Background Decades of war and political instability have forced millions of Afghans to flee from their homes, resulting in one of the world's largest humanitarian crises. Many refugees have resettled in North America, particularly in Canada and the United States, where they have encountered numerous psychosocial and systemic barriers to adapting to their new environment. Objective This scoping review aims to explore the settlement experiences of Afghan refugees in North America, synthesize existing evidence on integration challenges, and identify key gaps in the literature. Methods Following Arksey and O’Malley's methodological framework, six electronic databases were searched for relevant literature published between 2014 and 2024, which focused on Afghan refugee settlement experiences in the North American context. Seventeen eligible studies were included in the final review. Results Mental health emerged as the most studied topic, with Afghan refugees experiencing moderate to high rates of psychological distress, depression, and post-traumatic stress disorder. Key risk factors included female gender, older age, pre-migration trauma, financial constraints, and social isolation. Protective factors, such as, strong social support networks, English language proficiency, and gainful employment were associated with improved mental health outcomes. In spite of the generally positive healthcare experiences, Afghan refugees encountered language barriers, limited health literacy, transportation difficulties, and cultural misunderstandings with healthcare providers. Conclusion Afghan refugees in North America face complex and intersecting barriers to health and healthcare access, and integration. Current literature by and large focuses on mental health, and there is an urgent need to expand research in other important areas of post-migration and (re)settlement.
Amanzai et al. (2026) studied this question.