Health and Related Factors for Sudanese Refugees in Nebraska

Abstract

Results of a health survey covering demographics, health risk/prevention factors, and barriers to health care among 263 refugees from Sudan, now living in Nebraska, are presented. Data are compared to Nebraska's general and minority populations. Sudanese refugees are generally young, highly mobile, uneducated, and live in poverty. Refugees are proportionally different from other Nebraskans, in terms of risk factors and rates of common U.S. conditions, but are unable to use preventive systems for maintaining high health status. Nearly 40% do not have health or dental insurance, 20% have never visited a dental or eye care professional, and 11% have never been to a doctor. Federal programs should standardize resettlement site screening so that mobile populations can begin the resettlement process healthy and prevent the spread of infectious disease. Good health at the outset will allow more time and resources for education, language, and employment acquisition, all of critical importance to the Sudanese refugee community.

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

“…For instance, some studies utilize instruments similar to the USDA food security assessment tool (Hadley et al 2007), while others rely on a single item measure of food insufficiency (Gallegos et al 2008). Still others use single items that are at best suggestive of food insecurity (Willis and Nkwocha 2006). For example, a study of 263 Sudanese refugees living in Nebraska noted that 58% of the sample reported being "concerned about nutrition or eating" since arriving in the United States (Willis and Nkwocha).…”

Initiatory Mental Health Assessments for Dinka and Nuer Refugees from Sudan

“…This is especially important for refugees from Sudan as they face very dramatic changes in the relocation from Africa to North America-e.g., air travel to a continent with a wholly different cultural milieu and climate, diverse languages and educational systems, and vastly different legal codes and procedures (Willis & Nkwocha, 2006). Moreover, Sudanese refugees face these dramatic environmental and contextual changes having fled a country at war for more than two decades and having survived lengthy confinement within African refugee camps (U.S. Committee for Refugees, 2003).…”

“…S. Department of Health & Human Services, 2003), few refugees receive the training and preparation necessary to navigate U.S. life. Consequently, we asked Dinka and Nuer what they felt was the most important health concern and a majority responded with a request for the permanent replacement of lower front teeth removed through childhood ritual in Sudan (Willis & Nkwocha, 2006). We then designed a dental restoration program that provided the highest quality permanent replacement for the missing anterior teeth.…”

“…Although refugee resettlement might establish a "Sudanese community," great cultural and linguistic diversity are often represented, even within a small population. For example, in a survey of less than 300 Sudanese refugees in a single Nebraska county, 13 distinct ethnic groups were reported, each with a unique language and culture (Willis & Nkwocha, 2006). Such diversity requires individualized cultural assistance to bring about effective resettlement.…”

“…Refugees from Sudan began arriving in Nebraska during the late 20th century; however, the bulk of Sudanese refugees who were sent to Nebraska as their primary settlement site arrived between 2000 and 2001 (Willis & Nkwocha, 2006). Although the Sudanese refugee population is currently estimated at 5,000 to 7,000 people, the majority arrived through an entirely different state resettlement system-at least 26 different states in one previous survey-and subsequently migrated to Nebraska (Willis & Nkwocha, 2006).…”