Refugee agencies noticed a high number of suicides among Bhutanese refugees resettled in the United States between 2009 and 2012. We aimed to estimate prevalence of mental health conditions and identify factors associated with suicidal ideation among Bhutanese refugees. We conducted a stratified random cross-sectional survey and collected information on demographics, mental health conditions, suicidal ideation, and post-migration difficulties. Bivariate logistic regressions were performed to identify factors associated with suicidal ideation. Prevalence of mental health conditions were: depression (21 %), symptoms of anxiety (19 %), post-traumatic stress disorder (4.5 %), and suicidal ideation (3 %), significant risk factors for suicidal ideation included: not being a provider of the family; perceiving low social support; and having symptoms of anxiety and depression. These findings suggest that Bhutanese refugees in the United States may have a higher burden of mental illness relative to the US population and may benefit from mental health screening and treatment. Refugee communities and service providers may benefit from additional suicide awareness training to identify those at highest risk.

Objectives This study sought to determine the impact of health literacy and acculturation on oral health status of Somali refugees in Massachusetts. Methods Survey of 439 adult Somalis who arrived in the U.S. < 10 years ago. Subjects had an oral examination with decayed, missing, and filled teeth (DMFT) counts. STOFHLA was used to measure health literacy. Generalized linear multivariable regression models were used to assess the association between English literacy (STOFHLA) and the oral health parameters. Results Participants had means of 1.4 decayed, 2.8 missing, and 1.3 filled teeth. Among subjects in the U.S. 0-4 years, subjects with low STOFHLA scores had lower mean DMFT (Mean Rate Ratio=0.78, p=0.016) compared with subjects with higher STOFHLA scores; however, among subjects in the U.S. 5-10 years, those with low STOFHLA scores had higher mean DMFT (Mean Rate Ratio=1.37, p=0.012) compared with subjects with higher STOFHLA scores. No significant association between STOFHLA and decayed teeth was detected. Participants with low STOFHLA scores had marginally lower risk of periodontal disease compared to those with high scores (OR=0.22, p=0.047) Conclusions Overall Somali oral health status is good. Oral health of Somalis with low health literacy worsens over time in the U.S. It is possible that beneficial factors linked to low literacy for newly arrived Somali refugees diminish and may be countered by less access to preventive care and less utilization of beneficial oral hygiene practices.

Attention has been drawn to high rates of suicide among refugees after resettlement and in particular among the Bhutanese refugees. This study sought to understand the apparent high rates of suicide among resettled Bhutanese refugees in the context of the Interpersonal-Psychological Theory of Suicidal Behavior (IPTS). Expanding on a larger investigation of suicide in a randomly selected sample of Bhutanese men and women resettled in Arizona, Georgia, New York, and Texas (Ao et al., 2012), the current study focused on 2 factors, thwarted belongingness and perceived burdensomeness, examined individual and postmigration variables associated with these factors, and explored how they differed by gender. Overall, factors such as poor health were associated with perceived burdensomeness and thwarted belongingness. For men, stressors related to employment and providing for their families were related to feeling burdensome and/or alienated from family and friends, whereas for women, stressors such as illiteracy, family conflict, and being separated from family members were more associated. IPTS holds promise in understanding suicide in the resettled Bhutanese community.

Background This study investigated the impact of English health literacy and spoken proficiency and acculturation on preventive dental care use among Somali refugees in Massachusetts. Methods 439 adult Somalis in the U.S. ≤ 10 years ago were interviewed. English functional health literacy, dental word recognition, and spoken proficiency were measured using STOFHLA, REALD, and BEST Plus. Logistic regression tested associations of language measures with preventive dental care use. Results Without controlling for acculturation, participants with higher health literacy were 2.0 times more likely to have had preventive care (p=0.02). Subjects with higher word recognition were 1.8 times as likely to have had preventive care (p=0.04). Controlling for acculturation, these were no longer significant, and spoken proficiency was not associated with increased preventive care use. Discussion English health literacy and spoken proficiency were not associated with preventive dental care. Other factors, like acculturation, were more predictive of care use than language skills.

Recently arrived refugee children have significant growth abnormalities. European refugees were overweight; those from developing countries had growth retardation.