The United Nations estimates that that there are currently 10 million refugees in the world. A small number of these individuals are eligible for resettlement in the USA, but little is known about the health and well being of these individuals once they are resettled into developed countries. Theorists hypothesize that while freed from the violence and war that characterize refugee situations, refugees will face poverty and concomitant shifts in dietary practice and health seeking behavior, which may negatively affect health. This study will focus on one particularly important aspect of public health: food insecurity. Food insecurity is a good indicator of poor dietary practice and is associated with a range of health outcomes including excess body weight. The aim is to quantify the magnitude of food insecurity in two refugee communities, examine the cultural, social, and economic correlates of food insecurity (and its sequelae), and assess the validity of current food insecurity measurement tools. The project utilizes a two site, two ethnic group longitudinal study design. Methods of data collection include focus groups, participant observation, a survey, and anthropometric measures of weight and height. It will be the largest longitudinal study to date of these populations, and one of the few measuring the health impact of resettlement among African refugees living in the USA. Such data is imperative to addressing concerns about the costs and burdens of hosting refugees.
Broader Impact Concern over the well-being of refugees and the costs of hosting refugees are widespread, and there is growing interest in the social determinants of health and well-being. This project will add significantly to our understanding in each of these areas. The project will help fill a huge gap in knowledge about public health nutrition among resettled refugees, as it aims to not only identify who is most at risk of food insecurity but why, and in doing so would offer useful programmatic insights. This information will be particularly important for designing interventions and health-education programs. The research would also address the pressing issue of how to best measure food insecurity among newly arrived refugees. Ensuring that a food security scale is a valid indicator of deprivation is of enormous importance for monitoring and advocacy and for identifying determinants of food insecurity. Several refugees will also be hired as interviewers. The results that come from the project will be distributed to both professional groups that represent refugees and to resettlement agencies; the information can be used by these groups for advocacy and to monitor trends in several health outcomes.
