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Burden of Mental Illness and Non-communicable Diseases and Risk Factors for Mental Illness Among Refugees in Buffalo, NY, 2004–2014

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Abstract

Introduction

Limited is known about mental illness and non-communicable diseases (NCDs) and their risk factors among refugees. These were studied using data collected from a refugee population in Buffalo, NY.

Methods

Longitudinal data collected on 1055 adults (> 18 years) at a large refugee health center in Buffalo, NY, during 2004–2014 were used. Main outcomes were hypertension, diabetes, tobacco use, obesity, overweight/obesity, and mental illness. Risk factors were assessed using multivariate regression models.

Results

Compared to those without mental illness, refugees with mental illness had higher rates of hypertension (16.9 vs 28.4%, P < 0.001), diabetes (8.4 vs 13.6%, P = 0.03), tobacco use (9.3 vs 18.3%, P < 0.001), obesity (13.0 vs 25.4%, P < 0.001), and overweight/obesity rates (45.0 vs 61.5%, P < 0.001). During 2004–2014, obesity rates increased among those with mental illness (25.4 to 36.7%, P < 0.001) and without mental illness (13.0 to 24.5%, P < 0.001). The overall mental illness prevalence among refugees was 16%, ranging from 6.9% among Asians to 43.9% among Cubans. Women were more likely to have mental illness (odds ratio = 2.45; 95% confidence interval [CI] = 1.68–3.58) than men. Refugees who lived longer in the USA were more likely to carry psychiatric diagnoses (OR = 1.12; 95% CI = 1.04–1.21).

Conclusion

Mental illness rates varied considerably across various refugee groups. Rates of obesity and NCDs among refugees with mental illness were higher than among those without mental disorders. Gender, region of origin, and length of stay in the USA were associated with mental illness. Accurate and culturally sensitive screenings and assessments of mental illness are needed to reduce these health disparities.

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Acknowledgments

We would like to thank Mrs. Jessie Mossop, Information Services and Reporting Manager at Jericho Road Community Health Center, for her assistance in data retrieval. The content of the paper is solely the responsibility of the authors and does not necessarily represent the official views of the funders. This study was partly supported by research grants from the National Institute of Health (NIH, U54 HD070725, 1R01HD064685-01A1). The U54 project (U54 HD070725) is funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) and the Office of the Director, National Institutes of Health (OD). Dr. Youfa Wang is the principle investigator of the grants.

Funding

This study was partly supported by research grants to Dr. Youfa Wang from the National Institute of Health (NIH, U54 HD070725, 1R01HD064685-01A1). The U54 project (U54 HD070725) is funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) and the Office of the Director, National Institutes of Health (OD).

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Authors and Affiliations

  1. Department of Medicine, Cambridge Health Alliance, Harvard Medical School, 454 Broadway, Revere, MA, 02151, USA

    Wudeneh Mulugeta

  2. Systems-Oriented Global Childhood Obesity Intervention Program, Fisher Institute of Health and Well-being, College of Health, Ball State University, Muncie, IN, USA

    Hong Xue, Jungwon Min & Youfa Wang

  3. Jericho Road Community Health Center, Buffalo, NY, USA

    Myron Glick

  4. Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, NY, USA

    Michael F. Noe

  5. Department of Nutrition and Health Sciences College of Health, Ball State University, Muncie, IN, USA

    Youfa Wang

Authors
  1. Wudeneh Mulugeta
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  2. Hong Xue
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  3. Myron Glick
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  4. Jungwon Min
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  5. Michael F. Noe
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  6. Youfa Wang
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Corresponding author

Correspondence to Wudeneh Mulugeta.

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Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

Institutional review board (IRB) approval was received from the State University of New York at Buffalo for the study. For this type of study, formal consent is not required.

Appendix

Appendix

Table 4 Comparing characteristics of those who followed up vs lost to follow-up/excluded from the study among adult refugees resettled in Buffalo, New York, during 2004–2014
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Mulugeta, W., Xue, H., Glick, M. et al. Burden of Mental Illness and Non-communicable Diseases and Risk Factors for Mental Illness Among Refugees in Buffalo, NY, 2004–2014. J. Racial and Ethnic Health Disparities 6, 56–63 (2019). https://doi.org/10.1007/s40615-018-0498-6

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  • DOI: https://doi.org/10.1007/s40615-018-0498-6

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