Abstract
Background: 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. Method: A longitudinal study involving 1235 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. Results: 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 (beta = - 0.01, p = 0.031), higher education (beta = - 0.23, p = 0.026), family separation (beta = 0.29, p < 0.001), traumatic experiences (beta = 0.03, p = 0.003), longer time in the protracted displacement settings (beta = 0.05, p = 0.030), and post-displacement stressors (beta = 0.99, p < 0.001) significantly predicted higher social disconnection at baseline. Conclusion: 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.