"until We Can Stand on Our Own": A Mixed Methods Study of Benefit Utilization Among Recently Resettled Afghans In St. Louis, Missouri

Background and Purpose: This study is one of the first to investigate access to government assistance programs among recently arrived Afghan refugees in the United States, a group characterized by an unprecedented scale of arrival and complex post-resettlement needs. While structural barriers such as informational gaps, administrative burdens, and psychological deterrents are known to hinder benefit access across the general U.S. population, this research fills a critical gap by exploring how these factors shape the experiences of recently resettled Afghans navigating the resettlement landscape.

Methods: This study utilizes a convergent mixed methods design. Qualitative data consisted of 27 semi-structured interviews and two focus group discussions, conducted in Dari or Pashto, with 39 newly resettled Afghans, two community leaders, and one service provider. Participants were recruited using purposive sampling to ensure diversity in age, gender, length of stay in the U.S., education, and employment. Qualitative data were analyzed through Strauss and Corbin’s coding paradigm. Quantitative data were collected through a cross-sectional survey of 172 Afghan households, recruited through convenience and snowball sampling. The survey was available in Dari, Pashto, and English. These data were analyzed using descriptive statistics to determine program participation rates and ordered logistic regression to identify key predictors of benefit utilization levels.

Results: Qualitative findings revealed the critical role of public benefits for refugees, benefit cliffs as a structural barrier to economic integration, informational and compliance barriers to benefit utilization, a disconnect between refugee expectations and the realities of the resettlement process, and a reliance on individual caseworkers rather than the broader institutional system. Quantitatively, 80.81% of households accessed at least one benefit program, though participation was largely concentrated in Medicaid and SNAP. Ordered logistic regression models indicated that larger household size (OR = 1.60, p < .001), income poverty (OR = 3.95, p = .003), and heightened vigilance (OR = 1.10, p = .031) were significant predictors of increased benefit use. The study further details areas of convergence and divergence between these qualitative and quantitative findings.

Conclusions and Implications: The findings have several implications for social work practice and policy. Key among them is a critical need to transition resettlement services from caseworker-dependent practice models toward systemic empowerment and bureaucratic literacy training for refugees to better support their ability to engage with systems in the U.S. and their long-term integration. Proposed interventions include trainings on identifying and understanding government communications, digital literacy, and strategies to mitigate benefit cliffs. Informational barriers should be addressed through comprehensive post-arrival orientations that transparently discuss eligibility criteria for various benefit programs and application and re-enrollment processes. Caseworkers should also adopt trauma-informed approaches that acknowledge the psychological burden associated with navigating systems perceived to be discriminatory. At the macro level, policy interventions, such as automatic enrollment and cross-program eligibility checks, are necessary to reduce administrative burdens. Furthermore, as federal policies increasingly restrict access to various assistance programs, the study emphasizes that sustained advocacy is vital to protecting the support structures essential for the wellbeing and integration of newly arrived refugees.