Racialized vulnerability and socioeconomic determinants of health among Afghan refugees in Pakistan

Afghan refugees face persistent poverty, social marginalization, and restricted access to healthcare in Pakistan, making them one of the world's largest and longest-displaced groups. Health disparities have been made worse by decades of instability, especially among marginalized groups living in informal urban settlements and refugee camps. With an emphasis on how income, education, and legal status affect health outcomes and healthcare access, this study explores the socioeconomic determinants and health burdens among Afghan refugees residing in Pakistan. Between January and June 2025, 250 Afghan refugee families (n = 1460 people) in the provinces of Balochistan and Khyber Pakhtunkhwa were surveyed. To guarantee proportionate representation from camp-based and urban populations, stratified random sampling was employed. Data were gathered via structured questionnaires using a cross-sectional methodology, and SPSS v.27 was used for analysis. Multiple logistic regression, chi-square tests, and descriptive statistics were used to find predictors of poor health outcomes. Undocumented status (OR = 3.11, p < 0.001) and low income (OR = 2.34, p < 0.001) were found to be significant risk variables. Results show that poor health outcomes are strongly correlated with socioeconomic deprivation. Reducing health disparities among Afghan refugees in Pakistan requires bolstering social protection systems, livelihood initiatives, and inclusive healthcare access.