Post-Migration Stressors and Mental and Physical Health among Refugees and Migrants in Need of Protection: A Mixed-Methods Analysis with Weekly Panel Data

Refugees and migrants in need of protection (MNP) experience high levels of psychological distress and somatic symptoms—physical symptoms linked to stress. While a large body of literature explores the relationship between pre-migration trauma and health, less is known about the role of post-migration stressors. Drawing on a novel 13-week intensive panel survey (N=247 individuals; 3,093 observations) and in-depth interviews (N=65) with MNP in Costa Rica, I examine the relationship among stressors, psychological distress, and physical symptoms in the receiving context. Quantitative analysis highlights that post-migration stressors, including economic precarity and discrimination, are strongly associated with heightened psychological distress, which in turn increases the likelihood of somatic symptoms. Interview data corroborate these results and further uncover how MNP perceive and articulate the process of somatization. This study advances understanding of the dynamic pathways linking stressors, psychological distress, and physical health, offering both theoretical insights and practical recommendations for service providers and policymakers.