"I left my country and the people I love. It gave me hypertension": a qualitative study of social support and hypertension management in refugees.

BACKGROUND

Refugees experience a disproportionately high burden of hypertension, with war-related displacement disrupting their social networks. Countries from the Middle East and North Africa (MENA) are among the largest producers of refugees globally. While previous research has established the role of social support in improving chronic disease management, little is known about its impact among refugees from Arabic-speaking MENA countries. This study focuses on refugees diagnosed with hypertension from two Arabic-speaking MENA countries, Syria and Iraq, to investigate perceived social connectedness and the influence of social support on hypertension management.

METHODS

107 refugees from Iraq (n = 84) and Syria (n = 23) who resettled in San Diego, CA, were recruited from a federally qualified health center in a refugee-majority neighborhood. Participants completed quantitative surveys; a subsample of 54 completed in-depth interviews until thematic saturation was reached.

RESULTS

Mean age was 61.61 years (SD = 9.81), mean years since United States resettlement was 9.6 years (SD = 5.82), and 48.6% (n = 52) of participants were female. Overall, 60.7% (n = 65) reported social disconnection, and 61.7% reported an annual income <$15,000. Participants described 3 forms of social support (or lack thereof) that impact hypertension management. (1) Informational: reliance on close social networks for health information; (2) Instrumental: lack of transportation and language barriers in clinical spaces; and (3) Emotional: loss of social networks and social status, causing psychosocial stress.

CONCLUSION

Findings suggest that prioritizing family reunification during resettlement and integrating social support into public health interventions, such as family-centered care, shared medical appointments, and community-based peer support, may mitigate the loss of social support and related hypertension disparities among refugees.