Background

Group Origins

Iraq is located in the Middle East bordering Iran, Turkey, Syria, Jordan, Saudi Arabia, and Kuwait; it has a small seacoast on the Persian Gulf (Figure 1).

As of 2013, the Middle East has the highest number of refugees and internally displaced persons (IDPs) of any region in the world (1 ). Since the early 1980s, Iraq has faced wars, political instability, and economic sanctions, resulting in the displacement of over 9 million people—approximately 7 million have fled the country, and 2 million are internally displaced (2). The most recent Iraqi displacement began in 2003 with the US-led war in Iraq and the sectarian violence that followed (3).

Over 80% of Iraqi refugees originate from Baghdad (4). Since 2003, Iraqi refugees have settled mostly in Jordan and Syria, but also in smaller numbers in Egypt, Iran, Lebanon, Turkey, and the Gulf States (5).

Figure 1: Map of Middle East

Language and Literacy

Arabic, the official language of Iraq, is spoken by approximately 77% of Iraqis as a first language. Almost all Iraqis speak Arabic with some level of proficiency (2) (6).

Other languages spoken in Iraq include

• Kurdish – spoken by the Kurds (20% of the population)
• Anatolian Turkish – spoken by the Turkomans (5%-10% of the population)
• Syriac, Neo-Aramaic – spoken by the Assyrians (3%-5% of the population)
• Mandaic and other Neo-Aramaic varieties, Shabaki, Armenian, Roma, and Farsi are each spoken by less than 1% of the population (2).

Prior to the 1991 Gulf War, Iraq had one of the best educational systems in the Middle East, including respected institutions of higher education in science and technology. However, by 2004, only 55% of Iraqis aged 6-24 were enrolled in school (6). Literacy is estimated at 74% for youth aged 15-24 and higher among Iraqis aged 25-34 (4).

Almost half of Iraqi immigrants who participated in the US Census Bureau’s American Community Survey were classified as limited English proficient (10). Of Iraqis over age 5 years, 9% reported speaking “English only” and 44% reported speaking English “very well”; 47% reported speaking English less than “very well.” Over half of limited English-proficient Iraqi immigrants spoke Arabic (53%), 29% spoke Syriac/Aramaic/Chaldean, and 11% spoke Kurdish (10).

Religious Beliefs

Islam is practiced by 95% of the population (6); ~63% are Shia and ~32% are Sunni Muslims (11). Minority religious groups include Chaldo-Assyrians, Sabeans, Mandaeans, and Yazidis, about half of whom have fled Iraq due to persecution (11). Although they represented less than 5% of the prewar Iraqi population, 40% of Iraqi refugees registered as Christians, and 62% of Iraqis resettled in the United States by 2008 identified themselves as Christian (11).

Family and Kinship

The family is the center of life for most Iraqis; it represents honor, loyalty, and reputation, and a person’s social standing is usually determined by his or her family (4). Like most Arab societies, Iraqi society is patriarchal, and men tend to have more decision-making power than women.

Cultural Approach to Health Care

Husbands and fathers may accompany their wives and children to medical appointments because the health of each individual is important to the family as a unit (12). Like many refugee groups unaccustomed to the US health care system, Iraqi refugee patients may feel dissatisfied with the quality of care if they do not receive a tangible treatment or prescription medication (12). CDC and state and local health partners learned from focus groups with Iraqis in the United States that many experienced confusion about whether to go to their family physician or the emergency room in case of an emergency (8). Even though most Iraqis are familiar with and respectful of Western medicine, preventive health care may not be a priority; patients are likely to resist physician-driven changes in diet and exercise, regular screenings, and follow-up appointments (13). Discussions with female Iraqi refugees regarding preventive care revealed that disease prevention is seen as a function of hygiene and diet, rather than something achieved through health care providers (14).

Additional Resources

For more information about the orientation, resettlement, and adjustment of Iraqi refugees, please visit the Cultural Orientation Resource Center.