Non-communicable disease prevalence among asylum seekers and Swiss nationals: a comparative cross-sectional study in emergency care

Background Non-communicable diseases (NCDs) are the leading causes of death worldwide. Ongoing global migration increases the proportion of recently arrived migrants in many countries. Yet data on NCD prevalence and care among asylum seekers (AS), a marginalised population with barriers to healthcare access, remain scarce. Emergency departments (EDs) often serve as healthcare access points for vulnerable populations, providing valuable data to identify unmet needs and health inequities. The primary objective of this study was to assess NCD prevalence, along with care, patterns and ED consultation frequency among AS compared with Swiss nationals (SN), with a focus on potential disparities. Methods Cross-sectional study at the ED of University Hospital Bern (January 2017 to December 2018). Patients ≥30 years with AS status were matched 1:1 to SN by age (±5 years) and gender. Routine data from electronic medical records included demographics, consultation characteristics and the presence, type and medication of NCDs. Group-level comparisons were performed and sensitivity analyses tested result robustness. Results NCD and multimorbidity prevalences did not differ (AS: respectively 34.5% and 10.2% of 420, SN: 36.9% and 9.0% of 445, p=0.475 and 0.322), with cardiovascular diseases most prevalent. Diabetes was more prevalent in AS (9.3% vs 3.8%, p=0.001), particularly among women, while neoplasms and respiratory disease were less frequent. ED consultation frequencies were comparable between AS and SN (each N=538). In both groups, ~10% of ED visits were primarily NCD-related, with similar rates of previously known or unknown NCDs and resource utilisation, while untreated cardiovascular disease or diabetes was more frequent among AS. Conclusion Despite similar overall ED consultation frequency and NCD prevalence between groups, higher diabetes prevalence, gender-specific differences and potential chronic care gaps among AS indicate health inequities. EDs play a crucial role in detecting such disparities and can inform inclusive, equity-oriented strategies to strengthen NCD prevention and care continuity for displaced populations.