Visa Status, Physical Activity and Mental Health Among Farsi/Dari Speaking Refugees, Immigrants and Asylum Seekers in Sydney, Australia

Background: Asylum-seekers in Australia are subjected to restrictive access, such as to education, work, and family reunion, which can affect mental and physical health. We examined the relationship between these restrictive measures and mental health symptoms and physical activity in a sample of Iranian and Afghan asylum seekers, refugees, and immigrants in Sydney. Methods: 276 Iranian and Afghan asylum seekers, refugees, and immigrants were recruited using a probability proportional to size representative, time by location sampling frame across randomly selected Iranian and Afghan grocery shops in Sydney. The interview recorded physical activity levels (Simple Physical Activity Questionnaire); posttraumatic stress disorder (PTSD) symptoms and trauma events (Harvard Trauma Questionnaire); depression symptoms (Hopkins Symptom Checklist) and demographics (Visa, gender, age). Cross-sectional hierarchical logistic regression examined the relationship between visa status and achieving World Health Organisation physical activity guidelines. Hierarchical linear regression examined visa status and sedentary time. Path Analysis tested whether these relationships were mediated by PTSD or depression symptoms. Results: Forty-six percent of Iranian and Afghan respondents who had secure residency in Australia engaged in levels of moderate to vigorous activity that met the WHO recommended rates. After controlling for variables, asylum seekers (with insecure visas) were three times less likely to meet guidelines and reported an average of 30 min per day more sedentary time. Mediation analysis indicated that depression symptoms and PTSD symptoms mediated the visa status and physical activity relationship. Likewise, depression and PTSD mediated the relationship between visa status and sedentary behaviour. Conclusion: Insecure visa status is associated with physical inactivity and sedentary behaviour, which are influenced by psychiatric symptoms. This could have long-term physical and mental health consequences for asylum seekers. So, What?Visa restrictions placed on people seeking asylum when they arrive in Australia could have long-term physical and mental health consequences. This could affect the quality of life for those affected, as well as placing a greater burden on the health system in the future.