AB078. Mental health disparities by sex: unraveling determinants and changes during the resettlement process
Abstract

AB078. Mental health disparities by sex: unraveling determinants and changes during the resettlement process

Meng Zheng1,2, Xin-Yan Bu1,2, Wen Chen1,2

1Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China; 2Center for Migrant Health Policy, Sun Yat-sen University, Guangzhou, China

Background: Significant sex differences in mental health have been observed among resettled refugees, yet how these disparities and their determinants evolve over time remains unclear. This study sought to unravel determinants and changes in mental health disparities by sex in a quantitative way.

Methods: Data were drawn from Waves 1 [2013–2014], 5 [2017–2018], and 6 [2023] of the 10-year Building a New Life in Australia (BNLA) cohort. Post-traumatic stress disorder (PTSD) and high-risk of severe mental illness (HR-SMI) were measured using the PTSD-8 and Kessler-6 scales. Fairlie decomposition was used to quantify the disparity (total predicted probability difference) and the contribution proportion of individual determinants (explained difference/total predicted probability difference × 100%).

Results: A total of 2,261 refugees were included at Wave 1, with 1,833 (81.1%) and 905 (40.0%) followed up at Waves 5 and 6. Female refugees consistently experienced poor mental health, with a total predicted probability difference decreasing from the initial (Wave 1, 8.33%) to middle stage (Wave 5, 4.61%), then increasing in the long term (Wave 6, 6.31%). Determinants varied across waves, but poor status of physical health-related factors was a persistent contributor (e.g., total contribution of predicted probability difference: PTSD 57.42%, 70.95%, 60.05%). Family conflict contributed at the initial (contribution proportion: HR-SMI 4.53%) and long-term stages (PTSD 8.68%), while financial hardship (PTSD 13.41%; HR-SMI 24.07%), marital status (HR-SMI 25.82%), and family concerns (PTSD 8.39%) were key at the middle stage. Unmet support or help during coronavirus disease 2019 (COVID-19) was a major contributor at Wave 6 (PTSD 23.93%; HR-SMI 8.39%).

Conclusions: Sex disparities in refugee mental health require sustained attention and tailored, stage-specific strategies. Providing necessary physical health care and addressing family conflict (initial/long-term stage), financial hardship (middle stage), and female- specific needs during crises like COVID-19 is essential for promoting mental health equity.

Keywords: Building a New Life in Australia cohort (BNLA cohort); determinants; humanitarian refugees; mental health; sex disparity

Footnote

Conflicts of Interest: The authors have no conflicts of interest to declare.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the noncommercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/jphe-26-ab078
Cite this abstract as: Zheng M, Bu XY, Chen W. AB078. Mental health disparities by sex: unraveling determinants and changes during the resettlement process. J Public Health Emerg 2026;10:AB078.

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