Multitasking is using several apps at the same time.

Whereas background app refresh is the app refreshing in the background even when not in use.

Why are they synonyms?

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    Multitaksing is not running several apps at the same time. It's running several tasks at the same time, thus the name. Background refresh, by it's very definition is performing a task in the background (like fetching email) while in the foreground something else is happening (like surfing the web). – Allan Dec 31 '18 at 23:50

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