Acculturation, economics and food insecurity among refugees resettled in the USA: a case study of West African refugees

OBJECTIVES: To assess the occurrence and severity of food insecurity, and examine associations between food insecurity and measures of socio-economic status and indicators of acculturation. DESIGN: Structured interviews among a non-probability sample of West African refugees at baseline and 6 months' follow-up.Setting Mid-sized city in north-eastern USA. SUBJECTS: One hundred and one caregivers with children under the age of 5 years and who have been living the USA for fewer than 4 years. RESULTS: Food insecurity was indicated in approximately half of households (53%). The occurrence of food insecurity was associated with measures of socio-economic status such as income, employment status and participation in the Food Stamp Program (P < 0.05). Measures of acculturation such as difficulty in the shopping environment and language difficulty were also associated with the occurrence and severity of food insecurity, as was time lived in the USA (P < 0.05). Among households who had been in the USA for 1 year or less, food insecurity was indicated in 73%, whereas among households who had been in the USA for at least 3 years food insecurity was indicted in 33%. CONCLUSIONS: Refugees are a potentially vulnerable group and our results echo others in suggesting a need for more thorough monitoring of the health and well-being of recently resettled refugees. These results also suggest that reliance on employment as the sole indicator of success in the resettlement process may be too narrow an indicator. Future research should focus on a wider range of measures of health and well-being.