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.

中文翻译：

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塞尔维亚和肯尼亚过渡安置点的难民健康和生理特征：性别和社会支持影响的比较证据

当武装冲突迫使人们逃离家园时，他们就会踏上漫长的旅程，在此期间他们会经历广泛的身体、社会和心理挑战。很少有研究关注被迫移民过渡阶段的难民心理社会和生理状况，该过渡阶段通常涉及临时庇护。临时难民的经历可能因临时安置点当地的社会生态条件而有很大差异，包括停留时间、生活条件以及物质和社会资源的可用性和可及性。在这项研究中，我们分别比较了塞尔维亚和肯尼亚难民（N = 365；406 个观察值）的生理和心理社会数据，以及不同的时间（停留时间）和社会生态条件。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，他们住在卡库马难民营（平均停留时间：8.8 年），这是当时世界上最大的难民营之一。我们直接比较心理社会测量的能力有限，并使用荟萃分析技术来评估两个地点难民心理和身体健康的预测因素，包括基于感知的社会支持。与卡库马难民相比，塞尔维亚难民的指甲皮质醇水平较高 (p < 0.001)，且 C 反应蛋白 (CRP) 水平升高的可能性较小 (p < 0.01)。我们发现这两种环境中存在共同的性别差异；与男性相比，女性的皮质醇较低，但 EBV 抗体滴度较高，并且 CRP 升高的可能性较高（所有 p < 0.01）。女性的心理和身体健康状况也较差（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期间对压力、暴力和创伤等因素的心理社会和身体体验的差异。最后，我们还发现，感知社会支持水平较低的难民的身心健康状况较差（p < 0.001）。尽管我们的结果是横向的，但它们表明，难民经历的这一间歇阶段是通过强调人际和社区支持系统来帮助提高难民福祉的关键窗口。