P2.187: Social Determinants of Health and Post-Migration School Transition among Afghan Refugee Children

Background: Since the evacuation of the U.S. Armed Forces from Afghanistan in 2021, the Afghan population in the U.S. has quadrupled to 200,000. This community continues to face migration-associated trauma, which particularly impacts children. Using access and adjustment to school in the U.S. as indicators of Afghan refugee children’s well-being, this study aims to elucidate the effect of social determinants of health across migration phases on the education of Afghan children newly resettled in Oklahoma City.

Methods: In collaboration with local resettlement agencies, a survey was created to assess social determinants of health across migration phases among the resettled Afghan community in Oklahoma City. The instrument was translated into Pashto and Dari and verified by back-translation. A snowball sampling approach was utilized to disseminate surveys at public events and among respondent contacts. Eligible participants were 18 years or older, resettled from Afghanistan within the past year, and able to speak Dari, Pashto, or English. Pearson correlation, chi-square, and one-way ANOVA tests were conducted to identify correlations.

Results: Of 230 respondents with school-aged children, 86.5% confirmed their children were enrolled in school. When asked to rate the difficulty of their children’s adjustment to school in the U.S. on a scale of 0-10 (0 = not at all difficult, 10 = extremely difficult), parents reported a mean difficulty of 3.41 (SD 2.30). Adjustment was inversely correlated with pre-migration socioeconomic status (-.146, p = .040), financial strain (-.204, p = .004), and duration of stay in refugee camps (-.365, p <.001). ANOVA confirmed a significant association between time in refugee camps and adjustment (7.788, p < .001). Independent housing, assessed by residence in their own apartment/home, was positively correlated with adjustment (.147, p = .038). Chi-square tests confirmed this: χ2 (1, N = 199) = 4.323, p = .038. Of note, school enrollment was positively correlated with access to food supplemental programs (.257, p <.001); chi-square tests confirmed this: χ2 (1, N = 230) = 15.156, p <.001. Income, neighborhood safety, and social support were not significantly associated with enrollment or adjustment.

Conclusion: The strongest correlation observed in this study was the inverse relationship between time in refugee camps and difficulty of school adjustment. This data likely reflects the loss of prior educational foundation during years in displacement. As expected, financial strain increased difficulty of adjustment, whereas independent housing was associated with an easier transition. Interestingly, pre-migration socioeconomic status (SES) correlated inversely with adjustment, possibly indicating that children from high SES backgrounds experience more difficulty adapting to refugee status in a new culture. In summary, the authors support risk stratification of resettled children by time in refugee camps, financial resources, and housing status to identify those likely to benefit from additional support in U.S. schools.