The broad, long-term objective of this proposed project is to understand the relations between stigma and health outcomes in refugee children. Although stigma has been clearly linked to negative health outcomes in various populations, no work examines stigma in refugee populations. The results of this study will lay the foundation for further examination of types of stigma experienced by adolescent refugees, pathways through which stigma relates to health outcomes, and potential areas of intervention for this population. Link and Phelan (1995, 2000, 2002) posit a theoretical model in which stigma results in general social disadvantage (e.g., decreased knowledge, money, power, prestige and social connections), via discrimination. Social disadvantage, in turn, leads to a greater exposure to risk factors and decreased access to protective factors related to health outcomes. In addition, stigma directly contributes to life stress, which impacts health outcomes. This model forms the theoretical basis for examining the relations between stigma and health in refugee children. This study seeks to examine the link between stigma associated with race, religion, and mental illness, and mental health outcomes (particularly PTSD) in Somali refugee adolescents who have resettled in the U.S. It further seeks to test a theoretical model in which stigma relates to mental health problems through a variety of pathways. Social disadvantage, environmental stressors, and mental health service access will be examined as variables mediating the relationship of stigma and mental health. Specifically, this project has the following Specific Aims: 1) to examine and analyze the relations between stigma and mental health symptoms in refugee adolescents, and 2) to test a model relating stigma to mental health via social disadvantage, environmental stressors, and treatment access in refugee adolescents. The study will employ a cross-sectional design to assess 150 Somali adolescent refugees who have been resettled in the states of Massachusetts and Maine. Variables of stigma, social disadvantage, environmental stressors, service access, and mental health will be assessed, and relations between variables examined. In addition, supplementary data examining coping, social support, and social capital in relation to mental health outcomes will be examined. ? ?
