Social Determinant Correlates of Self-Rated Health Among Newly Resettled Afghan Refugees in Oklahoma City

Abstract Afghan refugees in the US face significant challenges, including limited access to healthcare. This study investigates the relationship between social determinants of health (SDOH), including-material circumstances, psychosocial circumstances, behavioral and/or biological factors - and self-rated health among recently resettled Afghan refugees (who received Special Immigrant Visas) in Oklahoma. Data were collected from 348 Afghan refugees using a community-based survey administered in English, Pashto, or Dari in 2022. Measures included sociodemographic characteristics, SDOH, and self-rated health (assessed using a single-item question asking participants to rate their health as poor, fair, good, very good, or excellent). Multivariable logistic regression analyses examined the associations between sociodemographic factors, SDOH, and self-rated health. Of the 348 participants, 59.5% of participants were male, with an average age of 31.5 years. In terms of behavioral factors, high rates of inadequate fruit and vegetable consumption (55.2%), insufficient sleep (58.0%), and insufficient physical activity (83.6%) were observed. With regard to material circumstances—defined based on the World Health Organization’s Commission on Social Determinants of Health (CSDH) framework as physical and economic living conditions—chronic health conditions (12.6%) and disabilities (7.8%) were noted. In adjusted models, chronic health conditions (AOR = 0.41, 95% CI: 0.19–0.86), disability (AOR = 0.31, 95% CI: 0.12–0.79), and inadequate sleep (AOR = 0.46, 95% CI: 0.24–0.89) were significantly associated with poor self-rated health. There were no significant associations found between psychosocial factors and self-rated health. This study highlights the significant impact of SDOH, especially material circumstances and behavioral factors on the well-being of Afghan refugees. Future interventions aimed to improve Afghan refugee health need to consider the roles of SDOH in order to optimize their care.