a respondent was likely a refugee – rather than to ask explicitly about citizenship status. Because many Afghan nationals living in Pakistan lack documentation and are not registered with UNCHR as either asylum seekers or confirmed refugees (UNCHR, 2024b), the study did not differentiate between verified refugees, asylum seekers and unregistered Afghan nationals, the group of which are collectively referred to as “refugees” within this paper. Enumerators determined refugee status of the household by confirmation of at least one of the following factors: the primary caregiver or her parents were born in Afghanistan; the use of Afghani Pashto, Persian and/or Dari as the primary language in the home; respondent declined to share identification, or the target child’s date of birth card or other documentation was valid for Afghanistan but not Pakistan; community leaders had identified the household as Afghani; or enumerator-reported knowledge of the household’s refugee/migrant status based on previous survey engagement. A “yes” response to any one of these indicators placed the respondent and household in the refugee category for analytical purposes.

_Food Insecurity._ Food insecurity was assessed by the Food Insecurity Experience Scale (FIES), an 8-item questionnaire comprised of yes/no questions relating to experiences of food insecurity. It has been previously used in Pakistan and found to be reliable (Afridi et al., 2021). The Cronbach’s alpha of the scale was .91, indicating high internal consistency reliability.

_Asset Index._ An asset index was calculated by a principal components analysis of a series of questions related to household materials, access to water, and home ownership, among other resource-related factors. For each household, based on respondent report, an asset quintile was created to categorize by quintile from lowest asset index values (quintile 1) to highest asset index values (quintile 5).

_Flooding Impact._ Respondents were asked a series of questions about the impact of flooding on their day-to-day life in both 2022 and 2023. Households were categorized as being “impacted by flooding” if they answered “yes” to at least one question about whether flooding impacted their day-to-day life in 2022 or 2023.

_Domestic Violence._ Domestic violence experiences and attitudes were measured based on selfreport using three questions: (a) In your opinion, is a husband justified in hitting or beating his wife? (b) Did your husband ever hit or beat you? And (c) Are (were) you afraid of your husband: most of the time, sometimes, or never? These questions have been used in the Government of Pakistan Demographic and Health Survey 2017-2018. For the regression analyses, fear of husband was controlled for as it was the only variable that was correlated with all mental health outcomes and child development. Fear of husband was categorized from 1 to 3, with 1 indicating never afraid, 2 indicating sometimes afraid, and 3 indicating afraid most of the time.

_Community Safety._ Perceptions of and experiences of safety in the community (or lack thereof) were determined by exposure to crime (i.e., if anyone has taken or tried taking something from you by using force or threatening to use force in the last 12 months) and perceptions of safety in the community—specifically, feeling safe while home alone at night or while walking through the neighborhood alone after dark.

_Discrimination._ Respondents were asked if, in the past 12 months, they felt discriminated against or harassed on the basis of ethnic origin, immigration or refugee status, sex, sexual orientation, 8