Understanding the Health and Social Determinants of Health Needs of Resettled Afghan Refugees in Houston, Texas.

PurposeThe global refugee crisis includes Afghan refugees, driven by decades of conflict. Understanding the currently unidentified, unique challenges of this group upon resettlement in the United States is crucial for bettering health outcomes. This needs assessment identifies the challenges surrounding health experiences of resettled Afghan refugees in Houston, Texas.MethodsAdult Afghan refugees resettled in Houston, Texas were surveyed via a needs assessment adapted from validated health screeners (PRAPARE, the RHS15, and CoPaQ) with translator assistance. Health experiences across demographics, urgent needs, accessibility, and healthcare services were assessed.Results: 73 participants were surveyed (median age: 33 years, 74% female). Most had lived in the U.S. for 1-3 years, primarily spoke Dari, lacked English proficiency, were unemployed, and earned less than $20,000 annually. Top needs were employment, food, and transportation, and key accessibility issues included transportation, clothing, and learning English. Though many had health insurance, only some felt comfortable visiting a doctor alone and felt understood by their physician. About one-third rated their health as fair or poor. For medical visits, most relied on case managers and interpreters for navigating appointments, traveled by car, and had wait times under an hour. Social determinants like housing, childcare, and healthcare access showed significant variation.ConclusionFindings reveal key elements, including language, transportation, provider communication, that shape the health experiences of resettled Afghan refugees. These access contributors can inform more responsive healthcare systems. Given the urgency of our analysis, healthcare, governmental and community programs should pursue targeted approaches to meet this population's needs.