Difficulty in the Food Environment and the Experience of Food Insecurity among Refugees Resettled in the United States

Abstract

The objective of this cross-sectional study was to assess the prevalence and correlates of food insecurity in 281 refugees resettled in the United States. Participants were recruited through a resettlement center and word of mouth. In addition to measures of socioeconomic status, education, time in the U.S., and food insecurity, we also measured individual difficulty in navigating the food environment using a food difficulty scale. Only 23% of the sample did not endorse any of the food insecurity items. Nearly half of the sample also noted difficulty in navigating the food environment. Food insecurity scores above the median were predicted by both income and non-income variables. In a multivariable logistic model, income and having more than one year of education were associated with lower food insecurity (p < .05), while "difficulty in the food environment" was associated with high food insecurity (p < .01). Results suggest that income is an important constraint but that non-income variables may also be important determinants of food insecurity.

A Systematic Examination of Food Intake and Adaptation to the Food Environment by Refugees Settled in the United States

“…These studies indicated low income, low education, low acculturation, shorter length of time in the United States, and language barriers as major factors leading to food insecurity among refugees. Further, refugees lacking knowledge about food outlet locations were 2.5 times more likely to report food insecurity (26). Depression was also associated with food insecurity among refugees (18).…”

“…In a study of Liberian refugees, child hunger was most likely to be present in households in which mothers reported difficulty navigating and understanding the American food environment (29). In addition, 63% of refugees reported not knowing how to cook American foods, and 40% reported difficulties finding stores with desired foods (26). Nevertheless, the level of difficulty in adapting to the US food environment was inconsistent across studies and refugee groups.…”

“…Burmese refugees reported neither knowing which foods were healthy in US stores nor how to prepare meals with those foods (17). Multiple refugee groups wanted to learn more about healthy foods in the United States (17,26,28,29). In 2 studies, refugees reported improvements in diets since US resettlement (30,32); however, more refugees considered US diets less healthy than preresettlement diets (16,23,30,31).…”

“…Several studies collected self-reported refugee needs. Data suggested that refugee health and nutrition could be improved by learning: 1) what are healthy foods in the United States (17,26,28,29), 2) recipes in the United States (17,26,28,29), 3) food market locations (24,26,27,29), 4) how to participate in exercise (17,30), and 5) how to utilize resources including food stamps (15,18,29). More than half of the Hmong and Cambodian interviewees expressed interest in taking American food cooking classes (32).…”

Migration as a Turning Point in Food Habits: The Early Phase of Dietary Acculturation among Women from South Asian, African, and Middle Eastern Countries Living in Norway

“…There are indications that there may be specific challenges related to this phase (Burns 2004;Dean et al 2010;Delavari et al 2012;Himmelgreen et al 2007;Mellin-Olsen and Wandel 2005;Newbold 2009;Tuomainen 2009). Unavailability or high prices of food used in traditional diets, limited information about shopping and cooking options, and changes in lifestyle and working conditions may result in dietary modifications that have an impact on health and food security (Donkin and Dowler 2002;Hadley, Patil, and Nahayo 2010;Mellin-Olsen and Wandel 2005;Sellen, Tedstone, and Frize 2002;Shaw 2009). Together with the lack of availability of familiar food, immigrants also face uncertainty about how to adapt their food habits to the new environment (Dean et al 2010;Himmelgreen et al 2007;Tuomainen 2009).…”