Syrian Refugee Inflows, Health-Care Access, and Childhood Vaccination in Turkey - Research Findings

Jul 19, 2026

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This study examines how Syrian refugee arrivals in Turkey affect access to health-care resources and shift infectious disease rates among native children. Using a distance-based instrument, it finds higher infection risk for children in provinces with large refugee inflows. The study finds no significant changes in noninfectious conditions such as diabetes, cancer, or anemia. It also shows reduced health-care professional and hospital-bed availability per capita, alongside a lower likelihood that native children are fully vaccinated in heavily affected provinces.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages20

Reading Time50 min

Introduction

Forced displacement and health burdens

Study design and identification

Differential refugee arrival across provinces

Health-care supply, vaccination behavior, and outcomes

Health-care resources and preventive care

Infectious versus noninfectious disease effects

Pub lic Disclosure Authorized Pub lic Disclosure Authorized The World Bank Economic Review, 37(1), 2023, 127–146 [https://doi.org10.1093/wber/lhac023](https://doi.org10.1093/wber/lhac023) Article Syrian Refugee Inflows, Health-Care Access, and Childhood Vaccination in Turkey Bilge Erten, Pinar Keskin, Miray Omurtak, and Ilhan Can Ozen Abstract This study explores the impact of the arrival of Syrian refugees in Turkey on access to health-care resources and subsequent changes in infectious disease rates among native children. Employing a distance-based instrument, it finds that native children living in regions that received large inflows of Syrian refugees experienced an increase in their risk of catching an infectious disease compared to children in less affected regions. In contrast, there is no evidence of significant changes in the incidences of noninfectious diseases such as diabetes, cancer, or anemia. The findings also reveal that the number of health-care professionals and hospital beds per capita declined in provinces that received large refugee inflows. This study also documents a decrease in native children’s probability of being fully vaccinated in provinces that received large refugee inflows. Although contact with potentially infected refugees may increase disease spread among natives, the migration-induced supply constraints in health-care access may also worsen health outcomes in host countries. JEL classification: F22, I12, J13 Keywords: refugees, forced migration, vaccination, infectious disease, children 1. Introduction Armed conflicts and climate change forcibly displace millions of people worldwide every year. According to the UNHCR (2020), 82.4 million people experienced forced displacement in 2020, 26.4 million of whom live as refugees abroad. Developing countries host 86 percent of these refugees despite facing numerous resource constraints. Previous studies have documented that forced migration aggravates the disease burden in host countries because of the arrival of refugees with poor health (Montalvo and Reynal-Querol 2007; Baez 2011; Ibáñez, Rozo, and Urbina 2021) . However, the increase in infectious Bilge Erten is an Associate Professor of Economics and International Affairs at Northeastern University, Boston, MA, USA anda research fellow at IZA. Her email address [is b.erten@northeastern.edu. Pinar Keskin](is b.erten@northeastern.edu. Pinar Keskin) (corresponding author) is an Associate Professor of Economics at Wellesley College, Wellesley, MA, USA. Her email address is [pinar.keskin@wellesley.edu. Miray](pinar.keskin@wellesley.edu. Miray)[ ](pinar.keskin@wellesley.edu. Miray)Omurtak was a student at Wellesley College, Wellesley, MA, USA. Her email address [is momurtak@wellesley.edu. Ilhan Can](is momurtak@wellesley.edu. Ilhan Can)[ ](is momurtak@wellesley.edu. Ilhan Can)Ozen is a Professor of Economics at Middle East Technical University, Ankara, Turkey. His email address is [iozen@metu.edu.tr](iozen@metu.edu.tr). This paper is partly based on Miray Omurtak’s undergraduate honors thesis at Wellesley College. We are grateful to Gunes Asik, Alessando Bonatti, Kristin Butcher, Lakshmi Iyer, Mindy Marks, Kartini Shastry, and Ajay Shenoy for helpful discussionsand feedback, as well as the seminar participants at the Eastern Economic Association Meeting 2022, Northeastern University, the Southern Economic Association Meeting 2021, and Wellesley College for their comments and suggestions. Bilge Erten gratefully acknowledges the hospitality of the Institute of Economic Development at Boston University. Miray Omurtak gratefully acknowledges the Jerome A. Schiff Fellowship for financial support. Any errors are our own. A supplementary online appendix is available with this article at The World Bank Economic Review website. © The Author(s) 2022 . Published by Oxford University Press on behalf of the International Bank for Reconstruction and Development / THE WORLD BANK. All righ

FAQs

How does the study measure the impact of Syrian refugee inflows on health outcomes in Turkey?

It uses a distance-based instrument that exploits differential arrival of refugees across Turkish provinces as an exogenous shock to native health outcomes.

What happens to infectious disease risk for native children in provinces with large refugee inflows?

Native children in more affected regions experience an increased risk of catching an infectious disease compared with children in less affected regions.

Do refugee inflows also change noninfectious disease incidences such as diabetes or cancer?

No. The study reports no evidence of significant changes in noninfectious disease incidences, including diabetes, cancer, or anemia.

Jul 19, 2026

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