Abstract
INTRODUCTION In 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. RESULTS Perceptions 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. KEYWORDS Refugees, emigration, immigration, minority health, health care disparities, diet, environment, USA.
Highlights
In 2012, North Carolina ranked in the top ten states in refugee resettlement, with central Guilford County one of the most diverse in the southeast
We found that initial placement of refugees was constrained due to limited housing options and management inflexibility or disinterest in partnering with resettlement agencies
Low physical activity levels and increasing trends of overweight and chronic conditions among refugees have been reported in other studies. [11,12,13,14,15,16,17,18,19,20] Despite concerns expressed about safety and housing conditions, the support and strength of the communities were perceived as factors that reduced migration away from initial resettlement locations
Summary
In 2012, North Carolina ranked in the top ten states in refugee resettlement, with central Guilford County one of the most diverse in the southeast. Factors influencing refugee health are complex and include conditions and risks from both the country of origin and those faced in the host country (i.e., camp settings) after fleeing their homeland prior to arrival in the USA.[5] Refugees often suffer from unmanaged acute and chronic conditions, micronutrient deficiencies and mental health issues.[5] Refugee resettlement in the USA remains steady (e.g., 69,909 in 2013, 58,179 in 2012, 56,384 in 2011), health care systems facing an increasingly diverse population composition with unique health needs.[2] Despite continuing annual resettlement of new arrivals, research and resources for refugee health and nutrition remain limited This is of particular importance because refugee populations are at high risk for health disparities. Improved health for these populations falls within the priority objectives of Healthy People 2020, which aims to eliminate health disparities and ensure health care access for all people.[6]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
