Examining self-reported depressive symptoms in refugees resettled in the United States: a cross-sectional study using the social determinants of health framework

Abstract Aim Depression is one of the major mental health crises impacting refugees who have endured traumatic experiences before and after resettlement in a new country. Guided by the Social Determinants of Health (SDH) framework, this study examined factors associated with depressive symptoms among refugees resettled in the United States (U.S). Subjects and methods This study employed a cross-sectional survey derived from the 2020 Annual Survey of Refugees (ASR). The participants were refugees resettled in the U.S. between 2014 and 2019 (N = 1527). Ordinal logistic regression was conducted to determine the significant associations between selected SDH domains and self-reported depressive symptoms among refugees resettled in the U.S. Results Across five selected domains of SDH, refugees who reported overall good physical health (β = -0.96, AOR = 0.38, 95% CI = 0.27–0.53, p < .001), had access to Medicaid and other types of health insurance (β = -0.43, AOR = 0.65, 95% CI = 0.46–0.93, p < .05), and felt welcomed in their resettled communities (β = -0.57, AOR = 0.57, 95% CI = 0.45–0.72, p < .001), were associated with a lower likelihood of exhibiting depressive symptoms during the past 30 days. However, refugees who experienced discrimination were associated with higher odds of exhibiting depressive symptoms during the past 30 days (β = 0.58, AOR = 1.79, 95% CI = 1.23–2.60, p < .001). Conclusion This study underscores the need for policymakers and service providers to advocate for improved access to affordable health insurance and mental health services, foster a sense of community connectedness, and address discrimination to alleviate depressive symptoms impacting vulnerable refugees resettled in the U.S.