iraq is located in the Middle East bordering Iran, Turkey, Syria, Jordan, Saudi Arabia, and Kuwait; it has a small seacoast on the Persian Gulf (Figure 1).
As of 2013, the Middle East has the highest number of refugees and internally displaced persons (IDPs) of any region in the world (1 ). Since the early 1980s, Iraq has faced wars, political instability, and economic sanctions, resulting in the displacement of over 9 million people—approximately 7 million have fled the country, and 2 million are internally displaced (2). The most recent Iraqi displacement began in 2003 with the US-led war in Iraq and the sectarian violence that followed (3).
Over 80% of Iraqi refugees originate from Baghdad (4). Since 2003, Iraqi refugees have settled mostly in Jordan and Syria, but also in smaller numbers in Egypt, Iran, Lebanon, Turkey, and the Gulf States (5).
Figure 1: Map of Middle East
Arabic, the official language of Iraq, is spoken by approximately 77% of Iraqis as a first language. Almost all Iraqis speak Arabic with some level of proficiency (2) (6).
Other languages spoken in Iraq include
- Kurdish – spoken by the Kurds (20% of the population)
- Anatolian Turkish – spoken by the Turkomans (5%-10% of the population)
- Syriac, Neo-Aramaic – spoken by the Assyrians (3%-5% of the population)
- Mandaic and other Neo-Aramaic varieties, Shabaki, Armenian, Roma, and Farsi are each spoken by less than 1% of the population (2).
Prior to the 1991 Gulf War, Iraq had one of the best educational systems in the Middle East, including respected institutions of higher education in science and technology. However, by 2004, only 55% of Iraqis aged 6-24 were enrolled in school (6). Literacy is estimated at 74% for youth aged 15-24 and higher among Iraqis aged 25-34 (4).
Almost half of Iraqi immigrants who participated in the US Census Bureau’s American Community Survey were classified as limited English proficient (10). Of Iraqis over age 5 years, 9% reported speaking “English only” and 44% reported speaking English “very well”; 47% reported speaking English less than “very well.” Over half of limited English-proficient Iraqi immigrants spoke Arabic (53%), 29% spoke Syriac/Aramaic/Chaldean, and 11% spoke Kurdish (10).
Islam is practiced by 95% of the population (6); ~63% are Shia and ~32% are Sunni Muslims (11). Minority religious groups include Chaldo-Assyrians, Sabeans, Mandaeans, and Yazidis, about half of whom have fled Iraq due to persecution (11). Although they represented less than 5% of the prewar Iraqi population, 40% of Iraqi refugees registered as Christians, and 62% of Iraqis resettled in the United States by 2008 identified themselves as Christian (11).
The family is the center of life for most Iraqis; it represents honor, loyalty, and reputation, and a person’s social standing is usually determined by his or her family (4). Like most Arab societies, Iraqi society is patriarchal, and men tend to have more decision-making power than women.
Husbands and fathers may accompany their wives and children to medical appointments because the health of each individual is important to the family as a unit (12). Like many refugee groups unaccustomed to the US health care system, Iraqi refugee patients may feel dissatisfied with the quality of care if they do not receive a tangible treatment or prescription medication (12). CDC and state and local health partners learned from focus groups with Iraqis in the United States that many experienced confusion about whether to go to their family physician or the emergency room in case of an emergency (8). Even though most Iraqis are familiar with and respectful of Western medicine, preventive health care may not be a priority; patients are likely to resist physician-driven changes in diet and exercise, regular screenings, and follow-up appointments (13). Discussions with female Iraqi refugees regarding preventive care revealed that disease prevention is seen as a function of hygiene and diet, rather than something achieved through health care providers (14).
For more information about the orientation, resettlement, and adjustment of Iraqi refugees, please visit the Cultural Orientation Resource Center.External
- United Nations High Commissioner for Refugees. UNHCR Iraq Fact Sheet. 2010. Accessed November 2013. http://www.unhcr.org/pages/49e486426.htmlExternal
- Queensland Health Multicultural Services. Community Profiles for Healthcare Providers: Iraqi Australians. Queensland Health. [Online] July 8, 2011. [Cited: September 13, 2011.] www.health.qld.gov.au/multiculturalExternal.
- Giese, Amanda. An Assessment of the Health of Iraqi Refugees in Chicago. Heartland Alliance. 2010.
- Harper, Andrew. Iraq’s Refugees: Ignored and Unwanted. 869, 2008, International Review of the Red Cross, Vol. 90, pp. 169-190.
- Doocy, Shannon, et al. Food Security and Humanitarian Assistance Among Displaced Iraqi Populations in Jordan and Syria. 2, 2011, Social Science & Medicine, Vol. 72, pp. 273-282.
- Ghareeb, Edmund, Ranard, Donald and Tutunji, Jenab. Refugees from Iraq: Their History, Cultures, and Background Experiences. Center for Applied Linguistics. 2008. COR Center Enhanced Refugee Backgrounder No. 1.
- Women’s Commission for Refugee Women and Children. Iraqi Refugee Women and Youth in Jordan: Reproductive Health Findings, A Snapshot from the Field. 2007.
- Taylor, Eboni et al. Physical and Mental Health Status of Iraqi Refugees Resettled in the United States. Springer, Journal of Immigrant and Minority Health, August, 2013. Web. August, 2013.
- Iraq Family Health Survey 2006/7 (World Health Organization). Accessed 2012, at http://www.emro.who.int/iraq/pdf/ifhs_report_en.pdf).rmCdc-mediaExternal
- Terrazas, Aaron. Iraqi Immigrants in the United States. Migration Information Source. [Online] March 5, 2009. [Cited: September 9, 2011.] http://www.migrationinformation.org/USfocus/display.cfm?id=721External.
- O’Donnell, Kelly and Newland, Kathleen. The Iraqi Refugee Crisis: The Need for Action. Migration Policy Institute. 2008.
- Wisconsin Department of Health Services. Tips for Health Care Providers about Iraqi Refugees. 2010.
- Stratis Health. Iraqis in Minnesota. Stratis Health. [Online] 11 1, 2009. [Cited: September 13, 2011.] http://www.stratishealth.orgExternal.
- Saadi, Altaf, Bond, Barbara and Percac-Lima, Sanja. Perspectives on Preventive Health Care and Barriers to Breast Cancer Screening Among Iraqi Women Refugees. 2011, Journal of Immigrant & Minority Health. PMID 21901446 .
- IRC Commission on Iraqi Refugees. A Tough Road Home: Uprooted Iraqis in Jordan, Syria and Iraq. New York : International Rescue Committee, 2010.
- Frelick, Bill. “The Silent Treatment”: Fleeing Iraq, Surviving in Jordan. [ed.] Peter Bouckhaert, Christoph Wilcke and Sarah Leah Whitson. Human Rights Watch. November 2006, Vol. 18, 10.
- Schinina, et al. Assessment on Psychosocial Needs of Iraqis Displaced in Jordan and Lebanon. International Organization for Migration. 2008.
- Centers for Disease Control and Prevention (2012), Electronic Disease Notification System (EDN).
- US Department of State, Bureau of Population, Refugees, and Migration (PRM), Worldwide Refugee Admissions Processing System (WRAPS).
- Joint Appeal by UNFPA, UNHCR, UNICEF, WFP, and WHO. Meeting the Health Needs of Iraqis Displaced in Neighbouring Countries. 2007.
- World Health Organization/UNICEF/Johns Hopkins University. The Health Status of the Iraqi Population in Jordan: 2009
- United Nations High Commissioner for Refugees; United Nations Children’s Development Fund; World Food Program. Assessment on the Situation of Iraqi Refugees in Syria. 2006.
- Women’s Refugee Commission. Baseline Study: Dcumenting Knowledge, Attitudes and Practices of Iraqi Refugees and the Status of Family Planning Services in UNHCR’s Operations in Amman, Jordan. 2011.
- Chynoweth, Sarah. The Need for Priority Reproductive Health Services for Displaced Iraqi Women and Girls. 31, 2008, Reproductive Health Matters, Vol. 16, pp. 93-102.
- World Health Organization, Regional Office for the Eastern Mediterranean (EMRO) website. Accessed September, 2012. http://www.emro.who.int/External
- Ramos, M, et al. Health of Resettled Iraqi Refugees–San Diego County, California, October 2007-September 2009. 2010, Morbidity and Mortality Weekly Report, Vol. 59, pp. 1614-1618.
- World Health Organization. Tuberculosis Profile: Iraq. World Health Organization. [Online] January, 29th 2013. [Cited: January 29th, 2013] www.who.int/tb/dataExternal.
- Yanni, E, et al; The Health Profile and Chronic Diseases Comorbidities of US-Bound Iraqi Refugees Screened by the International Organization for Migration in Jordan: 2007–2009. Journal of Immigrant and Minority Health; DOI 10.1007/s10903-012-9578-6
- World Health Organization. Non-Communicable Disease Profile: Iraq. World Health Organization. [Online] September 12, 2011. [Cited: September 12, 2011.] http://Infobase.who.int.
- International Rescue Committee. The Health of Refugees from Iraq. 2009. http://www.rescue.org/iraqi-refugeesExternal.
- Darwish-Yassine M, Wing D. Cancer epidemiology in Arab Americans and Arabs outside the Middle East. Ethn Dis. 2005;15 (1 Suppl 1):S1-5–S1-8.
- 32. Michigan Department of Community Health. Color me healthy: a profile of Michigan’s racial/ethnic populations, May 2008. 2011. Accessed on 22 Jan 2011 at http://www.michigan.gov/documents/mdch/ColorMeHealthyProfileMay2008_2362457.pdfCdc-pdfExternal
- Shah SM, et al. Arab American Immigrants in New York: health care and cancer knowledge, attitudes, and beliefs. J Immigr Minor Health. 2008;10:429–36.
- Alhasnawi, Salih, et al. The prevalence and correlates of DSM-IV disorders in the Iraq Mental Health Survey (IMHS). 2, 2009, World Psychiatry, Vol. 8, pp. 97-109.
- United Nations High Commissioner for Refugees. 2013 UNHCR country operations profile – Iraq. http://www.unhcr.org/pages/49e486426.htmlExternal