Longitudinal Changes and High-Risk Subgroups for Obesity and Overweight/Obesity Among Refugees in Buffalo, NY, 2004-2014.

Introduction: Very few studies have been conducted on non-communicable diseases among resettled refugees. The purpose of the study was to examine longitudinal changes in obesity and overweight/obesity rates among resettled refugees and identify high-risk subgroups.

Methods: Longitudinal health assessment data of 818 children (2-18 years) and 1055 adults (≥19 years) were used from a refugee clinic in Buffalo, NY, during 2004-2014. Univariate and bivariate analyses were performed. Risk factors of obesity and overweight/obesity were assessed using multivariate regression models.

Results: Obesity (8.7 to 12.7%) and overweight/obesity (16.9 to 26.7%) rates increased among children over 4.5 years (p < 0.01). Over 3.9 years, overweight/obesity rates increased in men (39.6 to 58.6%, p < 0.01) and women (55.1 to 73.5%, p < 0.01), exceeding the prevalence of overweight/obesity of 65.8% in US-born women. Interestingly, longitudinal overweight/obesity rates decreased among Middle Eastern (81.4 vs 78.0%, p < 0.01) and East European (75.0 vs 70.8%, p < 0.01) women. African children had 2.31-folds (odds ratio [OR] = 2.31; 95% confidence interval [CI] = 1.46-3.67) greater overweight/obesity risk than Asians. African girls who were not overweight or obese at baseline had the highest risk of becoming obese at follow-up visits (OR = 0.21; 95%CI = 0.09-0.52). For each additional year refugees lived in the USA, overweight/obesity risk among men (OR = 1.23; 95%CI = 1.09-1.39) and women (OR = 1.18; 95%CI = 1.04-1.35) increased.

Conclusion: Obesity and overweight/obesity rates increased among refugees, but significant variations existed. Overweight/obesity rate among refugee women surpassed the US average. African origin, baseline weight, and longer duration of stay in the USA were risk factors. Culturally tailored programs are needed to prevent obesity and reduce health disparities among refugees.