Sociodemographic and Mental Health Factors Associated with Obesity in Resettled Refugees in Syracuse, New York

Introduction: Resettled refugees have been exposed to stressful and life-threatening events preresettlement and are among the most marginalized and vulnerable groups in society. Postresettlement, they face challenges when assimilating to an unfamiliar host country, which renders them vulnerable to adverse health outcomes including obesity, a major public health burden. This study was conducted to examine the association of mental health and sociodemographic factors, including language proficiency and educational attainment, with obesity in first-generation resettled refugees.

Methods: We used data from electronic health records from the Adult Ambulatory Medicine Clinic of the State University of New York Upstate, Syracuse, NY. The probability of being overweight and obese (class I and class II) relative to normal weight was estimated using fully adjusted multinomial logistic regression models with relative risk ratios (RRRs).

Findings: Relative to male refugees, female refugees were more likely to have class I obesity (RRR=1.83; 95% confidence interval [CI]=1.19, 2.80) and class II obesity (RRR=4.07; 95% CI=2.41, 6.87). Limited English proficiency increased the risk of being overweight (RRR=2.02; 95% CI=1.29, 3.17) and having class II obesity (RRR=2.14, 95% CI=1.20, 3.81). A clinical mental health diagnosis increased the risk of class I (RRR=2.00; 95% CI=1.35, 2.96) and class II (RRR=1.76; 95% CI=1.15, 2.71) obesity. Having no formal education was associated with decreased risk of class II obesity (RRR=0.42; 95% CI=0.19, 0.90).

Discussion: Obesity prevalence and subsequent related morbidity continue to be major public health burdens in vulnerable, often underserved populations in the United States. Further investigation into social determinants of obesity in refugees in a community setting that captures the unique experiences of heterogenous refugee groups outside the clinical setting is warranted.