A new study finds Ukrainian refugees in Estonia report similar physical health to locals but worse overall well-being, driven by higher rates of mental health challenges.
The study, involving researchers from the National Institute for Health Development (TAI), compared data from more than 1,200 refugees with a comparable group of Estonian residents aged 16 to 64.
While refugees often rated their physical functioning as equal to or even better than locals, they reported higher levels of anxiety, depression and pain.
More than 60 percent said they experienced mental health issues, compared with about 55 percent of Estonians.
“The impact of war extends into people’s health even after reaching a safer environment,” said TAI Department of Epidemiology and Biostatistics director Rainer Reile.
This impact, he said, shows up in their mental well-being and daily functioning.
The study used the widely recognized EQ-5D measure, which evaluates mobility, self-care, usual activities, pain and discomfort, and anxiety and depression. On a scale where 1 represents perfect health, Estonia’s general population averaged 0.763, compared with 0.742 among refugees.
Reile said the findings reflect a complex picture. Refugees may benefit from a “healthy migrant effect,” meaning those able to relocate often start out in relatively better physical health.
Socioeconomic factors also key
But that advantage may fade over time as stress and economic hardship take hold.
Financial strain stood out as a key gap: about two-thirds of refugees lived on less than €900 per person per month, far more than among Estonians.
“A significant share of the difference in quality of life is linked to socioeconomic factors and mental health,” Reile said, stressing that support must go beyond healthcare to include stability and a sense of security.
Ukrainian refugees in Estonia have access to healthcare, social services and mental health support, but the study points to a need for more targeted solutions.
Under temporary protection, they are eligible for a range of support, including family benefits, food aid, mental health services and counseling, while organizations such as the Estonian Refugee Council help them navigate services.
The study’s authors say outcomes should be tracked over time to see what actually helps narrow the gap.
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