Social Vulnerability of Refugees to Climate Disasters in the Texas Panhandle

Publication Date: 2024

Abstract

This study explores the social vulnerability of refugees who recently resettled in the United States to climate hazards and how they perceive and prepare for health risks associated with these hazards We conducted survey research with 177 refugees in the Texas Panhandle, a predominantly rural region where more than 6,000 refugees from diverse countries, cultures, and ethnic groups have resettled during the last decade. The survey yielded four major findings. First, refugees were highly vulnerable to disasters, evidenced by a collection of social-demographic variables. Second, refugees demonstrated low levels of disaster awareness and disaster preparedness. Third, refugees’ perceived health risks were predicted by age, gender, income, housing status, and involvement in social groups. Finally, perceived neighborhood characteristics predicted refugees' belief in the effectiveness of preventive actions in coping with disasters (i.e., response efficacy), and social and community context predicted refugees’ confidence in their abilities to take preventive actions (i.e., self-efficacy). The results emphasize the need for targeted public health interventions and policies to address refugees’ social vulnerability, improve awareness of climate-related risks, and enhance access to diverse information sources crucial for disaster preparedness. By amplifying the voices of refugees in the rural Texas Panhandle, this project serves as formative research for public health education and disaster communication targeting refugees and similar vulnerable communities in rural areas.

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Introduction

The whole community approach to disaster management encourages incorporating refugees into disaster mitigation, preparedness, response, and recovery planning and policy (Gonzalez Benson et al., 2022¹; Wieland et al., 2022²). However, the existing institutional structure of disaster management agencies often ignores the specific needs of refugee communities (Walker et al., 2021³); as a result refugees face higher risks for health problems caused by climate-related disasters than other population groups. These health risks are exacerbated in rural areas, such as the Texas Panhandle, which lack the public health infrastructure of larger urban areas and where a growing number of refugees have been resettled (Aka, 2022⁴; Leonard, 2022⁵). Previous research suggests that communities of color in the Texas Panhandle—which include some nonwhite refugees along with other nonwhites—have poorer health outcomes than Whites; these health disparities could be exacerbated by climate-related disasters. A report by Feeding America, for example, found a huge disparity in food insecurity among people of color in the Texas Panhandle (Green, 2022⁶).

In the rural context, effective health and safety education about disaster management is essential to protect vulnerable populations from hazards and reduce health disparities. Understanding how social vulnerabilities affect the ways that people access, process, and utilize public health information is imperative to equitably addressing public health threats (Taylor-Clark et al., 2010⁷).

Over the past two years, we have established close connections with the Amarillo Public Health Department and community organizations such as Refugee Services of Texas, Church World Service, Catholic Charities of the Texas Panhandle, Refugee Language Project, and Amarillo Chin Christian Church. Building on our research and engagement efforts, we have been actively conducting studies on refugees’ disaster preparedness and integration. Additionally, we regularly conduct cultural orientation workshops covering various subjects for refugees and participate in numerous roundtable conferences focused on refugee resettlement. These experiences not only have granted us access to our research site and populations, but also have allowed us to learn about the difficulties, needs, and cultural values of refugee communities.

To provide health and disaster communicators with first-hand information about refugees’ vulnerability to disasters, we seek to examine the following topics in this exploratory study: (a) refugees’ current levels of social vulnerability in the Texas Panhandle, (b) the social determinants of health that predict refugees’ access to risk information, and (c) the factors that shape refugees’ perceptions of the health risks caused by climate-related disasters.

Literature Review

Social Vulnerability of Rural Populations and Refugees

Social vulnerability refers to “the sociodemographic characteristics of a population and the physical, social, economic, and environmental factors that increase their susceptibility to adverse disaster outcomes and capacity to anticipate, cope with, resist, and recover from disaster events” (Adams et al., 2022, p. 14⁸). In the context of disasters, understanding and addressing social vulnerability is essential for effective disaster preparedness, response, and recovery efforts. Extreme events like floods, wildfires, and heat waves are getting worse as climate change influences their frequency and intensity imposing significant costs on individuals, households, and society. These events exacerbate public health risks by altering the frequency or intensity of extreme weather events and increasing rates of infectious diseases (U.S. Environmental Protection Agency, 2022⁹).

Certain aspects of rural livelihoods and community settings place people in rural areas at higher risk for poor health outcomes (Christenson et al., 2014¹⁰). For example, rural residents typically have less access to quality health care than people in urban and suburban areas, resulting in poorer health conditions (Boyle, 2023¹¹). In some rural areas, residents have less access to fresh food and fewer opportunities for physical activity (Hartley, 2004¹²). Evidence suggests that rural populations are very susceptible to health risks associated with climate-related disasters. For example, rural populations are more likely to work outdoors or in agricultural activities, which increases their vulnerability to climate hazards (Evangelakaki et al., 2020¹³; Kalogiannidis et al., 2023¹⁴; Yang et al., 2021¹⁵). Also, rural populations tend to be lower income and older compared to urban residents (Erwin et al., 2010¹⁶; Long et al., 2018¹⁷). During periods of extreme heat, rural people suffer heat-related illnesses at five to ten times the rates of people in urban areas (Boyle, 2023).

Refugees are likely to have fewer abilities to cope with or adapt to climate hazards than other groups in their host nations (Fransen et al., 2023¹⁸). This is due to a number of factors. Experiencing violence, persecution, and displacement in their home countries, for example, likely means refugees come to their new homes with long-term mental, emotional, and physical health needs. In addition, due to their economic constraints and limited social networks, refugees often resettle in host communities that are themselves marginalized and, as a result, more exposed to climate hazards and with fewer public health resources. Indeed, an increasing number of refugees are resettling in “climate change hotspots,” the areas of the world most prone to climate disasters (USA for UN Refugee Agency, 2024¹⁹). The rural Texas Panhandle is an example of such a place.

Refugees, however, are not a homogeneous group. Their age, gender, cultural background, health status prior to resettlement, length of stay in the host country, community cohesion, and various socioeconomic factors lead to significant differences in their coping and adaptive capacity to climate-related health risks and overall well-being (Crimmins et al., 2016²⁰). Edberg et al. (2011²¹) proposed a model of health trajectory determinants for immigrant and refugee populations; this model includes nine domains: migration experience, social adjustment, socioeconomic status (e.g., economic, employment, housing status), social supports, neighborhood characteristics, health status, health knowledge and practices, access to care, and perceived discrimination. This model introduces how migration and social adjustment experiences may make immigrants and refugees more socially vulnerable to disasters. Since refugees vary greatly in all nine domains, however, their vulnerability may be very different. Therefore, instead of lumping refugees together into a single group, researchers should use a community-based and case-by-case approach to examine their climate-related health risks. Such a research approach would allow researchers to identify risk communication strategies that work best for each refugee community.

Social Determinants of Health and Public Health Disparities in Refugee Communities

Social determinants of health encompass all the non-medical factors that can influence health outcomes in positive or negative ways; these factors include income, education, job security, housing, social inclusion, and access to health services (World Health Organization, n.d.). The U.S. of Health and Human Services (2014) further sorts social determinants of health into five domains, namely economic stability, education access and quality, health care access and quality, neighborhood and built environment, and social and community context. Social determinants from all domains exert a powerful influence on one’s vulnerability, exposure, and capacity (Nomura et al., 2016²²), which subsequently determine individuals’ and communities’ health status and disaster resilience.

There is very little research on refugee health in the United States, and even less that examines refugee health through a social determinants of health lens. Scholars have examined, however, the social factors that shape immigrants’ health outcomes and risks. Refugees are similar to immigrants in many respects, so findings from research on immigrants set the foundation for the current study. Chang (2019²³), for example, identified that immigrants faced several major barriers to their well-being, including health care access, poverty, housing insecurity and homelessness, education, and immigration policies and laws. Refugees are likely to face similar barriers to those mentioned in Chang’s study (2019), however, several aspects of refugees’ backgrounds are distinct from other migrant groups—including their experiences of persecution and displacement, the resettlement process, their legal status, and other social and cultural factors. Because refugees are forced migrants, for example, they may have more difficulty integrating into their host society due to limited language or cultural literacy skills or other mental health conditions related to displacement (Wahoush, 2009²⁴).

Our investigation aimed to learn about refugees’ social vulnerability to disasters in the rural Texas Panhandle and how social determinants of health shape their perceptions of climate-related health risks and disaster preparedness. By revealing refugees’ perspectives on climate hazards and health risks, we will help build an evidence-base of refugees’ disaster preparedness and response needs (Adams et al., 2024²⁵).

Research Questions

To address the research gaps concerning refugees and their social vulnerability to climate hazards and health risks in the rural Texas Panhandle, we sought to answer three research questions:

1. What are refugees’ current levels of social vulnerability in response to the health risks caused by climate-related disasters in rural communities?

2. How do social determinants of health influence refugees’ exposure to information about the health risks caused by climate-related disasters?

3. How do social determinants of health and refugees’ exposure to health information affect refugees’ perceptions of the health risks caused by climate-related disasters?

Research Design

This study was designed to assess the risk perceptions and behaviors of refugees in the Texas Panhandle. We used survey research methods because this approach allows researchers to collect descriptive data about individuals. We used a paper-and-pencil survey format and relied on refugees’ self-reported answers. The survey (Appendix A4) had 63 questions that asked respondents about their demographic background (e.g., age, gender, country of origin, climate-related disaster experiences, health information seeking and scanning activities, and perceptions of health risks caused by climate-related disasters.

Refugees are a hard-to-reach population due to the language and cultural barriers described above. It is also difficult to develop population-based sampling frames because “there is no exhaustive listing of group members for random sampling” (Pham et al., 2023, p. 1631²⁶). For these reasons we employed a community-based research approach and worked closely with community organizations to recruit survey participants. This report is based on findings from 177 refugees in the Texas Panhandle that agreed to participate in the survey. Our recruitment methods and survey sample are described in more detail below after the description of our study site.

Study Site and Access

The Texas Panhandle is a rural area dominated by agriculture and home to the highest concentration of cattle feeding operations in the nation. According to the rural classification of the U.S. Department of Agriculture (2024²⁷), only five counties among the 26 counties in the Texas Panhandle are not classified as rural area. It is also a place with a growing refugee population with people resettling from Afghanistan, Cuba, Iran, Myanmar, and Somalia, among other countries. The city of Amarillo, the largest city in the area, has one of the highest per capita rates of refugee resettlement in Texas (Fernandez, 2020²⁸; Refugee Language Project, n.d.²⁹).

The Texas Panhandle has also been experiencing a growing number of climate-related disasters in recent years. In June 2023, for example, a historical flash flood event caused by a unique and rare weather pattern devastated Amarillo. Multiple days of heavy rain resulted in area rivers and creeks flooding streets, businesses, and residences. Over 200 people and 50 pets had to be rescued (National Weather Service, n.d.³⁰). In the same month, two tornados hit the area within one week (Burt, 2023³¹). On June 15, a tornado hit the rural town of Perryton, Texas, killing three and injuring more than 100 people. On June 21, another tornado struck the rural community of Matador and killed four people.

Survey

Survey Recruitment and Distribution

We conducted a survey to address our research questions. Over the past two years, our team has established close connections with the Amarillo Public Health Department and community organizations in the area including Catholic Charities of the Texas Panhandle, Refugee Language Project, and Amarillo Chin Christian Church while working on multiple research projects. To recruit participants for this study, we worked closely with these organizations to gain access to refugee populations. We contacted the organizations to explain the purpose of the study and obtained their permission to distribute our survey at their public events—which included cultural orientation workshops, book club meetings, holiday luncheons, and church services.

Prior to recruiting research participants, we anticipated that large numbers of them would have limited English proficiency. So, we contracted bilingual people from the refugee communities to translate the consent form and the survey questionnaire into Spanish, Burmese, Chin (an ethnic language in Myanmar), and Swahili. Translators were not staff members at community-based organizations, but rather were members of their own ethnic groups with whom we had established personal connections over the past two years at multiple public events. We provided the translators with a sample copy of our survey questionnaire in English and asked them to translate it into their ethnic language. We paid each translator $100 to acknowledge and reward their work. We also anticipated that refugees would have limited capacities to complete surveys online on computers or mobile devices. For that reason, we disseminated paper-and-pencil questionnaires during the events.

We attended 20 events to recruit research participants. To inform people at the events about the opportunity to take the survey, the organizations offered opportunities for us to introduce our research project. We asked people who came up to us if they were interested in participating in our study and explained that participants had to be refugees and 18 years or older. If the person said they met these criteria, we gave them the consent form to read. Once the person understood our research objectives, types of data to be collected, research procedure, and potential risks, they could choose to sign the consent form. After receiving the participant's consent, we asked them to complete the written questionnaire in-person at the event. It took each participant about 10 minutes to complete the questionnaire and they received a $5.00 Walmart gift card in exchange as an appreciation gift.

Survey Sample

As shown in Table 1, the study participants were from various countries including Cuba, Myanmar, Congo, Thailand, Rwanda, Uganda, and Somalia, with a mean age of 37.97 years. We asked respondents to evaluate their English proficiency on a scale ranging from “no proficiency or complete inability to communicate in English” (1) to “native-level proficiency or near-native fluency” (10). Their average score was 3.88. Participants had been living in the United States for an average of 6.3 years. The average household size was 4.16 people. Gender distribution was nearly balanced, with 46.9% male and 52.0% female. We discuss other demographic variables in the survey—including participants’ education, income, employment, and housing type—below, in the section on the social vulnerability of refugees. (Table A1 in the appendix provides the full participant demographic results table.)

Table 1. Select Demographic Characteristics of Survey Respondents

Characteristic	n	M	SD	Min	Max
Age (Years) a	176	37.97	12.98	18	78
English Proficiency (On a Scale of 1-10) b	158	3.88	3.08	0	10
Time of Stay in the United States (Months) c	164	76.19	101.07	0.13	720
Household Size d	175	4.16	1.99	1	10
Gender e (n = 177)	n	%
Male	83	46.9
Female	92	52.0
Country or Area of Origin f (n = 169)	n	%
Cuba	92	54.4
Myanmar	51	30.2
Thailand	5	3.0
Mexico	3	1.8
Afghanistan	2	1.2
Congo	5	3.0
Uganda	3	1.8
Rwanda	2	1.2
Kenya	3	1.8
Nigeria	1	0.6
Somalia	1	0.6
Africa	1	0.6

Survey Measures: Independent Variables

We included independent variables in the survey that have been linked in the research literature to the multiple dimensions of the social determinants of health. These include variables associated with dimensions of economic stability (e.g., employment, housing status, annual income), education (e.g., high school graduation, language and literacy), neighborhood and built environment (e.g., access to healthy foods, free from crime and violence), and social and community context (e.g., civic participation, social cohesion). We did not ask refugees about their health and healthcare access, because per the U.S. Department of Health and Human Services regulations, refugees had access to a similar set of healthcare programs provided by the Office of Refugee Resettlement, including basic health coverage, medical screening, mental health and wellness, etc. (Office of Refugee Resettlement, 2023³²). Refugees are eligible for this healthcare service for up to eight months after arrival in the United States. After eight months, they might be eligible to other health insurance such as Medicaid or Marketplace (U.S. Department of Health and Human Services, 2019³³).

In selecting demographic variables to include in the survey, we followed recommendations from Bigsby and Hovick (2018³⁴) and used variables associated with measuring social determinants of health. The demographic variables we measured included age, gender, educational level, household size, zip code, housing status, annual household income, employment status, country of origin, English language proficiency, and number of years/months staying in the United States.

To measure refugees’ involvement in social groups, we asked participants if they had been involved in a collection of social groups identified by Beaudoin and Thorson (2004³⁵). We included nine types of social groups: business or civic groups like Kiwanis or Rotary, religious organizations, charity or volunteer organizations, ethnic or racial organizations, neighborhood associations, parent-teacher association or other school-related organizations, political clubs or organizations, social clubs such as card playing, music, hobbies, book clubs, and youth groups like scouts or children’s sports. We added up participants’ scores for all the groups to measure their involvement in social groups.

For the questions measuring how refugees perceived their neighborhoods and their social and community contexts, we employed questions using a 7-point Likert scale with answer options ranging from “strongly disagree” (1) to “strongly agree” (7). To measure perceived neighborhood characteristics, we adopted a 12-item construct from Auchincloss et al. (2009³⁶). The items in this composite measure included the suitability of the environment for physical activity (e.g., “my neighborhood offers many opportunities to be physically active”), free from crime and violence (e.g., “my neighborhood is safe from crime”), and the availability of healthy foods (e.g., “a large selection of fresh fruits and vegetables is available in my neighborhood”). We used three questions to measure how refugees perceived their social and community contexts and their collective efficacy (Bateman et al., 2017³⁷). These questions asked about their feelings of social cohesion and trust (e.g., “this is a close-knit or unified neighborhood”).

We employed a separate 4-point Likert scale to ask refugees about their information seeking behaviors and exposure to health information, with answer options ranging from “not at all” (1), “occasionally” (2), “sometimes” (3), and “a lot” (4). To ask refugees about their information seeking activities we adapted questions from Dillard et al. (2021³⁸). The questions included such items as “within the past six months, how actively have you looked for information about the health risks caused by climate-related disasters”?

To ask refugees about their exposure to information about the health risks associated with climate-related disasters, we used the concept of information scanning from Shim et al. (2006³⁹). Information seeking refers to active and intentional behaviors to acquire specific kinds of information (Case & Given, 2012⁴⁰). It encompasses all the “active efforts to obtain specific information outside of the normal patterns of exposure to mediated and interpersonal sources” (Niederdeppe et al., 2007, p.155⁴¹). In the current research context, information seeking refers to activities such as actively searching for disaster-related information. We adapted the scales from Bigsby & Hovick (2018) to measure information seeking: “within the past six months, how actively have you looked for information about the health risks caused by climate-related disasters from the following sources”? The sources we asked about included traditional media outlets like TV and radio, social media, and interpersonal communication channels.

Information scanning is a less purposeful mode of information acquisition (Niederdeppe et al., 2007), which is defined as “information acquisition that occurs within routine patterns of exposure to mediated and interpersonal sources that can be recalled with a minimal prompt” (p.154). A typical kind of information scanning is people coming across information in the media, even if they do not actively look for it (Niederdeppe et al., 2007). We adapted a survey question from Shim et al. (2006) to assess information scanning: “Within the past six months, how actively have you paid attention to information about the health risks caused by climate-related disasters”? The information sources we asked about were the same as the information seeking.

Survey Measures: Dependent Variables

The survey included several dependent variables. The first dependent variable was disaster preparedness and we measured it using one question: “Think about preparing yourself for a climate-related disaster, which of the following best represents your degree of preparedness.” Respondents could choose from one of six answer options, ranging from “I am NOT prepared, and I do not intend to prepare in the next year” to “I have been prepared for more than a year and continue preparing.” Respondents who were not prepared could also say whether they intended to prepare within the next year or six months, whereas prepared respondents could also say if they had been prepared for less than one year. If respondents did not know or did not want to answer, they could also choose this response option. We used composite measures from the Extended Parallel Processing Model (EPPM) developed by Witte and colleagues (Witte, 1992⁴², 1994⁴³, 1996⁴⁴; Witte et al., 2001⁴⁵) to measure how refugees perceived the severity of health risks associated with climate disasters, their susceptibility to them, and their capabilities to cope with these risks. The EPPM posits that two characteristics—perceived threat and perceived efficacy—are the major predictors of one’s intentions to take protective actions to deter threats and risks. Perceived threat encompasses two constructs: perceived susceptibility and perceived severity (Witte, 1996). Perceived susceptibility refers to “beliefs about one’s risk of experiencing the threat” (Witte et al., 1996, p. 320), and perceived severity refers to “beliefs about the significance or magnitude of the threat” (p. 320). Perceived efficacy also includes two constructs. One is response efficacy, which refers to “beliefs about the effectiveness of the recommended response in deterring the threat” (p. 320). The other construct is self-efficacy, which means “beliefs about one’s ability to perform the recommended response to avert the threat” (p. 320). The model suggests that individuals are likely to perform a recommended preventive action when they develop highly perceived threat and perceived efficacy.

We used composite measures or scales to assess refugees’ perceived severity, susceptibility, response efficacy, and self-efficacy to climate hazards. The questions that we employed for these composite measures asked respondents to provide an answer corresponding to a 7-point Likert scale which ranged from “strongly disagree” (1) to “strongly agree” (7). Perceived susceptibility to and perceived severity of the health risks caused by climate-related disasters were assessed using scales adapted from the EPPM (Witte et al., 2001). We employed three questions to measure perceived susceptibility, (e.g., “it is likely that I will be affected by the health risks caused by climate-related disasters.”) We used three other questions to measure perceived severity, (e.g., “I believe that the health risks caused by climate-related disasters are severe.”) We also used three questions to measure response efficacy, which describes how respondents perceive the preventive actions that they take prior to disasters (e.g., “simple things that I do at home can reduce the risks that extreme weather events post to my household”). And we used three-questions from Witte et al. (2001) to measure refugees’ perceived self-efficacy for taking preventive actions, which includes signing up for alerts to reduce the health risks caused by climate-related disasters (e.g., “I am able to sign up for Amarillo Weather and Health Alerts to prevent the health risks caused by climate-related disasters”). Table A2 in the appendix shows variable correlations.

Data Analysis Procedures

We used SPSS software to calculate the means and standard deviations of all the variables. To test the direct effects of social determinants and health information exposure on refugees’ perceptions of the health risks caused by climate-related disasters, we conducted multiple linear regression analyses.

Ethical Considerations, Researcher Positionality, and Reciprocity

We obtained the approval for this research project from the Institutional Review Board at West Texas A&M University on December 1, 2023 (WTAMU IRB #2023.11.007). As explained above, we collected consent forms from the research participants prior to having them fill out questionnaires. All the collected data remained confidential and no individually identifiable information was collected.

In addition to compliance with the IRB guidelines, we strictly adhered to the guidelines of respect for persons, beneficence, and justice in disaster research. To achieve this goal, we adopted several approaches. First, both the consent form and survey questionnaire were translated into the languages that refugees spoke and read. This ensured that refugees truly understood our research purpose and procedures and voluntarily participated in our study. Second, we honored refugees’ cultural practices, experiences, and perceptions and their personal feelings about health and disasters. While we were attending refugee communities’ cultural events, we respected their practices, norms, and values and ensured that our behaviors were culturally appropriate. Third, we prioritized flexibility to accommodate refugees’ preferences and comfort levels. We always recruited survey participants within refugee communities and distributed questionnaires at the locations where they felt the most comfortable. Finally, we engaged community leaders and liaisons who could bridge the gap between us and refugee communities. Those community liaisons and leaders encompassed staff members of community organizations and members from refugee communities such as church pastors, college students, and nurses. They facilitated understanding, built trust, and ensured the research process was respectful and inclusive.

In addition, as a form of reciprocity and to show our appreciation to the refugee-serving organizations and the refugees who participated in this research, our research team conducted cultural orientation workshops for newly arrived refugees at the Catholic Charities of the Texas Panhandle every two weeks during the spring of 2024. In total, we conducted 15 workshops during the research period. The workshops covered disaster preparedness, public health awareness, and job readiness and provided essential information for newly arrived refugees about the host community. Our engagement and activities have been mutually beneficial for both our research project and the local community.

Results

Social Vulnerability of Refugees in Texas Panhandle

Our first research question concerned the social vulnerability of refugees in the Texas Panhandle to climate-related disasters. The survey data shows refugees had numerous socioeconomic disadvantages. As Table 2 shows, most respondents had annual household incomes below the median household income in Amarillo, which was $55,174 (Data USA, n.d.⁴⁶); 45.7% earned below $49,999 and 57.6% below $74,999. The educational level of refugees was also relatively low, with only 17.5% of respondents holding a bachelor's degree or higher. As mentioned above, refugees were asked to rate their English proficiency on a scale of 1-10; their average score on this question was 3.88, which suggests a significant need for English language support and education among the Texas Panhandle refugee population. Furthermore, more than half (56.5%) of the respondents were not employed, indicating potential barriers to workforce participation, which may be linked to language proficiency and educational background as well as low reported incomes.

Table 2. Demographic Indicators of Social Vulnerability Among Survey Respondents

Demographic Characteristic	n	%
Education (n = 161)
Less Than High School	37	20.9
High School or GED	43	24.3
Some College or Associate Degree	50	28.2
Bachelor’s Degree	22	12.4
Master’s Degree	5	2.8
Professional or Doctorate	4	2.3
Annual Household Income (n = 130)
Less Than $25,000	45	25.4
$25,000- $49,999	36	20.3
$50,000- $74,999	21	11.9
$75,000- $99,999	7	4.0
$100,000- $149,999	0	0
$150,000 or more	0	0
Prefer Not to Say	21	11.9
Housing Status (n = 174)
Renting an Apartment	67	37.9
Renting a House	41	23.2
Owning an Apartment	1	0.6
Owning a House	47	26.6
Renting/Owning a Mobile Home	3	1.7
Homeless	2	1.1
Other	13	7.5
Employment Status (n = 168)
Full-Time Employment	52	31.0
Part-Time Employment	19	11.3
Self-Employment	2	1.2
No Employment	95	56.5

To understand their community contexts, we asked respondents to provide their current zip code as that datapoint often correlates with socioeconomic factors such as income levels, access to resources, and quality of infrastructure. Table 3 reveals a notable concentration of respondents residing in neighborhoods characterized by lower median household incomes, indicating refugees were living among neighbors with socioeconomic constraints. The largest percentage of refugees (31.6%) resided in the 79107 zip code areas, with a medium household income of $38.047. Other zip codes where a considerable portion of our participants resided included 79101, 79102, and 79104, which had lower median incomes. In contrast, very few respondents resided in zip codes with higher median household incomes. For example, only 1% of our sample participants resided in 79124, an area with a median income of $101,604.

Table 3. Participant Zip Code and Median Household Income

Zip Code	Median Household Income in Zip Code ($)	Survey Respondents in Zip Code
		n	%
79107	38,047	55	31.6
79101	38,291	8	4.5
79104	45,119	14	7.9
79102	47,878	29	16.4
79013	49,013	1	0.6
79106	50,271	8	4.5
79045	52,124	2	1.1
79103	53,879	12	6.8
79414	58,439	1	0.6
79110	63,647	4	2.3
79029	65,101	6	3.4
79109	67,831	22	12.4
79019	70,167	1	0.6
79121	73,375	1	0.6
79118	82,990	9	5.1
79124	101,604	1	0.6

To further understand how refugees are shaped by their community contexts, we explored their perceptions of their neighborhoods and feelings of social cohesion and trust with their neighbors. Our findings show that the average score on the neighborhood perception item was 4.98/7, which meant that refugees had slightly positive perceptions of their neighborhoods. More specifically, they tended to see their neighborhoods as having spaces for physical activity, providing access to fresh food, and having low levels of crime or violence. Regarding their feelings about their neighbors, the average score on this item was 4.52/7, which meant refugees believed that their neighborhood was slightly socially cohesive and trustworthy.

Despite the economic vulnerability of their neighborhoods, refugees do appear to have positive feelings about the places where they live and their neighbors. These social contexts underscore another dimension of the socioeconomic vulnerability present among the surveyed population—namely their neighborhoods are economically vulnerable but may also have elements of social cohesion and organization that foster resilience. The analysis, however, highlights challenges related to language proficiency, employment, and socio-economic status. Addressing these challenges and understanding the distribution of respondents across different socioeconomic strata is crucial for tailoring interventions and support services to address the specific needs of individuals living in disadvantaged communities.

Climate Hazard Exposure and Disaster Preparedness Among Refugees in Texas Panhandle

In terms of risks to climate-related disasters, we asked refugees if they or the people they knew were affected by a variety of natural and public health disasters. On average, 5.5% of the participants claimed that they had been affected by some disasters and 6.8% reported that someone they knew had been affected, whereas 38.1% of the participants claimed that they were uncertain about their exposure to disasters. Table 4 displays refugees’ responses to each item.

Table 4. Percentage of Respondents Affected by Climate Hazards

Climate Hazard	n	Hazard Affected Me	Hazard Affected People That I Know	Hazard Did Not Affected Me in Anyway	Don’t Know/Uncertain
Destructive Flood	164	3.7	5.5	56.1	34.8
Health Effects From Heat Waves	165	4.8	7.9	54.5	54
Health Impacts From Cold Temperatures	167	7.8	7.8	52.1	32.3
Diseases Caused by Ticks or Mosquitos	167	3.0	4.2	58.7	34.1
Damaging Winds	165	7.3	9.7	48.5	34.5
Destructive Droughts	157	6.4	5.7	49	38.9
Average		5.5	6.8	53.15	38.1

We also asked respondents whether they observed less, about the same, or more occurrences of various climate hazards in their host community than in their home countries. The climate hazards we asked about included heavy rain, floods, tornados, droughts, heatwaves, extremely cold temperatures, severe wind, and wildfires, since they moved to the Texas Panhandle. Table 5 summarizes their responses.

Table 5. Regfugee Perception of Climate Hazard Risk in Host Community Compared to Home Country

Climate Hazard	n	Percentage of Respondents
		Hazard Less Likely in Host Community	Hazard Has About the Same Likelihood	Hazard More Likely in Host Community	Don't Know
Heavy Rain	165	33.3	22.4	14.5	29.7
Floods	165	33.9	12.7	6.7	46.7
Tornados	162	28.4	16.0	4.9	50.6
Droughts	165	24.2	17.6	9.7	48.5
Heat Waves	159	22.6	21.4	12.6	43.4
Extremely Cold Temperatures	165	16.4	29.1	23.0	31.5
Severe Wind	161	11.8	29.8	18.6	39.8
Wildfires	159	15.7	15.7	11.3	57.2
Ticks	159	16.4	16.4	3.8	63.5
Mosquitos	161	16.8	19.9	8.1	55.3
Average		16.4	16.4	3.8	63.5

The results reveal notable patterns and trends across different categories of climate-related events. While some respondents perceived decreased likelihood of certain events, such as heavy rain and floods, uncertainty was prevalent across most categories, with a significant proportion of respondents being unsure about the changes in disaster occurrences. This uncertainty may stem from factors such as limited access to information, differing perceptions of what constitutes a climate-related disaster, or challenges in accurately assessing changes in environmental patterns. It also suggests potential gaps in awareness or comprehension regarding the definition and identification of climate hazards within the refugee population.

Table 6 shows the results for the levels of disaster preparedness reported by respondents. As the table demonstrates, only 8% of respondents reported that they were prepared. More than half (52.6%) reported that they intended to start preparing within six months to one year. A significant number (17.5%) said they were not prepared and had no intention of getting prepared. Overall, results suggest that most refugees are not prepared for climate hazards and may need information or other assistance to become so.

Table 6. Disaster Preparedness Levels Among Survey Respondents

Preparedness Level	n	%
I am NOT Prepared, and I Do Not Intend to Prepare in the Next Year.	14	7.9
I am NOT Prepared, but I Intend to Start Preparing in the Next Year.	55	31.1
I am NOT Prepared, but I Intend to Get Prepared in the Next Six Months.	38	21.5
I Have Been Prepared for LESS Than a Year.	7	4.0
I Have Been Prepared for MORE Than a Year and I Continue Preparing.	7	4.0
Don’t Know/Prefer Not to Answer	31	17.5
Total	152	100

These results underscore the need for further research and understanding in this area. Effective mitigation and adaptation strategies rely on accurate assessments of risks and vulnerabilities, which in turn require comprehensive understanding and recognition of climate-related hazards. Addressing gaps in knowledge and perception within communities is essential for facilitating informed decision-making, building resilience, and implementing targeted interventions to mitigate the impacts of climate-related disasters.

Social Determinants of Health and Access to Risk Information

Our second research question concerned refugees’ access and exposure to information about the health risks associated with climate hazards and how social determinants of health may influence these outcomes. First we asked refugees the information sources they had used to obtain information about preparing for climate-related disasters. As described above, respondents were able to rank their use of information seeking and scanning sources on scales ranging from “not at all” (1) to “a lot” (4). Table 7 shows that refugees had relatively low levels of information seeking and scanning activities across all types of information sources. TV, social media, and online search engines were the sources they used most, with mean scores ranging from 2.09 to 2.55 for information seeking and 2.07 to 2.52 for information scanning. Radio, newspapers, government websites, and refugee-serving organizations were the least used.

Table 7. Information Seeking and Scanning Sources

Information Source	Information seeking		Information scanning
	M	SD	M	SD
TV	2.27	1.12	2.09	1.03
Radio	1.49	0.86	1.48	0.84
Newspaper	1.56	0.93	1.61	0.95
Social Media	2.55	1.17	2.52	1.14
Online Search Engine (e.g., Google)	2.41	1.17	2.29	1.13
Families	2.28	1.13	2.07	1.04
Churches	2.14	1.16	2.01	1.10
Refugee Serving Organizations	1.71	0.98	1.70	0.99
Case Workers	1.73	1.02	1.69	0.98
Government Websites	1.72	0.96	1.78	1.02

We also asked participants about the kinds of disaster preparedness information they received from any information sources with the question: “In the past year, have you read, seen, or heard about any of the following information regarding getting prepared for disasters?” Table 8 shows that refugees were not adequately exposed to information about preparing for climate-related disasters. Less than one-third of respondents received information regarding safeguarding documents, making a plan, making their home safer, knowing their evacuation routes, or signing up for hazard warnings and alerts. Fewer people received any information introducing other preventive actions such as practice drills and plan with neighbors. Due to insufficient exposure to disaster preparedness information, refugees were not actively engaged in disaster preparedness activities, such as signing up for alerts and warnings, making plans, and practicing emergency drills. It demonstrates the need for targeted efforts to improve information dissemination and accessibility to enhance refugees’ awareness and preparedness for climate-related disasters.

Table 8. Refugee Exposure to Disaster Preparedness Information in Past Year

Type of Preparedness Information Received	n	%
Safeguard Documents	57	32.2
Make a Household Emergency Plan	57	32.2
Make Your Home Safer	57	32.2
Know Evacuation Routes	53	29.9
Sign Up for Alerts and Warnings	46	26.0
Assemble or Update Supplies	34	19.2
Practice Emergency Drills or Habits	26	14.7
Test Family Communication Plan	23	13.0
Save for a Rainy Day	21	11.9
Document and Insure Property	21	11.9
Get Involved in Your Community	19	10.7
Plan with Neighbors	18	10.2
None of the Above	14	7.9
Don’t Know	35	19.8
Prefer Not to Answer	9	5.1

We hypothesized that involvement in social groups—which, as described above, we defined as business or civic groups, religious organizations, neighborhood associations, youth groups, etc.—would increase refugees’ awareness of disaster preparedness. Results showed that refugees’ participation in social groups ranged from 0 (not involved in any types of social groups, n = 91) to 7 (being involved in seven organization types, n = 1). The average score of 0.85 on this item showed that most refugees were involved in fewer than one social group outside their own communities. Many refugees experience a period of adjustment upon arrival in a new country, which can include adapting to a new language, culture, and societal norms. This adjustment process can be time-consuming and may initially limit their ability to participate in social activities. They may also face practical challenges such as finding stable housing, securing employment, and meeting basic needs. These priorities can take precedence over social engagement, especially during the early stages of resettlement. Regarding the impact of social group participation on refugees’ information seeking or scanning activities, a simple linear regression showed that involvement in social groups significantly predicted refugees’ seeking of disaster information [F (1, 153) = 7.71, p = .006, R² = .05, B = 1.37, Beta = .22, t = 2.78] and scanning of disaster information [F (1, 153) = 6.92, p = .009, R² = .04, B = 1.32, Beta = .32, t = 2.63]. The more intensively involved in social groups, the more actively refugees sought disaster information and were more likely to be incidentally exposed to disaster information. Therefore, the low involvement of social engagement limited refugees’ information exposure.

Refugee Risk Perceptions, Perceived Efficacy, and Preparedness

The third research question concerned refugees’ risk perceptions and perceived efficacy regarding climate hazards and how social determinants of health affect these outcomes. As described above, we employed scales adapted from the EPPM to measure perceived susceptibility, perceived severity, response efficacy, and self-efficacy; response options for these composite measures used a 7-point Likert ranging from “strongly disagree” (1) to “strongly agree” (7). The average score for refugees on the perceived susceptibility scale—which measures how likely they feel it is that their health could be affected by climate hazards—was 4.69 out of 7, which suggests that refugees believed that it was slightly likely their health could be impacted in the future. Their perceived severity of these effects had an average score was 5.42 out of 7, suggesting refugees believed that the negative health impacts caused by climate hazards were likely to be moderately severe.

As mentioned above, we used two scales to assess refugees’ perceptions of their efficacy to prevent climate-related health impacts from occurring: response efficacy and self-efficacy. Their average score on response efficacy—which rates their how refugees perceive the effectiveness of preventive actions available to them—was 4.79 out of 7, which suggests refugees believed that taking preventive actions could slightly protect them from the health risks associated with climate-related disasters. Their average score on self-efficacy—which rates their perceptions of their own ability to take protective actions on such items as signing up for alerts—was 4.90 out of 7, which shows that refugees were slightly confident in their abilities to take preventive actions.

Next, we conducted a series of hierarchical multiple linear regression tests to examine the effects of social determinants of health on refugees’ perceived susceptibility to the health risks associated with climate hazards, perceived severity of those risks, response efficacy, and self-efficacy. Among risk perception variables, perceived susceptibility was the only one predicted by refugees' demographic characteristics and social group involvement. (Below we describe the results of the modeling. survey in the appendix provides the full results table.)

In Model 1, the demographics block accounted for 18% of the total variance in refugees’ perceived susceptibility to climate-related health risks: age and gender were significant predictors. Older adults were more likely to think that they might be affected by the health risks caused by climate disasters. Compared to female participants, male participants also perceived a higher level of susceptibility. In Model 2, economic stability variables, including income and employment status, did not predict the dependent variable, but age and gender remained significant predictors. In Model 3, neither economic stability variables nor education variables predicted perceived susceptibility, but age and gender continued to significantly predicted perceived susceptibility. Model 4 explained 38% of the total variance in perceived susceptibility. Age, gender, and housing status were positively associated with perceived susceptibility. Income was negatively associated with perceived susceptibility. Model 5 explained 43% of the total variance in perceived susceptibility. Age, gender, housing status, and group involvement were positively associated with perceived susceptibility. Income was negatively associated with perceived susceptibility. Overall, older age, being male, lower income, owning a house or an apartment, and more active involvement in social groups predicted higher perceived susceptibility to the health risks caused by climate-related disasters.

Our regression analyses of response efficacy and self-efficacy produced two outcomes of note. Regarding response efficacy, neighborhood characteristics significantly predicted the outcome, F (1, 124) = 5.97, p =.02, R² = .05, B = .31, Beta = .21, t = 2.44. Those who perceived their neighborhood as safe and convenient were more likely to believe that preventive actions could effectively reduce the health risks caused by climate-related disasters. Regarding self-efficacy, social and community contexts significantly predicted the outcome, F (1, 158) = 9.10, p =.003, R² = .05, B = .26, Beta = .23, t = 3.02. Those who perceived members of their communities as credible and trustworthy felt more confident in their abilities to prevent the health risks caused by climate-related disasters.

Discussion

Refugees in the Texas Panhandle Lack Information about Climate Hazards and Disaster Preparedness

Overall, the survey results highlight significant socioeconomic disadvantages among the surveyed refugee population, with a majority earning below the city’s median household income and possessing lower levels of educational attainment. Language proficiency also emerged as a challenge, with respondents reporting a low perceived proficiency in English. The concentration of respondents in neighborhoods characterized by lower median household incomes underscores the prevalence of economic vulnerability within the refugee population.

In addition, refugees in the Texas Panhandle lack information about the climate hazards that they are exposed to and their potential health effects. While a small percentage reported experiencing or knowing individuals affected by various climate-related events, with uncertainty prevalent across most categories. Our results also showed that most refugees in our sample (52.6%) were not prepared for climate hazards, although they intended to prepare within the next six months or year. It was also concerning that 17.5% of them were not prepared and had no intention to get prepared. This data underscores a concerning gap between awareness and action, highlighting the urgent need for targeted interventions to bridge this disparity and foster proactive measures towards disaster preparedness among refugee communities.

Indeed, the results showing that refugees have low levels of information seeking and scanning activities may be the result of communication barriers. Few mass media or commercial social media channels provide information in the languages refugees speak. Given refugees’ low level of perceived English proficiency, it was likely that language barriers prohibited them from obtaining disaster information from those media channels. Accordingly, disaster information in refugees’ languages can help enhance refugees’ access to and use of diverse information sources. Webpages, apps, brochures, and posters in refugees’ languages can contribute to refugees’ exposure to reliable disaster information.

Local governments and community-based organizations are encouraged to devote more efforts to learn about the languages refugees speak and create disaster communication materials in corresponding languages. Local disaster management agencies should also consider developing empowerment-based education and training programs tailored to the needs of refugee communities. As Lejano et al. (2020⁴⁷) suggested, people might experience disempowerment and therefore became passive during disaster communication. Therefore, the empowerment-based approach emphasizes co-construction of risk knowledge and information in the communication process. In addition to raising awareness, events such as workshops and hands-on training sessions can teach refugees about practical skills and encourage peer-to-peer conversation.

Involvement in Social Groups Increases Refugees’ Disaster Preparedness

Our results showed that involvement in social groups positively predicted refugees’ disaster information seeking and scanning activities. In their research with the service providers at refugee-serving organizations, Xie and Chen (2023⁴⁸) found that refugee-serving organizations allowed refugees to gain a variety of cognitive and structural social capital through their interactions with service providers. Our research findings demonstrate that involvement in local organizations could have motivated refugees to actively seek more information and increased their exposure to disaster preparedness information. The findings further demonstrate the necessity of involving refugees in local groups and organizations: refugees not only directly receive tangible and intangible forms of support from those groups and organizations (Xie & Chen, 2023), but they also expose themselves to disaster preparedness information, which subsequently raises their awareness of disasters preparedness and encourages them to take actions to get prepared.

Refugee Perception of Susceptibility to Climate Hazards Is Shaped by Social Engagement Outside the Home

Among the EPPM variables, perceived susceptibility to health risks associated with climate hazards was the only variable predicted by demographic and social characteristics. In particular, being older and male, having lower income, owning a house or an apartment, and active involvement in social groups predicted higher perceived susceptibility. The findings have several explanations and implications. First, refugees’ overall perceived disaster severity, response efficacy, and self-efficacy did not vary across groups, whereas perceived susceptibility was the only thing that might change due to refugees’ different levels of involvement in the host society and competence in processing disaster information. Second, susceptibility was predicted by older age, owning a house or an apartment, and involvement in social groups. These three variables indicate that refugees who were better adjusted to the host society were more concerned about the likelihood of disaster occurrences. Some refugees might have personally experienced a natural disaster while residing in Texas, leading to higher perceived susceptibility. For others, knowing more about the natural environments of the host society could have increased their perceived susceptibility to disasters.

Higher perceived susceptibility did not indicate higher actual susceptibility to disasters but indicated a better awareness of disasters. Therefore, more education and communication efforts are needed to target those who have not been sufficiently adjusted to the host society. As other scholars have suggested, reach, relevance, reception, and relationship are all important factors affecting people’s disaster perceptions (Buylova et al., 2020⁴⁹; McNeill et al., 2018⁵⁰). For example, people with limited financial resources, low linguistic competency, and limited social networks are less likely to see disasters as relevant to them (Marlowe et al., 2022⁵¹). Therefore, the host community and community organizations should ensure refugees have access to resources and information critical to assisting them.

Third, lower income predicted higher perceived susceptibility to disasters as well. It was likely that refugees with lower incomes face higher risks of climate-related disasters, therefore, more research is needed to examine the relationship between refugees’ perceived susceptibility to disasters and their actual susceptibility to disasters. Finally, gender played a role in affecting perceived susceptibility, such that males found them to be more susceptible to disasters than females. In line with our discussions of the previous two points, the effects of gender had two possible explanations. It was likely that male refugees faced higher risks of disasters because many of them worked outside or in industries with known health risks such as meat packing plants. According to the U.S. Department of Agriculture (2021⁵²), rural counties with a high concentration of meatpacking plants also have high poverty rates. As became evident during COVID-19 pandemic, conditions in meatpacking plants make them susceptible to spreading respiratory and other viruses; indeed the meatpacking plants in Texas had the state’s highest COVID-19 infection rate (Ura, 2020⁵³).

Men may also have opportunities to become more socially adjusted to their host society than women due to cultural traditions or childcare concerns that keep women in their homes. As Xie and Chen (2023) identified, due to their religious and cultural traditions, refugees from a number of ethnic groups tried to “preserve” their traditional gender roles that discouraged women from taking part in social or community activities. Having more interactions with local residents and knowing more about the local society made male refugees more aware of the likelihood of disasters. Regardless of the reasons behind this phenomenon, risk communicators and disaster management professionals should consider gender difference in their communication to refugees to address gender-specific needs.

Neighborhood Characteristics and Efficacy

The findings from our regression analyses reveal some potential strategies for disaster preparedness intervention. Specifically, our study underscores the significance of self-efficacy and response efficacy in influencing individuals’ beliefs in their ability to effectively respond to and mitigate the impacts of disasters. This aligns with existing literature on self-efficacy (Adams et al., 2019⁵⁴; Wang et al., 2021⁵⁵), which posits that individuals’ beliefs in their capacity to effectively respond to challenges significantly impact their preparedness efforts. Moreover, our results highlight the role of perceived neighborhood characteristics and social/community context in influencing these key determinants of preparedness. These findings resonate with the broader literature on self-efficacy and preparedness, which emphasizes the importance of environmental and social factors in bolstering individuals' confidence and abilities to navigate disaster scenarios.

Our study underscores the importance of tailored interventions aimed at enhancing refugees' self-efficacy and response efficacy in disaster preparedness. Specifically, policymakers and service providers can play a pivotal role in fostering environments conducive to building refugees' confidence in coping with disasters and associated health risks. By prioritizing initiatives such as creating safe and accessible neighborhoods, enhancing infrastructure to promote physical activities, and fostering social cohesion within and between refugee communities and local populations, stakeholders can empower refugees to effectively respond to disasters. Notably, these efforts extend beyond mere disaster communication or management, but they serve as mechanisms for empowering refugees to navigate and overcome the challenges posed by disasters, thereby fostering resilience and community well-being.

Conclusions

Public Health Implications

The research findings underscore the complex interplay between social determinants of health, risk communication behaviors, risk perceptions, and disaster preparedness among refugee populations in rural areas. This study has several implications for public health practice and policy that can be applied to address refugees’ social vulnerability and health risks to climate hazards.

Social Vulnerability and Health Risks. The significant socioeconomic disadvantage of refugees underscores the need for targeted interventions to address economic disparities and improve access to resources, education, and employment opportunities. Policies focusing on economic stability, language support, and educational initiatives could help alleviate barriers to workforce participation and socioeconomic integration among refugee populations.

Climate-Related Disaster Preparedness. The low levels of perceived risks and awareness of climate-related disasters among refugees highlight the importance of enhancing awareness and preparedness efforts. Public health interventions should prioritize educational campaigns, community outreach programs, and disaster preparedness training tailored to the specific needs and cultural backgrounds of refugee communities.

Information Seeking and Scanning Behaviors. Our findings suggest a need for targeted efforts to improve refugees' access to and use of diverse information sources related to disaster preparedness. Public health initiatives should focus on leveraging trusted channels such as social media, community organizations, and refugee-serving agencies to disseminate reliable and culturally appropriate information about climate-related risks and the corresponding preventive actions.

Perceived Susceptibility and Response Efficacy. Improving neighborhood characteristics and building social support networks can enhance refugees' self-efficacy and response efficacy regarding climate-related health risks. Community-based interventions aimed at fostering social cohesion, neighborhood safety, and community resilience can empower refugees to adopt preventive actions and mitigate the negative impacts of disasters on health.

Community-Based Approaches to Disaster Preparedness. Policymakers should consider implementing specific policy measures aimed at addressing the unique needs of refugees by leveraging their connections to social groups and neighbors. For example, investing in community-based disaster preparedness and response programs, such as providing training in disaster preparedness and response, establishing community emergency response teams, launching public education and awareness campaigns, fostering community relationships, and facilitating the development of neighborhood-level disaster plans, can empower vulnerable populations to take proactive measures to protect themselves and their communities.

Limitations

This study has several limitations. First, since some refugee populations do not actively participate in events organized by the refugee-serving organizations or other community groups where we recruited research participants, we faced challenges in accessing these communities. Many of these refugee groups are socially isolated from broader society, limiting our ability to include their perspectives in our dataset. In fact, those refugee communities might be the most vulnerable to disasters and have the greatest need for disaster preparedness information, but their voices were not represented in our study. Second, although we provided survey questionnaires in various languages, the translators we hired may have spoken a different dialect or variant of the language that respondents had difficulty understanding. Respondents may have also had low literacy levels that affected their understanding of survey questions and response options, leading to misinterpretation or difficulty in providing accurate responses. Finally, the study focused on a specific set of social determinants of health, information exposure sources, perceived susceptibility, and disaster preparedness measures. Other factors, such as access to healthcare services, social support networks, and cultural beliefs, were not fully explored, limiting the comprehensiveness of the analysis.

Future Research Directions

Building upon the insights gained from this study, we plan to continue studying this topic by focusing on several specific areas to advance understanding and inform targeted interventions for refugee populations in rural communities.

First, we plan to delve deeper into the role of literacy and reading comprehension abilities among refugee populations in understanding disaster preparedness and health education information. This includes exploring the impact of language barriers and educational backgrounds on refugees’ access to, understanding of, and engagement with disaster-related information. Based on this, we will explore the effectiveness of culturally and linguistically tailored interventions in enhancing refugees’ awareness, preparedness, and response to climate-related disasters. The goal is to develop and test educational materials, communication strategies, and community-based programs that resonate with the cultural norms, values, and languages of diverse refugee groups.

Second, we will continue examining the influence of social networks, community organizations, and informal support systems on refugees’ disaster preparedness and resilience. For example, we will continue our ongoing research on the role of social capital in facilitating information-sharing, decision-making, and collective action among refugee populations in rural settings.

Third, we will conduct longitudinal studies to track changes in refugees' knowledge, attitudes, and behaviors related to disaster preparedness over time. The follow-up studies will evaluate how intervention programs, community partnerships, and policy initiatives are effective in improving refugees’ access to reliable disaster communication information and resources and enhancing their resilience to the health risks caused by climate-related disasters.

By addressing the above research priorities, we hope to contribute to the development of evidence-based interventions and policies that empower refugee communities to effectively mitigate, adapt to, and recover from the health impacts of climate-related disasters in rural areas.

Acknowledgments. We sincerely appreciate the invaluable support we have received from Catholic Charities of the Texas Panhandle, Amarillo Chin Christian Church, Amarillo Emmanuel Revival Church, Samantha Moreno, Samuel Uwimana, and Biak Nung during our data collection process.

References