Associations of Social Networks with Physical and Mental Health Among Burmese Refugees in the U.S

Background and Purpose: Social networks are considered a significant predictor of an individual’s physical and mental health. However, such associations have not been investigated among Burmese refugees in the U.S., who are at high risk of physical and mental health problems due to their acculturative stress. This study aimed to examine the associations of social networks with physical and mental health among Burmese refugees, particularly in an underserved local community where a small number of Burmese refugees reside and resources are limited.

Methods: In collaboration with a local community agency that works for refugee resettlement, all adult Burmese refugees (ages 18 and older) who resettled in the community between January 2008 and December 2012 were identified as eligible participants for the study. The recruitment process yielded a sample of 24 Burmese refugees (approximately 60% of the eligible individuals). A structured survey was developed using back-translation methods, and the survey in the Burmese language was conducted via mail and in group. To measure social networks, study respondents were asked to identify the number of people in their social networks, and how often they had contact with their network members on a five-point Likert scale. Physical health status was assessed on a five-point Likert scale and then used as a binary variable in the analyses (excellent/very good/good vs. fair/poor). The Hopkins symptom checklist-25 was used to examine mental health status and then was also dichotomized according to the cutoff point of 1.75. A series of independent samples t-tests were conducted. To better understand survey results, one focus group of service providers (n=4) was also conducted.

Results: The mean number of network size was 25.8 individuals (SD=17.1). Among those who reported one or more network members, the mean proportion of network members who are Burmese was 97%. Approximately 52% of the sample reported their health was fair or poor, and 20.8% was identified having clinical mental health symptoms. The results of bivariate analyses indicate that a greater number of social networks is associated with better physical health (p=.04) and not having clinical mental health symptoms (p=.03). However, frequency of contact was found not to be associated with an individual’s physical and mental health status (p>.05). As with quantitative findings, service providers also demonstrated that Burmese refugees have strong in-group social networks, which share information and instrumental help, even though their strong in-group ties tend to lower their needs to seek help from community agencies and interact with non-Burmese individuals in the community. 

Conclusions and Implications: Study findings highlight the value of developing social networks among Burmese refugees, which may enhance their physical and mental health. Although strong cohesion within the Burmese refugee group has been identified as strength, enlarging their social networks may also be needed for this group since connecting with individuals who are not in the same ethnic group often works as a facilitator to getting high-paying jobs and using community resources. Social work practitioners should make an effort to create a balance between inner and outer networks among refugee groups.