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ISSN 1527-3172 (Electronic)

2015, Number 4

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MEDICC Review 2015; 17 (4)

Environmental, Nutrition and Health issues in a US refugee resettlement community

Sastre L, Haldeman L

Language: English
References: 34
Page: 18-24
PDF size: 94.42 Kb.


ABSTRACT

INTRODUCTION In 2012, North Carolina ranked in the top ten states in refugee resettlement, with central Guilford County one of the most diverse in the southeast.
OBJECTIVE Examine the local resettlement environmental, nutrition and health barriers and needs of refugees in Guilford County, as perceived by individuals providing services to them.
METHODS Participants (n = 40) included: medical and social service providers, educators, faith-based volunteers, resettlement agency caseworkers and liaisons to a variety of refugee communities. Guided semistructured interviews were audio-recorded and transcribed verbatim. Themes were identified using deductive content analysis and categorized by frequency of reporting by participants.
RESULTS Perceptions were consistent across participants regarding a diverse local refugee population. Resettlement housing was observed to be in poor condition, located in areas of poverty with transportation barriers. However, refugees rarely relocated, due to strong community relationships and support. Perceived dietary risks included: difficulties budgeting and maintaining food assistance, hoarding food, high consumption of sodas and sweets, misperceptions regarding US products (e.g., perceived need for infant formula), and limited health knowledge. Respondents observed that most refugees preferred "fresh" foods, and had strong agricultural skills but lacked green space. Major barriers to health care reported were: poverty, short duration of initial Medicaid coverage, and language (both lack of interpretation services and translated materials). Providers consistently observed type 2 diabetes, weight gain and dental problems across refugee groups.
CONCLUSIONS Direct service providers' experiences and observations working with a diverse resettlement population provide unique insight into consistent barriers to achieving good health that confront refugees. While refugees face many barriers, groups often have impressive strengths, such as agricultural skills, on which to focus.


REFERENCES

  1. The UN Refugee Agency [Internet]. Geneva: The UN Refugee Agency; c2015. Office of the United Nations High Commissioner for Refugees: About Us; [cited 2015 Aug 4]; [about 2 screens]. Available from: http://www.unhcr.org/ pages/49c3646c2.html

  2. Martin DC, Yankay JE. Annual Flow Report 2013: Refugees and Asylees [Internet]. Washington, D.C.: U.S. Department of Homeland Security Office of Immigration Statistics; 2013 [cited 2015 Feb 14]. Available from: http://www.dhs.gov/sites/ default/files/publications/ois_rfa_fr_2013.pdf

  3. Martin DC, Yankay JE. Annual Flow Report 2012 Refugees and Asylees [Internet]. Washington, D.C.: U.S. Department of Homeland Security Office of Immigration Statistics; 2012 [cited 2014 Mar 17]. 8 p. Available from: http:// www.dhs.gov/sites/default/files/publications/ ois_rfa_fr_2012.pdf

  4. The Center for New North Carolinians [Internet]. North Carolina: University of North Carolina; c2015. Immigrant Demographics of Guilford County; 2014 [cited 2014 Mar 17]; [about 3 screens]. Available from: http://cnnc.uncg.edu/ immigrant-demographics-of-guilford-county/

  5. U.S. Department of Health and Human Resources [Internet]. Washington, D.C: U.S Department of Health and Human Resources; c2015. Refugee Health. Office of Refugee Resettlement, Office of the Administration of Children and Families. Refugee Health; 2014 [cited 2014 Mar 17]. Available from: http://www.acf.hhs.gov/pro grams/orr/programs/refugee-health

  6. Healthy People.gov [Internet]. Washington, D.C.: Office of Disease Prevention and Health Promotion (US); c2014. Disparities; 2014 [cited 2014 Apr 15]; [about 3 screens]. Available from: http:// www.healthypeople.gov/2020/about/Disparities About.aspx

  7. Ogilvie LD, Burgess-Pinto E, Caufield C. Challenges and approaches to newcomer health research. J Trans Cult Nurs. 2008 Jan;19(1):64–73.

  8. Elo S, Kyngäs H. The qualitative content analysis process. J Adv Nurs. 2008 Apr;62(1):107–15.

  9. McNeill LH, Wyrwich KW, Brownson RC, Clark EM, Kreuter MW. Individual, social environmental and physical environmental influences on physical activity among black and white adults: a structural equation analysis. Ann Behav Med. 2006 Feb;31(1):36–44.

  10. Evenson KR, Block R, Diez Roux AV, McGinn AP, Wen F, Rodríguez DA. Associations of adult physical activity with perceived safety and policerecorded crime: the Multi-ethnic Study of Atherosclerosis. Int J Behav Nutr Phys Act. 2012 Dec 17;9:146.

  11. Willis MS, Buck JS. From Sudan to Nebraska: Dinka and Nuer refugee diet dilemmas. J Nutr Educ Behavior. 2007 Sep–Oct;39(5):273–80.

  12. Vue W, Wolff C, Goto K. Hmong food helps us remember who we are: perspectives of food culture and health among Hmong women with young children. J Nutr Educ Behav. 2011 May– Jun;43(3):199–204.

  13. Wilson A, Renhazo A. Intergenerational differences in acculturation experiences, food beliefs, and perceived health risks among refugees from the Horn of Africa in Melbourne, Australia. Public Health Nutr. 2015 Jan;18(1):176–88.

  14. Rondinelli AJ, Morris MD, Rodwell TC, Moser KS, Paida P, Popper ST, et al. Under and overnutrition among refugees in San Diego County, California. J Immigr Minor Health. 2011 Feb;13(1):161–8.

  15. Franzen L, Smith C. Acculturation and environmental change impacts dietary habits among adult Hmong. Appetite. 2009 Feb;52(1):173–83.

  16. Drummond PD, Mizan A, Burgoyne A, Wright B. Knowledge of cardiovascular risk factors in west African refugee women living in Western Australia. J Immigr Minor Health. 2011 Feb;13(1):140–8.

  17. Mulasi-Pokhriyal U, Smith C, Franzen-Castle L. Investigating dietary acculturation and intake among US-born and Thailand/Laos-born Hmong- American children aged 9-18 years. Public Health Nutr. 2012 Jan;15(1):176–85.

  18. Hrboticky N, Krondl M. Acculturation to Canadian Foods by Chinese immigrant boys: changes in the perceived flavor, health value and prestige of foods. Appetite. 1984 Jun;5(2):117–26.

  19. Smith C, Franzen-Castle L. Dietary acculturation and body composition predict American Hmong children’s blood pressure. Am J Hum Biol. 2012 Sep–Oct;24(5):666–74.

  20. Benbenek MM, Garwick AW. Enablers and barriers to dietary practices contributing to bone health among early adolescent Somali girls living in Minnesota. J Spec Pediatr Nurs. 2012 Jul;17(3):205–14.

  21. Hadley C, Patil CL, Nahayo D. Difficulty in the food environment and the experience of food insecurity among refugees resettled in the US. Ecol Food Nutr. 2010 Sep–Oct;49(5):390–407.

  22. Hadley C, Zodhiates A, Sellen DW. Acculturation, economics and food insecurity among refugees resettled in the USA: a case study of West African refugees. Public Health Nutr. 2007 Apr;10(4):405–12.

  23. Hadley C, Sellen D. Food insecurity and child hunger among recently resettled Liberian refugees and asylum seekers: A pilot study. J Immigr Minor Health. 2006 Oct;8(4):369–75.

  24. Dharod JM, Croom JE, Sady CG. Food insecurity: its relationship to dietary intake and body weight among Somali refugees women in the United States. J Nutr Educ Behavior. 2013 Jan– Feb;45(1):47–53.

  25. Peterman JN, Wilde PE, Silka L, Bermudez OI, Rogers BL. Food insecurity among Cambodian refugee women two decades post resettlement. J Immigr Minor Health. 2013 Apr;15(2):372–80.

  26. Patil CL, Hadley C, Nahayo PD. Unpacking dietary acculturation among new Americans: results from formative research with African refugees. J Immigr Minor Health. 2009 Oct;11(5):342–58.

  27. Garnweidner LM, Terragni L, Pettersen KS, Mosdøl A. Perceptions of the host country’s food culture among female immigrants from Africa and Asia: aspects relevant for cultural sensitivity in nutrition communication. J Nutr Educ Behav. 2012 Jul–Aug;44(4):335–42.

  28. Peterman JN, Silka L, Bermudez OI, Wilde PE, Rogers BL. Acculturation, education, nutrition education and household composition are related to dietary practices among Cambodian refugee women in Lowell, MA. J Am Diet Assoc. 2011 Sep;111(9):1369–74.

  29. Marshall GN, Schell TL, Elliott MN, Berthold SM, Chun CA. Mental health of Cambodian refugees 2 decades after resettlement in the United States. JAMA. 2005 Aug 3;294(5):571–9.

  30. Tufan AE, Alkin M, Bosgelmez S. Post-traumatic stress disorder among asylum seekers and refugees in Istanbul may be predicted by torture and loss due to violence. Nord J Psychiatry. 2013 Jun;67(3):219–24.

  31. Gerritsen AA, Bramsen I, Devillé W, van Willigen LH, Hovens JE, van der Ploeg HM. Physical and mental health of Afghan, Iranian and Somali asylum seekers and refugees living in the Netherlands. Soc Psychiatry Psychiatr Epidemiol. 2006 Jan;41(1):18–26.

  32. Filippi MK, Faseru B, Baird M, Ndikum-Moffor F, Greiner KA, Daley CM. A Pilot study of health priorities of Somalis living in Kansas City: laying the groundwork for CBPR. J Immigr Minor Health. 2014 Apr;16(2):314–20.

  33. Renzaho AMN, Bilal P, Marks GC. Obesity, type 2 diabetes, and high blood pressure amongst recently arrived Sudanese refugees in Queensland, Australia. J Immigr Minor Health. 2014 Feb;16(1):86–94.

  34. Morris MD, Popper ST, Rodwell TC, Brodine SK, Brouwer KC. Healthcare barriers of refugees post-resettlement. J Community Health. 2009 Dec;34(6):529–38.




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