UCSF

Social Determinants of Health-related Quality of Life in Palestinian Refugees Living Inside and Outside Camps in Jordan

Background: Palestinian refugees are the world’s largest and one of its longest standing refugee caseloads. Since 1948, Jordan has received several waves of Palestinian refugees who, with their descendants, count for half Jordan’s population. There is a clear concentration of poverty, household crowdedness, inferior housing standards, and limited healthcare and other services access inside camps, in which 18% of Jordan’s Palestinian refugees reside. The Health-related Quality of Life (HRQOL) is the product of not only individuals’ characteristics, but also the characteristics of the surrounding physical and sociopolitical environment.

Objective: Within the context of an integrated HRQOL ecological framework, the dissertation purpose was to (1) describe the state of and gaps in health and social outcomes of Palestinian refugees in Jordan; (2) describe HRQOL, depression and hopefulness to return to Palestine, taking into consideration the influence of age, gender, education and poverty; and (3) compare HRQOL between Palestinian refugees who live inside and outside camps in Jordan, taking into consideration sociodemographic characteristics.

Method: The sample of 177 adult Palestinian refugees living in Jordan was recruited from inside of UNRWA’s Al-Baqa’a Palestinian refugee camp (n = 86) and outside of the camp from surrounding communities in Abu Nsair (n = 91). Participants provided sociodemographic information and completed the World Health Organization QOL Brief Questionnaire.

Results: Palestinian refugees living in Jordan were depressed and nearly half experienced low HRQOL, particularly if refugees were older and poorer. Participants were ‘very hopeful’ about returning to Palestine in the future. Hopefulness, however, was not significantly associated with HRQOL or depression. Furthermore, refugees living inside and outside of camps in Jordan were significantly different by education, type of health insurance and poverty. Physical health, environment and overall HRQOL were significantly higher for non-camp refugees than camp refugees. Regression analyses indicate poverty and residency, individually and/or in combination, were significant predictors of environment, physical health and social relationships HRQOL.

Conclusion: Palestinian refugees in Jordan, especially those who lived inside camps, reported poor HRQOL. Community/public health programs and social policies need to be bolstered or created and implemented to benefit Palestinian refugees in Jordan, particularly inside camps.