Health and Syrian refugees in Türkiye: Trends in public discussions on X, 2011–2022

Abstract Background As the major host society for Syrian refugees, Türkiye has faced important problems in meeting refugees’ health needs and managing the strain on its healthcare system. We analyzed a large dataset of health-related Turkish tweets about Syrian refugees to examine the public opinion trends on refugee health. Methods We identified medical tweets from 2011 to 2022 from a corpus of 4.5 million Turkish tweets on Syrians in Türkiye using 26,000 unique annotated health-related tweets randomly selected and stratified across all years. Of these, 10,700 were annotated for topic and subtopic classification, and 10,000 for sentiment and stance analysis. We then fine-tuned a BERT-based Turkish LLM for classification. Tweets were classified into five main topics-Public Health and Disease Prevention, Financing and Coverage, Access to Medications and Pharmaceutical Services, Provision of Healthcare Services, and Human Resources-and 17 subtopics. Results 123,002 tweets were identified, with the annual numbers rising from 85 in 2011 to 41,352 in 2022, and health-related tweets rose from 1.1% to 5.4%. Sentiment analysis showed 69.9% of tweets were negative, 19.3% neutral, and 10.9% positive, with negativity rising from 31.0% in 2011 to 76.0% in 2022. Stance analysis revealed 60.8% of tweets were anti-refugee, 27.7% neutral, and 11.5% pro-refugee, with anti-refugee tweets rising from 15.8% to 70.4%. The main topics were Public Health and Disease Prevention (44.7%), Human Resources (18.4%), and Provision of Healthcare Services (18.3%). While “general healthcare services” was the dominant subtopic between 2011-2015, “fertility” became the most frequent from 2016 to 2022 Conclusions Health-related discussions about Syrians in Türkiye have intensified, marked by rising negativity and anti-refugee sentiment. These findings highlight the urgent need for targeted health communication strategies and inclusive policies that address the concerns of both refugee and host communities. Key messages • Negative attitudes toward Syrian refugees in health-related discussions on social media in Türkiye have substantially increased in recent years. • Strengthening public trust through targeted health communication is essential to address these attitudes and respond to concerns within the host population.