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Refugees are perceived as a category of people that are 'vulnerable' per se. However, once they have arrived in (high-income) hosting countries and are supported by a welfare state, vulnerability needs to be rethought, as they face new challenges and potential sources of inequality. In this paper, we have measured vulnerability as the probability of experiencing jointly three interdependent risks: social isolation, financial worries and poor health. For this purpose, we estimated a trivariate logit model to evaluate how individual and household characteristics are associated with vulnerability and also made inferences regarding the residual association between pairs of risks, conditionally to a set of selected covariates. Using the 2016 wave of the IAB-BAMF-SOEP survey of refugees in Germany, we demonstrated the significant correlations between the risks experienced by refugees and assessed a 'propagation effect' that affects vulnerability when the three risks come together. Taking this result into account may be useful in preventing vulnerability among refugees when they are faced with even one of these risks. [ABSTRACT FROM AUTHOR]

Background: Germany played a key role as receiving country during the so-called refugee and displacement crisis with about 5 million asylum seekers arriving in the EU between 2014 and 2020. It is well known that asylum seekers and refugees (ASRs) have a high burden of disease and are particularly prone to mental disorders such as trauma, stress-related and affective disorders. Not much is known about the determinants of health-related quality of life (HrQoL) among ASRs, especially in the context of the flight. Therefore, the aim of this study was to analyze the associations between flight-related characteristics and HrQoL of ASRs in Germany. Methods: The sample of this study was based on five consecutive waves of the Survey of Refugees samples of the German Socio-Economic Panel (n = 8015; 14,314 observations). Mental and physical HrQoL was measured using the mental (MCS) and physical (PCS) component summary scores of the SF-12v2. Associations between flight-related characteristics and HrQoL were examined using multilevel mixed-effects linear regressions. Results: The different countries of birth were associated with varying MCS and PCS scores. The MCS and PCS scores were lower among ASRs with an economic situation below average in their countries of origin. Persecution, discrimination, and poor living conditions as reasons for leaving the county were associated with lower MCS scores. ASRs who were dissatisfied with their own living situation and who were discriminated often due to their origin had both lower MCS and PCS scores. Not feeling welcome in Germany and missing people from one's country of origin were both associated with lower MCS scores. No worries about not being able to stay in Germany or not being able to return to one's country of origin were both associated with higher MCS scores. Conclusions: The economic situation in the country of origin and the presence of persecution, discrimination, and/or poor living conditions as reason for flight may be pre-flight-related determinants of HrQoL of ASRs in Germany. Possible post-flight-related determinants can be the residence status, the satisfaction with one's living situation, discrimination due to one's origin and a feeling of missing people from one's country of origin. With regard to those determinants, the clarity about the residence status, reducing racial discrimination and the mourning of flight-related circumstances must be ensured. [ABSTRACT FROM AUTHOR]