Social disconnection and health among refugees in a low-resource setting: A longitudinal study

• Social disconnection increases the risk of probable depression and PTSD among refugees over time. • Social disconnection reduces the likelihood of experiencing good overall health over time. • Multilevel interventions are needed to tackle social disconnection. Social disconnection- social isolation and loneliness- is global public health concern, adversely impacting mental and physical health. There is an urgent need to expand the evidence base with studies focused on at-risk populations in low-resource contexts. This study aimed to examine the longitudinal association of social disconnection and health outcomes (probable depression and post-traumatic stress disorder (PTSD), and general health), and to identify its individual and social determinants among refugees in a low-resource context. A longitudinal study involving 1,235 culturally and linguistically diverse refugees was conducted over a 2-year period across four time points. Social disconnection, probable depression and PTSD, and general health were measured using self-report instruments across four time points over two years (six-month intervals). Generalised Linear Mixed Models were used to examine whether social disconnection at the previous time point predicts health outcomes at the subsequent time point over a 2-year period. Linear regression was used to identify individual, social, and contextual factors associated with experiencing greater social disconnection. Social disconnection at the previous time-point was associated with increased odds of probable depression (OR = 1.41, 95% CI 1.32, 1.51), PTSD (OR = 1.29, 95% CI 1.20, 1.39), and poor health (OR = 0.86, 95% CI 0.81, 0.92) at the subsequent time point, after adjusting for the prior levels of these outcomes. Younger age (β = - 0.009, p = 0.031), higher education (β = - 0.232, p = 0.026), family separation (β = 0.292, p < .001), traumatic experiences (β = 0.034, p = 0.003), longer time in the protracted displacement settings (β = 0.048, p = 0.030), and post-displacement stressors (β = 0.987, p < 0.001) significantly predicted higher social disconnection at baseline. This study highlights the significant health risk associated with social disconnection among refugees in a low-resource setting. Multilevel interventions addressing individual, social, and contextual factors are needed to tackle social disconnection and improve health among refugees. Multilevel interventions addressing individual, social, and contextual factors are needed to tackle social disconnection and improve health among refugees.