(see Poster Gallery) Gender Differences in Physical Health Status in Somali Refugee Youth: A Role of Social Support and Religiosity

Background & Purpose: Refugee populations likely present poor health outcomes due to cumulative adversities and traumatic experiences throughout forced migration. Their physical and mental health needs may not be properly attended to during displacement due to acculturative stressors, barriers to healthcare access, income disadvantages, and legal documentation issues. Being displaced in a neighboring country, although providing a temporal sanctuary, often increases social vulnerability and contributes to the decline in health and well-being. Such adversities occur disproportionately in the refugee community and some stressors and psychosocial outcomes have more devastating effects on women than men (e.g., higher risk for sexual and gender-based violence). This study aims to identify factors influencing the physical health status of Somali refugees in displacement, focusing on gender differences in psychosocial, promotive factors.

Methods: Using a snowball sampling strategy, this study recruited 237 Somali refugee youth in Eastleigh, an urban area in Nairobi, Kenya. A cross-sectional survey questionnaire (available in both English and Somali) included questions on physical health status, mental health symptoms, religious beliefs, psychosocial factors, and demographic characteristics. This study conducted descriptive and bivariate analyses, followed by a series of logistic regression models, with a pre-established significance level of 0.05. A moderated mediation was conducted to analyze the effect of social support on physical health via religious belief. All analyses were conducted using IBM SPSS Statistics 27.

Results: Three logistic regressions were conducted to analyze factors (IVs) for male, female, and all participants: age, country of birth, religious belief, perceived social support, and somatic symptoms on physical health status (DV). Results showed that religious belief was significant in predicting the physical health status of the total sample (p= 0.010, CI: 1.146, 2.794) and somatic symptoms were significant in influencing the physical health status of the total sample (p =0.013, CI: 0.881, 0.985). When separated by gender, somatic symptoms were found to be significant in predicting physical health status in the women-only sample (p <0.05, CI: 0.862, 0.993). In the men-only sample, religious belief was a significant predictor of physical health status (p<0.05, CI: 1.143, 9.910), and social support was a significant predictor of physical health status (p<0.05, CI: 0.905, 1.379).

Conclusion: This study revealed that religious belief is a strong predictor of physical health status among male participants, whereas trauma-related somatic symptoms (i.e., mental ill-health) likely have more devastating impacts on physical health among female Somali refugee youth. This study has implications for future studies about how to approach and assess physical health and relevant psychosocial factors, including culturally responsive and relevant coping and the intricate relationship between physical and mental health through somatoform symptom reports. Results also highlight the integral role of gender-sensitive and gender-specific interventions to promote health among Somali refugee youth. Further implications for social work practice and policy will be discussed.