Predictors of Well-Being Among Syrian Women in Northern and Southern Turkiye

Background and purpose: The growing crisis of forced displacement calls for attention to factors that influence refugee well-being in specific environmental contexts. Türkiye is a primary host country for Syrian refugees. This study examined emotional distress among 123 young-adult Syrian women (ages 18-30 years) residing in five major cities in Türkiye including Istanbul, Ankara, Izmir, Adana, and Gaziantep. Risk and protective factors as well as differing risk contexts in northern and southern cities were examined. We hypothesized that 1) Social support is a protective factor for emotional distress; 2) Risk factors for emotional distress include discrimination, living difficulties, limited social services, isolation, and concerns about home; and 3) Women in northern cities experience different environmental contexts for emotional distress than those in southern cities.

Methods: This cross-sectional study examines the experiences of Syrian women in northern and southern cities in Türkiye. Participants were recruited through the non-government organization ASAM (Association for Social Development and Aid Mobilization), which provides services to all people in need including refugees and migrants across Türkiye. Eligibility criteria included being female, aged 18 – 30 years, and originally from Syria. Emotional distress was assessed using the Refugee Health Screening (RHS)-15. Exploratory factor analysis and confirmatory factor analysis were conducted to identify sensitive items and obtain latent factor scores for subsequent mixture modeling. Mixture modeling was conducted to examine hypotheses 1 – 3, considering which risk and protective factors best predicted emotional distress in which groups of participants.

Results: Emotional distress was experienced by 91% of the sample, with rates significantly higher among women in southern cities. Models examining measurement properties of the scales fit the data well, as indicated by the posterior predictive p-values (ppp > .12). Factor loadings and reliabilities suggested the constructs were measured well with the selected items. Mixture modeling results indicated social support was associated with increased well-being across locations. Isolation was higher among women in northern cities and associated with increased distress only for women in northern cities. Discrimination and living difficulties were more common among women in southern cities and associated with distress only among women in southern cities. Further testing showed that social support had similar effects on emotional distress (p = .48) across the two classes.

Conclusions and implications: Policies, host community perceptions, and media intersect to create environments that are discriminatory or supportive towards displaced people. Social support is a key resource for Syrian women residing in Türkiye and can be fostered through enhancing inter- and intra-group engagement in community settings, especially in places where women are more isolated. Where the Syrian community comprises a larger portion of the population, increased discrimination and living difficulties point to the need for additional resources and opportunities that support both refugee and host communities. Attention to regional stressors and resources points to a need for responsive policy solutions and context-specific social service programming to support well-being among forcibly displaced populations.