title: High prevalence of chronic non-communicable conditions among adult refugees: implications for practice and policy.
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.
authors.affiliation: Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, and The Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA. yunk@email.chop.edu
authors.forename: Katherine
authors.initials: K
authors.lastname: Yun
authors.forename: Kelly
authors.initials: K
authors.lastname: Hebrank
authors.forename: Lauren K
authors.initials: LK
authors.lastname: Graber
authors.forename: Mary-Christine
authors.initials: MC
authors.lastname: Sullivan
authors.forename: Isabel
authors.initials: I
authors.lastname: Chen
authors.forename: Jhumka
authors.initials: J
authors.lastname: Gupta
mesh_terms: D000328:Adult; D002908:Chronic Disease / Q000453:epidemiology*; D005191:Family Characteristics; D005260:Female; D006291:Health Policy; D006301:Health Services Needs and Demand; D006801:Humans; D007348:Insurance, Health / Q000706:statistics & numerical data; D007493:Iraq / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D009511:New England / Q000453:epidemiology; D015995:Prevalence; D012036:Refugees / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult