Department of Anthropology, Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, USA.
Department of Anthropology, University of South Carolina, Columbia, SC, USA.
Psychoneuroendocrinology. 2024 Jul;165:107024. doi: 10.1016/j.psyneuen.2024.107024. Epub 2024 Mar 12.
When armed conflict compels people to flee from their homelands, they embark on protracted journeys during which they experience wide ranging physical, social, and psychological challenges. Few studies have focused on refugee psychosocial and physiological profiles during the transitional phase of forced migration that often involves temporary sheltering. Transient refugees' experiences can vary substantially based on local socio-ecological conditions in temporary settlements, including the length of stay, living conditions, as well as the availability and accessibility of physical and social resources. In this study, we compared physiological and psychosocial data from refugees (N=365; 406 observations) in Serbia and Kenya, respectively, with divergent temporal (length of stay) and socio-ecological conditions. In Serbia, refugees resided in asylum centers (mean stay: 0.9 y); in Kenya they were living in Kakuma Refugee Camp (mean stay: 8.8 y), one of the world's largest camps at the time. We had limited ability to directly compare psychosocial measures and used meta-analytic techniques to evaluate predictors of refugee mental and physical health at the two sites, including based on perceived social support. Refugees in Serbia had higher fingernail cortisol (p < 0.001) and were less likely to have elevated C-reactive protein (CRP) levels (p < 0.01) than refugees in Kakuma. We found common gender differences in both settings; women had lower cortisol but higher EBV antibody titers and higher likelihood of having elevated CRP compared to men (all p < 0.01). Woman also reported poorer mental and physical health (p < 0.001). These physiological and health differences may reflect variation between men and women in their psychosocial and physical experiences of factors such as stress, violence, and trauma during their journeys and as transitional refugees. Finally, we also found that refugees with lower levels of perceived social support reported poorer physical and mental health (p < 0.001). Although our results are cross-sectional, they suggest that this intermittent phase of the refugee experience is a key window for helping enhance refugee well-being through an emphasis on interpersonal and community support systems.
当武装冲突迫使人们逃离家园时，他们会踏上漫长的旅程，在这段旅程中，他们会经历广泛的身体、社会和心理挑战。很少有研究关注难民在被迫移民的过渡阶段的心理社会和生理特征，而这个阶段通常涉及临时庇护。临时难民的经历可能会因临时定居点的当地社会生态条件而有很大的不同，包括停留时间、生活条件以及物质和社会资源的可获得性和可及性。在这项研究中，我们比较了塞尔维亚和肯尼亚的难民的生理和心理数据（N=365；406 次观察），这些难民的社会生态条件在时间（停留时间）上存在差异。在塞尔维亚，难民居住在庇护中心（平均停留时间：0.9 年）；在肯尼亚，他们生活在卡卡马难民营（平均停留时间：8.8 年），这是当时世界上最大的难民营之一。我们很难直接比较心理社会测量结果，因此使用元分析技术来评估两个地点难民的心理健康和身体健康的预测因素，包括基于感知到的社会支持。塞尔维亚的难民指甲中的皮质醇水平更高（p < 0.001），且 C 反应蛋白（CRP）水平升高的可能性更低（p < 0.01），而卡卡马的难民则不然。我们发现，在这两个地方都存在常见的性别差异；与男性相比，女性的皮质醇水平较低，但 EBV 抗体滴度较高，且 CRP 水平升高的可能性较高（所有 p < 0.01）。女性还报告称身心健康状况较差（p < 0.001）。这些生理和健康差异可能反映了男性和女性在旅途中以及作为过渡难民时，在压力、暴力和创伤等因素的心理社会和身体经历方面存在差异。最后，我们还发现，感知到的社会支持水平较低的难民报告称身心健康状况较差（p < 0.001）。尽管我们的结果是横断面的，但它们表明，难民经历的这一间歇性阶段是一个关键窗口，可以通过强调人际和社区支持系统来帮助增强难民的幸福感。
