Geographical Disparities and Settlement Factors and Mental Health of Refugees Living in Germany

Gerard Leavey, Julian Grabo

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1) Background: Approximately half of all refugees living in Germany experience discrimination, which may negatively affect their mental health. Moreover, German refugees have experienced hostility, especially in eastern regions. (2) Aims: We examined the effect of perceived discrimination on refugees’ mental health in Germany, with a particular focus on possible regional differences of refugee mental health and perceived discrimination. (3) Method: The data of 2075 refugees who arrived in Germany between 2013 and 2016, from a large-scale survey, was analysed using binary logistic regression. The refugee health screener, 13-item version, was used to assess psychological distress. All effects were investigated for the entire sample and both sexes independently. (4) Results: A third of refugees experienced discrimination which increased the risk of psychological distress (OR = 2.25 (1.80–2.8). Those living in eastern Germany were more than twice as likely to report experiences of discrimination, compared to their counterparts living in western Germany (OR = 2.52, [1.98–3.21). Differences were noted between males and females, and religious attendance. (5) Conclusions: Perceived discrimination is a risk factor for refugee mental health, particularly female refugees in eastern Germany. An east–west regional difference may be explained by socio-structural factors, rural placement, differential historical exposure to migrant populations, and a greater presence of right-wing and populist parties in eastern Germany.
Original languageEnglish
Article number4409
Pages (from-to)1-12
Number of pages12
JournalInternational Journal of Environmental Research and Public Health
Issue number5
Early online date1 Mar 2023
Publication statusPublished online - 1 Mar 2023

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© 2023 by the authors.


  • refugees
  • geography
  • mental health
  • discrimination


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