Long-Term Refugee Health

Abstract

Refugees in the United States have high rates of chronic disease. Both long-term effects of the refugee experience and adjustment to the U.S. health environment may contribute. While there is significant research on health outcomes of newly resettled refugees and long-term mental health experiences of established refugees, there is currently little information about how the combined effects of the refugee experience and the U.S. health environment are related to health practices of refugees in the years and decades after resettlement. We examined cross-sectional survey data for Cambodian refugee and immigrant women 35 to 60 years old (n = 160) from an established refugee community in Lowell, Massachusetts, to examine the potential contributors to health behaviors and outcomes among refugees and immigrants postresettlement. In our representative sample, we found that smoking and betel nut use were very low (4% each). Fewer than 50% of respondents walked for at least 10 minutes on 2 or more days/week. Using World Health Organization standards for overweight/obese for Asians, 73% of respondents were overweight/obese and 56% were obese, indicating increased risk of chronic disease. Depression was also high in this sample (41%). In multivariate models, higher acculturation and age were associated with walking more often; lower education and higher acculturation were related to higher weight; and being divorced/separated or widowed and being older were related to higher risk of depression. The interrelated complex of characteristics, health behaviors, and health outcomes of refugees merits a multifaceted approach to health education and health promotion for long-term refugee health.

Prevalence of General and Central Obesity and Associated Factors among North Korean Refugees in South Korea by Duration after Defection from North Korea: A Cross-Sectional Study

“…As for health-related lifestyle factors, smoking was the only factor negatively associated with obesity. Inconsistent with previous studies, regular exercise did not have any effect on the obesity status in our study [ 26 , 27 ]. Further research is needed to determine how physical activity affects the obesity status of NKRs, particularly among NKRs who defected from NK (≥10 years).…”

Differences in tobacco smoking prevalence and frequency between adolescent Palestine refugee and non-refugee populations in Jordan, Lebanon, Syria, and the West Bank: cross-sectional analysis of the Global Youth Tobacco Survey

“…For example, a 10 year review of refugees in a western US state showed that Iranian and Vietnamese refugees had increased odds of tobacco use while Ukrainian refugees had lower odds of tobacco use compared with the general population [ 10 ]. Lower prevalence of tobacco use among refugee than non-refugee populations has also been documented among adolescent refugees living in an urban Canadian city [ 11 ] and among Cambodian women living in an eastern US state [ 12 ]. A study conducted in the Lebanese capital Beirut showed that elderly Palestine refugees reported a higher prevalence of current cigarette use (34.3 % vs. 28.2) but a similar number of cigarette pack years and a later age of cigarette initiation than elderly non-refugees in neighbouring areas [ 13 ].…”

Cardiovascular Disease–related Health Beliefs and Lifestyle Issues Among Karen Refugees Resettled in the United States From the Thai-Myanmar (Burma) Border

“…It is possible that Karen refugees have additional barriers to PA. Among Cambodian and Iraqi refugees in the US, higher levels of acculturation were associated with higher levels of PA [ 24 , 25 ]. To promote PA among Karen refugees, it may be effective for health education programs to include acculturation interventions.…”