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Kibibi NI, Dena I, Cummings PDW, Hicks CD, Bao W, Schweizer ML. Obesity in Refugees post-resettlement in a high-income country: a meta-analysis. J Racial Ethn Health Disparities 2024; 11:2197-2209. [PMID: 37468741 DOI: 10.1007/s40615-023-01688-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 06/10/2023] [Accepted: 06/18/2023] [Indexed: 07/21/2023]
Abstract
BACKGROUND Refugees have a high prevalence of obesity post resettlement, but few studies have compared their risk of obesity to those of the host population. We systematically investigated the association between refugee status and obesity after resettlement in a high-income nation. METHODS We searched PubMed, Embase, OpenGrey and bibliographies of retrieved articles, with no date, location, and language restrictions, for observational studies assessing obesity rates in resettled refugees compared to the host population. RESULTS Nine studies were analyzed. We found no evidence of increased risk of obesity among refugees compared to the host population, with significant heterogeneity across studies. However, the risk of obesity among refugee men were significantly lower than the host population. DISCUSSION The heterogeneity between studies calls for more high-quality research to examine the risk of obesity among refugees compared to the host population in high-income countries. This will enable results to be pooled to provide more decisive evidence about obesity trends among refugees post migration in a high-income nation.
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Affiliation(s)
- Niclette I Kibibi
- Department of Epidemiology, University of Iowa College of Public Health, 145 N. Riverside Dr., S400 CPHB, Iowa City, IA, 52242, USA.
| | - Isabelle Dena
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Precious de-Winton Cummings
- Department of Epidemiology, University of Iowa College of Public Health, 145 N. Riverside Dr., S400 CPHB, Iowa City, IA, 52242, USA
| | - Chelsea D Hicks
- Harborview Injury Prevention and Research Center, Department of Pediatrics, University of Washington, Seattle, WA, USA
| | - Wei Bao
- Institute of Public Health Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230026, Anhui, China
| | - Marin L Schweizer
- Division of Infectious Disease, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
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Shortland T, McGranahan M, Stewart D, Oyebode O, Shantikumar S, Proto W, Malik B, Yau R, Cobbin M, Sabouni A, Rudge G, Kidy F. A systematic review of the burden of, access to services for and perceptions of patients with overweight and obesity, in humanitarian crisis settings. PLoS One 2023; 18:e0282823. [PMID: 37093795 PMCID: PMC10124894 DOI: 10.1371/journal.pone.0282823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 02/23/2023] [Indexed: 04/25/2023] Open
Abstract
INTRODUCTION Excess body weight causes 4 million deaths annually across the world. The number of people affected by humanitarian crises stands at a record high level with 1 in 95 people being forcibly displaced. These epidemics overlap. Addressing obesity is a post-acute phase activity in non-communicable disease management in humanitarian settings. Information is needed to inform guidelines and timing of interventions. The objective of this review was to explore the prevalence of overweight and obesity in populations directly affected by humanitarian crises; the cascade of care in these populations and perceptions of patients with overweight and obesity. METHODS Literature searches were carried out in five databases. Grey literature was identified. The population of interest was non-pregnant, civilian adults who had experience of humanitarian crises (armed conflict, complex emergencies and natural disasters). All study types published from January 1st, 2011, were included. Screening, data extraction and quality appraisal were carried out in duplicate. A narrative synthesis is presented. RESULTS Fifty-six reports from forty-five studies were included. Prevalence estimates varied widely across the studies and by subgroups. Estimates of overweight and obesity combined ranged from 6.4% to 82.8%. Studies were heterogenous. Global distribution was skewed. Increasing adiposity was seen over time, in older adults and in women. Only six studies were at low risk of bias. Body mass index was the predominant measure used. There were no studies reporting cascade of care. No qualitative studies were identified. CONCLUSION Overweight and obesity varied in crisis affected populations but were rarely absent. Improved reporting of existing data could provide more accurate estimates. Worsening obesity may be prevented by acting earlier in long-term crises and targeting risk groups. The use of waist circumference would provide useful additional information. Gaps remain in understanding the existing cascade of care. Cultural norms around diet and ideal body size vary.
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Affiliation(s)
- Thomas Shortland
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Majel McGranahan
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Daniel Stewart
- National Public Health Specialty Training Programme, South West Training Scheme, Bristol, United Kingdom
| | - Oyinlola Oyebode
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Saran Shantikumar
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - William Proto
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Bassit Malik
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Roger Yau
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Maddie Cobbin
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | | | - Gavin Rudge
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Farah Kidy
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
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Rahman A, Biswas J, Banik PC. Non-communicable diseases risk factors among the forcefully displaced Rohingya population in Bangladesh. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000930. [PMID: 36962636 PMCID: PMC10022334 DOI: 10.1371/journal.pgph.0000930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 09/05/2022] [Indexed: 11/19/2022]
Abstract
Rohingya refugees of Ukhiya, Cox's bazar are an unaccounted group of people who form the largest cluster of refugees worldwide. Non-communicable disease (NCD) alone causes 70% of worldwide deaths every year therefore, the trend of NCD among Rohingya refugees demands proper evaluation and attention. The objective of this study was to measure the NCD risk factors among a convenient sample of Rohingya refugees. This cross-sectional study was conducted among 249 Rohingya refugees living in Balukhali and Kutupalang Rohinga Camps at Ukhiya, Cox's bazaar using a survey dataset adapted from the WHO Stepwise approach to NCD Risk Factor Surveillance (STEPS). Data was collected through face-to-face interviews with a structured questionnaire. Anthropometric and biochemical measurements were done by trained medical assistants. Descriptive analysis was applied as appropriate for categorical variables. A Chi-square test and a student t test were performed to compare the categories. In general, the findings of NCD risk factors as per STEPS survey was 53.4% for tobacco use including smokeless tobacco, 2.8% for alcohol consumption, 23.7% for inadequate vegetable and fruit intake, 34.5% for taking extra salt, 89.6% for insufficient physical activity, 44.5%for confirmed hypertension, 16.9% for overweight, 1.2% for obesity and 0.8% for high blood sugar. Some modifiable non-communicable disease risk factors such as physical inactivity, tobacco smoking, extra salt with food, and hypertension are present among the Rohinga refugees in Bangladesh. These findings were timely and essential to support the formulation and implementation of NCD-related policies among the Rohingya refugees as a priority sub-population.
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Affiliation(s)
- Ayesha Rahman
- Department of Public Health, American International University Bangladesh (AIUB), Dhaka, Bangladesh
| | - Jheelam Biswas
- Department of Non-communicable Diseases, Bangladesh University of Health Sciences (BUHS), Dhaka, Bangladesh
| | - Palash Chandra Banik
- Department of Non-communicable Diseases, Bangladesh University of Health Sciences (BUHS), Dhaka, Bangladesh
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Atoloye AT, Nur H, Wengreen H, Archuleta M. Tackling Cultural Determinants of Health Through Nutrition Education Among Refugees. Health Equity 2021; 5:390-393. [PMID: 34104845 PMCID: PMC8182646 DOI: 10.1089/heq.2020.0109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2021] [Indexed: 11/30/2022] Open
Abstract
Nutrition education provides an avenue to address nutrition behavior change needs and prevents chronic disease in refugee communities. Previous studies have consistently identified cultural uniqueness as one of the barriers to meeting the needs of the refugee communities effectively. This current perspective describes the barriers and opportunities to improve nutrition education efforts among this population while taking into account the cultural context.
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Affiliation(s)
- Abiodun T. Atoloye
- Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford, Connecticut, USA
| | - Habiba Nur
- Department of Nutrition, Dietetics, and Food Sciences, Utah State University, Logan, Utah, USA
| | - Heidi Wengreen
- Department of Nutrition, Dietetics, and Food Sciences, Utah State University, Logan, Utah, USA
| | - Martha Archuleta
- Department of Nutrition, Dietetics, and Food Sciences, Salt Lake Center, Utah State University, Logan, Utah, USA
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Davis D, Phares CR, Salas J, Scherrer J. Prevalence of Overweight and Obesity in US-Bound Refugees: 2009-2017. J Immigr Minor Health 2020; 22:1111-1117. [PMID: 31974925 PMCID: PMC11321758 DOI: 10.1007/s10903-020-00974-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Refugees are an often understudied population and vulnerable to poor health outcomes. No large-scale analyses have evaluated the prevalence of overweight and obesity in US-bound refugees. Using data obtained from the Centers for Disease Control (CDC) Electronic Disease Notification system, we quantified the prevalence of overweight and obesity in adult US-bound refugees by nationality from 2009 through 2017. This repeated cross-sectional analysis used CDC data to quantify and examine body mass index (BMI) trends in US-bound adult refugees during 2009-2017. Utilizing data from an overseas medical exam required for all US-bound refugees, we determined BMI for 334,746 refugees ≥ 18 years old who arrived in the United States during January 1, 2009-December 31, 2017. We calculated and compared the prevalence of overweight and obesity as well as changes in demographic characteristics (age, sex, and nationality) by year. Adjusted prevalence and prevalence ratios (APR) for yearly trends were assessed using a modified Poisson regression model with robust error variances. After adjusting for age, sex, and nationality, we observed a significant linear trend in the prevalence of overweight/obesity with an average annual relative percent increase of 3% for refugees entering the United States from 2009 through 2017 (APR = 1.031; 95% CI 1.029-1.033). The adjusted prevalence of overweight/obesity increased from 35.7% in 2009 to 44.7% in 2017. The prevalence of overweight and obesity in US-bound refugees increased steadily over the analysis period. Investigation into pre-migration and post-resettlement interventions is warranted.
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Affiliation(s)
- Dawn Davis
- Department of Family and Community Medicine, Saint Louis University School of Medicine, 1402 S. Grand Blvd., Saint Louis, MO, 63104, USA.
| | - Christina R Phares
- Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Joanne Salas
- Department of Family and Community Medicine, Saint Louis University School of Medicine, 1402 S. Grand Blvd., Saint Louis, MO, 63104, USA
| | - Jeffrey Scherrer
- Department of Family and Community Medicine, Saint Louis University School of Medicine, 1402 S. Grand Blvd., Saint Louis, MO, 63104, USA
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Hasha W, Fadnes LT, Igland J, Vårdal R, Giusti LM, Strømme EM, Haj-Younes J, Heltne U, Kumar BN, Diaz E. Two interventions to treat pain disorders and post-traumatic symptoms among Syrian refugees: protocol for a randomized controlled trial. Trials 2019; 20:784. [PMID: 31881990 PMCID: PMC6935096 DOI: 10.1186/s13063-019-3919-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 11/18/2019] [Indexed: 01/18/2023] Open
Abstract
Background There is a high prevalence of pain and post-traumatic symptoms among refugees and feasible interventions to manage these are needed. However, knowledge about the effect of physiotherapy and psychological group interventions among refugees is scarce. Our aim is to determine whether two different interventions, the Physiotherapy Activity and Awareness Intervention (PAAI) and Teaching Recovery Techniques (TRT), reduce pain and post-traumatic symptoms among refugees from Syria living in Norway. Methods/design Syrian adults with either pain disorders or post-traumatic symptoms, or both, will be recruited to this randomized control trial. The trial will include two separate interventions: participants with dominating pain symptoms will be assigned to the PAAI; and those with a predominance of post-traumatic symptoms will be assigned to the TRT intervention. Participants will be randomized to either the immediate intervention group or the delayed intervention group, for each of the interventions (PAAI and TRT). A minimum of 68 participants will be recruited for the PAAI and 78 participants for TRT, in order to detect clinically and statistically significant symptom improvement, assuming 25–30% attrition after recruitment. The main outcomes for the analyses will be pain intensity measured by the Brief Pain Inventory questionnaire and the scores of the Impact of Events Scale — Revised. The effect will be evaluated at the end of interventions lasting 8 weeks (PAAI) and 6 weeks (TRT) using the same instruments after the end of the intervention, and again 4–6 weeks later. Additionally, a qualitative evaluation will be conducted through an embedded process evaluation and personal interviews with participants after each of the interventions is finished. Discussion Our study will determine the feasibility of the implementation of two different interventions and the effect of these interventions among refugees from Syria with pain disorders and/or post-traumatic symptoms. Trial registration Clinical Trials.gov, NCT03951909. Retrospectively registered on 19 February 2019.
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Affiliation(s)
- Wegdan Hasha
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
| | - Lars T Fadnes
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
| | - Jannicke Igland
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | | | | | | | - Jasmin Haj-Younes
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Unni Heltne
- Centre for Crisis Psychology, University of Bergen, Bergen, Norway
| | - Bernadette N Kumar
- Unit for Migration and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Esperanza Diaz
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Unit for Migration and Health, Norwegian Institute of Public Health, Oslo, Norway
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Prevalence of Tuberculosis Disease Among Adult US-Bound Refugees with Chronic Kidney Disease. J Immigr Minor Health 2019; 21:1275-1281. [DOI: 10.1007/s10903-018-00852-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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