Aging Alone in the City: Systemic Exclusion, Social Isolation, and Loneliness among Older Refugees in Nairobi, Kenya.

Protracted urban displacement poses unique challenges for older refugees, yet their mental health and psychosocial wellbeing remain underexplored. This study examines the experiences of older refugees in Nairobi, Kenya, focusing on systemic exclusion, social isolation, and loneliness. Using a community-based participatory research approach, we conducted 10 focus group discussions with 53 older refugees from the Democratic Republic of Congo, Ethiopia, Somalia, and South Sudan. We analyzed data using a framework analysis approach, generating the following themes: (a) systemic exclusion and forced dependency as determinants of distress, (b) displacement-disrupted networks and social isolation, and (c) loneliness as the emotional experience of social disconnection and systemic exclusion. Within these broader thematic areas, we found that exclusion and dependency stemmed from policy gaps, such as the delayed implementation of the 2021 Refugees Act in Kenya which restricted access to social protections. Many older refugees expressed a sense of intergenerational ambivalence and unmet expectations of aging resulting from forced displacement. Finally, participants described "being alone" as an idiom of distress related to loss of meaningful relationships, anger at societal exclusion, and hopelessness over present and future circumstances. Our findings underscore the need for age-inclusive and age-tailored strategies that address systemic exclusion and help older refugees build and restore social networks to mitigate isolation and loneliness. We provide recommendations to enhance social support in family and community contexts aligned with the Inter-agency Standing Committee's mental health and psychosocial support framework.