July 2024

Nicole Chicoine, D.O.

Globally as many as 2.5 million individuals identify as Afghan refugees.¹ Of these, nearly 2,700 have arrived in Washington in the year 2023; the majority of which reside in King County.^2,3 Afghan refugees face numerous challenges when resettling. These include language barriers, cultural differences, and the extreme complexities of navigating a new job and healthcare market. Employment is a critical factor in successful integration, providing a means to access the healthcare system, and overall well-being for this population. Evidence suggests that refugees (Afghan refugees included) suffer from high rates of unemployment, and or underemployment within the US.⁴

What is underemployment? Why is it a problem?

“Under Employment,” is when individuals obtain jobs below their education or credential level. For Afghan refugees, this means individuals obtain jobs below their education or credential level in the U.S., as compared to jobs they had in Afghanistan. This has the potential to not only effect career trajectory, but also long-term earning potential.⁵ Evidence of this problem is seen in the $32,000 income gap noted in Afghan Refugees with college education or beyond, who have had difficulty converting their foreign education into well-paying jobs in the United States.⁶ Data shows that when controlling for other factors in conjunction with cost of living including the amount of time in the U.S., education, English ability, and citizenship, Afghan refugees’ earned income remains the lowest as compared to other similar refugee and immigrant groups.⁶ Because of this, Afghan refugees, are more likely to live at or below the poverty level, despite living with an increased number of family members of working ages (18-64).⁶

This Photo by Unknown Author is licensed under CC BY

Do these employment barriers impact health?

Consider:

• How the majority of American’s obtain health insurance?
• Which types of jobs offer healthcare services and insurance?
• Would you be able to navigate applying for Medicaid/Medicare in a language different than your own?

Many American’s, not just refugees, rely on their employment to get health insurance to pay for their healthcare needs, and to gain access into the healthcare system. Additionally, high quality jobs often provide better health insurance or healthcare services.  Without this type of job, Afghan refugees are less likely to be able to access proper healthcare, dental and vision care.  Studies have shown that treatment of dental problems, emotional distress, and preventable infectious diseases are some of the most pressing healthcare needs of refugee communities in Washington state.^2,7 We can then see the impact unemployment and or underemployment has on refugee health.

What are we doing to better understand the employment barriers and their impact on healthcare for Washington’s Afghan Refugees?

The Porsesh Policy Research Institute aims to answer this question through a comprehensive research study, here in Washington. This cross-sectional study will utilize a preconstructed survey tool to assess the barriers to employment and healthcare access among Afghan Refugees in Washington. The survey will ask questions across 4 domains (demographic data, employment status, barriers to employment, health assessment and outcomes) and will be provided to participants in English, as well as Dari and Pashto, the official languages of Afghanistan.⁸ Through the help of key community partnerships, we aim to enroll a minimum of 200 participants throughout the community in the study. The primary aims of the study will include identifying the key barriers to employment for Afghan refugees in Washington, evaluating the impact of employment status on the physical and mental health of Afghan refugees, and based on these findings, to provide recommendations for policy and program interventions to support Afghan refugees in overcoming these barriers.

Conclusion

The unemployment rates for Afghan refugees in Washington reflect broader challenges faced by refugee populations in the United States. Addressing these challenges will likely require a multifaceted approach, including language training, credential recognition, job placement services, and community support. By investing in these areas and utilizing insights from the upcoming research survey, Washington can help Afghan refugees build new lives and contribute to the state’s economic and social vitality.

Interested in Learning More?

If you are interested in learning more about this project please contact The Porsesh Policy Research Institute via email at president@prresearch.us or Nicole Chicoine at nicole.h.chicoine@gmail.com

References:

1. Reihani, A.R., Zimmerman, H.G., Fernando, N., Saunders, D.R., Edberg, M., & Carter, E. (2021). Barriers and facilitators to improving access to healthcare for recently resettled Afghan refugees: A transformative qualitative study. Journal of Health and Social Sciences, 6(1), 59–72.
2. Washington State Department of Health. (2023). Refugee Medical Screening Report – FFY2023. www.doh.wa.gov/RefugeeHealth
3. Washington State Department of Social and Health Services. (2023). Office of Refugee and Immigrant Assistance Washington State Department of Social and Health Services Economic Services Administration • Community Services Division
4. Fix, M., Hooper, K., Zong, J. (2017). How Are Refugees Faring? Integration at US and State levels. Transatlantic Council on Migration. migrationpolicy.org/transatlantic
5. Fix, M., Hooper, K., Zong, J. (2017). How Are Refugees Faring? Integration at US and State levels. Transatlantic Council on Migration. migrationpolicy.org/transatlantic
6. Stempel, C., Alemi, Q. (2021) Challenges to the economic integration of Afghan refugees in the U.S., Journal of Ethnic and Migration Studies, 47:21, 4872-4892, DOI: 10.1080/1369183X.2020.1724420
7. Hicks, S. (2021). Understanding Healthcare Services Distribution among King County Community- Based Organizations Serving Immigrant and Refugee Populations. Pacific Hospital Preservation & Development Authority. https://phpda.org/wp-
8. Orfan, S. N., & van de Weijer, J. (2020). Afghan undergraduate students’ attitudes towards learning English. Cogent Arts & Humanities, 7(1). https://doi.org/10.1080/23311983.2020.1723831