Environmental, Nutrition and Health Issues in a US Refugee Resettlement Community

Abstract

INTRODUCTIONIn 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. RESULTSPerceptions 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.

From the Democratic Republic of the Congo to North Carolina: An Examination of Chronic Disease Risk

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A quantitative and qualitative analysis of a medication health literacy workshop for newly and recently arrived refugees

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“…4 These barriers include social determinants of health consisting of housing conditions, poverty, employment, food, language, temporary Medicaid coverage, mental illness, discrimination, mistrust, and navigating the healthcare system. [3][4][5] Barriers specific to pharmacy services include language and culture and navigating the healthcare system. 5 Specific pharmacy recommendations to improve these barriers include providing interpreting and translation services, along with staff who can effectively communicate cross-culturally.…”

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