ArticleBMJ global health2025
Legal residency status and its relationship with health indicators among Syrian refugees in Lebanon: a nested cross-sectional study.
Article in BMJ global health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Observational
- Workplace violence and self-reported physical and mental health: a national cross-sectional study in Lebanon.Journal of global health · 2026Article
- Process evaluation of an integrated community-based intervention to improve family planning, sexual reproductive Health, and wellbeing among Syrian refugee women and girls in Lebanon during active conflict.Conflict and health · 2026Article
- Social Determinants of Self-Reported Health in Vulnerable Populations During a Polycrisis in Lebanon.JAMA network open · 2025Article
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9 authors.
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Abstract
backgroundFailure to possess or renew legal residency permits increases the burden on a vulnerable refugee population. It risks detention or deportation, and hinders access to basic services including healthcare. This study aimed to examine the association between legal residency status and health of Syrian refugees living in Lebanon.
methodsData were from two independent nested cross-sectional studies collected in 2022 through telephone surveys. In the first study, all Syrian refugees aged 50 years or older from households that received humanitarian assistance were invited to participate. The second included all adult Syrian refugees residing in a suburb of Beirut. The exposure was self-reported possession of a legal residency permit in Lebanon. The self-reported health outcomes were mental health status, COVID-19 vaccine uptake, and access to needed healthcare services. Separate logistic regression models examined the association between lacking a legal residency permit and each health outcome, adjusted for age, length of stay in Lebanon, education, employment, wealth index and receipt of assistance.
resultsThe first sample included 3357 participants (median age 58 years (IQR: 54-64), 47% female), of whom 85% reported lacking a legal residency permit. The second sample included 730 participants (median age 34 years (IQR: 26-42), 49% female), of whom 79% lacked a legal residency permit. In both studies, lacking a legal residency permit increased the odds of having poor mental health (adjusted odds ratio (aOR): 1.46 (95% CI: 1.07 to 1.99); aOR: 1.62 (95% CI: 1.01 to 2.60)) and decreased the odds of COVID-19 vaccine uptake (aOR: 0.66 (95% CI: 0.54 to 0.80); aOR: 0.51 (95% CI: 0.32 to 0.81)). In the subsample who needed primary healthcare, lacking a legal residency permit decreased the odds of access to primary healthcare, which was statistically significant in the second study (aOR: 0.37 (95% CI: 0.17 to 0.84)).
conclusionsThe majority of Syrian refugees from these two samples reported lacking a legal residency permit in Lebanon. This was associated with poor mental health and lower uptake of COVID-19 vaccination, potentially originating from fear of detention or deportation. These findings call for urgent action to support access to legal documentation for refugees in Lebanon.
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