Comparison of the Nutritional Status of Overseas Refugee Children with Low Income Children in Washington State

Abstract

IntroductionThe extent that the dual burden of undernutrition and overnutrition affects refugee children before resettlement in the US is not well described.ObjectiveTo describe the prevalence of wasting, stunting, overweight, and obesity among refugee children ages 0–10 years at their overseas medical screening examination prior to resettlement in Washington State (WA), and to compare the nutritional status of refugee children with that of low-income children in WA.MethodsWe analyzed anthropometric measurements of 1047 refugee children ages 0–10 years old to assess their nutritional status at the overseas medical screening examination prior to resettlement in WA from July 2012—June 2014. The prevalence estimates of the nutritional status categories were compared by country of origin. In addition, the nutritional status of refugee children age 0–5 years old were compared to that of low-income children in WA from the Center for Disease Control and Prevention’s Pediatric Nutrition Surveillance System.ResultsA total of 982 children were eligible for the study, with the majority (65%) from Somalia, Iraq and Burma. Overall, nearly one-half of all refugee children had at least one form of malnutrition (44.9%). Refugee children ages 0–10 years were affected by wasting (17.3%), stunting (20.1%), overweight (7.6%) and obesity (5.9%). Among children 0–5 years old, refugee children had a significantly higher prevalence of wasting (14.3% versus 1.9%, p<0.001) and stunting (21.3% versus 5.5%, p<0.001), and a lower prevalence of obesity (6.2% versus 12.9%, p<0.001) than low-income children in WA.ConclusionThe dual burden of under- and over-nutrition among incoming refugee children as well as their overall difference in prevalence of nutritional status categories compared to low-income children in WA provides evidence for the importance of tailored interventions to address the nutritional needs of refugee children.

Nutritional assessment of resettled paediatric refugees in Western Australia

“…US researchers report similar findings, with Burmese children having the highest prevalence of stunting compared to African (specifically Somali) and Middle Eastern (mainly Iraqi) children . The authors speculate that the higher prevalence of stunting among Burmese children may be due to more prolonged periods of suboptimal nutrition and illness …”

“…The prevalence rate of 11.8% of underweight children ≥24 months at time of referral differs from US data where 17.3% of paediatric refugees were underweight just prior to resettlement . Anecdotally, lower WA rates may reflect resettlement bias away from severe malnutrition.…”

Working With Refugees in the U.S.: Trauma-Informed and Structurally Competent Social Work Approaches

“…Malnutrition is also a common pre-migration experience of refugee adults and children. A recent study of 982 refugee children aged 0 to 10 newly arrived in the United States found that 45% experienced at least one form of malnutrition (Dawson-Hahn, Pak-Gorstein, Hoopes, & Matheson, 2016).…”

Growth Trajectories of Refugee and Nonrefugee Children in the United States

“…14 -16 Refugee children arrive in the United States with variable nutritional status based on their preresettlement experiences. 9,12,17,18 Although several studies have reported an increase in the prevalence of obesity and obesity-related diseases among adult refugees and an increase in their BMI trajectories after US resettlement, the data among child refugees is limited. 19,20 Two small studies demonstrated a trend toward increasing obesity prevalence among refugee children.…”