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High Prevalence of Chronic Non-Communicable Conditions Among Adult Refugees: Implications for Practice and Policy

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Abstract

The global rise in non-communicable disease (NCD) suggests that US-based refugees are increasingly affected by chronic conditions. However, health services have focused on the detection of infectious disease, with relatively limited data on chronic NCDs. Using data from a retrospective medical record review of a refugee health program in the urban Northeast (n = 180), we examined the prevalence of chronic NCDs and NCD risk factors among adult refugees who had recently arrived in the US, with attention to region of origin and family composition. Family composition was included because low-income adults without dependent children are at high risk of becoming uninsured. We found that half of the adult refugees in this sample had at least one chronic NCD (51.1%), and 9.5% had three or more NCDs. Behavioral health diagnoses were most common (15.0%), followed by hypertension (13.3%). Half of adults were overweight or obese (54.6%). Chronic NCDs were somewhat more common among adults from Iraq, but this difference was not significant (56.8 vs. 44.6%). Chronic NCDs were common among adults with and without dependent children (61.4 vs. 44.6%, respectively), and these two groups did not significantly differ in their likelihood of having a chronic NCD after adjustment for age and gender (AOR = 0.78, 95% CI = 0.39, 1.55). This study suggests that chronic NCDs are common among adult refugees in the US, including refugees at high risk for uninsurance. We propose that refugee health services accommodate screening and treatment for chronic NCDs and NCD risk factors, and that insurance outreach and enrollment programs target recently arrived refugees.

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Acknowledgments

This study was made possible by CTSA Grant Number UL1 RR024139 from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH), and NIH roadmap for Medical Research. Its contents are solely the responsibility of the authors and do not necessarily represent the official view of NCRR or NIH.

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Authors and Affiliations

  1. Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

    Katherine Yun

  2. IRIS—Integrated Refugee and Immigrant Services, 235 Nicoll St, 2nd Floor, New Haven, CT, 06511, USA

    Kelly Hebrank

  3. Yale School of Medicine, Yale University, 333 Cedar Street, New Haven, CT, 06510, USA

    Lauren K. Graber

  4. Lahey Clinic, Lahey Ipswich, 36 Essex Road, Ipswich, MA, 01938, USA

    Mary-Christine Sullivan

  5. Faculty of Medicine, University of British Columbia, 317-2194 Health Sciences Mall, Vancouver, BC, V6T 1Z3, Canada

    Isabel Chen

  6. Chronic Disease Epidemiology, Yale School of Public Health, Yale University, 60 College St, PO Box 208034, New Haven, CT, 06520, USA

    Jhumka Gupta

  7. 34th and Civic Center Blvd, The Children’s Hospital of Philadelphia, CHOP North, Suite 1539, Philadelphia, PA, 19104, USA

    Katherine Yun

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  1. Katherine Yun
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Correspondence to Katherine Yun.

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Yun, K., Hebrank, K., Graber, L.K. et al. High Prevalence of Chronic Non-Communicable Conditions Among Adult Refugees: Implications for Practice and Policy. J Community Health 37, 1110–1118 (2012). https://doi.org/10.1007/s10900-012-9552-1

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