Collaborating Organizations

Research Group

Abstract

Background: Refugee populations face unique challenges that exacerbate their vulnerability to discrimination, which in turn has profound implications for their physical and mental health. This study examines perceived discrimination and its relationship with health outcomes, including chronic illnesses and mental health problems, among refugees resettled in Ohio.

Methods: Using a cross-sectional design, an online survey was conducted from November 2023 to February 2024. Participants were 18 years and older adults from five major refugee communities in Ohio: Afghan, Bhutanese, Congolese, Ethiopian/Eritrean, and Somali. Perceived discrimination was measured using the Everyday Discrimination Scale, while mental health symptoms were assessed with the PHQ-4. Chronic morbidity was captured through self-reported physician-diagnosed conditions. Multivariable logistic regression models were used to assess the relationships between discrimination and health outcomes, adjusting for demographic, social, and healthcare access variables.

Results: Among the 478 participants, 28.8% reported having at least one chronic condition, and 23.0% screened positive for mental health problems. Perceived discrimination was prevalent, with over a quarter of participants reporting experiences of discrimination on each item of the Everyday Discrimination Scale. Notably, more than half (52.1%) of participants reported being treated with less courtesy or respect. Over one-third (33.5%) of participants reported experiencing racial discrimination. Perceived discrimination was significantly associated with adverse mental health outcomes (adjusted odds ratio [AOR] = 1.34; 95% CI: 1.10–1.62). Participants who reported experiencing two or more types of discrimination had 2.02 times higher odds of chronic morbidity (AOR = 2.02; 95% CI: 1.14–3.58) and 2.68 times higher odds of mental health problems (AOR = 2.68; 95% CI: 1.45–4.95) compared to those who did not report discrimination.

Conclusions: Perceived discrimination emerges as a critical determinant of health disparities among refugee populations, reflecting significant associations with chronic morbidity and mental health issues. These findings underscore the need for culturally sensitive policies and programmatic interventions to reduce discrimination and improve the health and well-being of refugee communities.

Keywords: Perceived discrimination, refugee populations, chronic morbidity, mental health, Everyday Discrimination Scale, Ohio.

Research Aim & Hypothesis

Aim: To assess the relationship between perceived discrimination and health outcomes – specifically chronic illnesses and mental health problems – among resettled refugee populations in Ohio.

HO: Perceived discrimination negatively impacts the physical and mental health of refugees.

Presentation

Development of NACE Competencies

• Career & Self-Development: This study improved the undergraduate's understanding of how perceived discrimination negatively impacts the physical and mental health of resettled communities in Ohio. As the undergraduate is attending medical school this year, this has expanded her understanding of the social determinants of health that can affect future patients. 

• Communication: This project required communication between the research team and taught the undergraduate student how to seek guidance from other members when needed. 

• Critical Thinking: The student was able to think critically about a research concept to develop this manuscript and develop her scientific writing skills throughout. 

• Technology: The student utilized Microsoft Excel to produce multiple figures from the data sets produced from the research, overall learning how to efficiently use the software.

Acknowledgements

I would like to thank the entire research team, ETSS, & OhioMHAS for making this research possible. I would like to give a special thank you to my mentors, Dr. Saruna Ghimire & Isha Karmacharya, for all of their help and guidance throughout this entire project. 

Additionally, I would like to thank Miami University for their helpful scholarships, which were able to fund this research, including the Dean's Scholar scholarship and the Dr. Kenneth McLeish Premedicine Undergraduate Research Award.