Pediatrics
Volume 138, Issue 6, 2016

Growth trajectories of refugee and nonrefugee children in the United States (Article) (Open Access)

Dawson-Hahn E.* , Pak-Gorstein S. , Matheson J. , Zhou C. , Yun K. , Scott K. , Payton C. , Stein E. , Holland A. , Grow M. , Mendoza J.A.
  • a Department of Pediatrics, University of Washington, Seattle, WA, United States, Seattle Children's Research Institute, Center for Child Health, Behavior and Development, M/S CW8-6, PO Box 5371, Seattle, WA 98145, United States
  • b Department of Pediatrics, University of Washington, Seattle, WA, United States, Global Health, University of Washington, Seattle, WA, United States
  • c Refugee Health Program, Washington State Department of Health, Shoreline, WA, United States
  • d Seattle Children's Research Institute, Center for Child Health, Behavior and Development, M/S CW8-6, PO Box 5371, Seattle, WA 98145, United States
  • e PolicyLab, Children's Hospital of Philadelphia, Philadelphia, PA, United States
  • f Department of Family and Community Medicine, Thomas Jefferson University, Philadelphia, PA, United States
  • g Department of Family and Community Medicine, Thomas Jefferson University, Philadelphia, PA, United States
  • h Seattle Children's Research Institute, Center for Child Health, Behavior and Development, M/S CW8-6, PO Box 5371, Seattle, WA 98145, United States
  • i Refugee Screening Clinic, Seattle-King County Public Health, Seattle, WA, United States
  • j Department of Pediatrics, University of Washington, Seattle, WA, United States
  • k Department of Pediatrics, University of Washington, Seattle, WA, United States, Seattle Children's Research Institute, Center for Child Health, Behavior and Development, M/S CW8-6, PO Box 5371, Seattle, WA 98145, United States

Abstract

BACKGROUND AND OBJECTIVES: Limited data examine longitudinal nutrition outcomes of refugee children after United States resettlement. Among refugee children, our aims were to (1) assess the changes in weight-based nutritional status between baseline (0-3 months) and 10-24 months after arrival and (2) compare the BMI (BMIz) or weight-for-length z score (WFLz) trajectories to nonrefugee children for up to 36 months after arrival. METHODS: We conducted a retrospective study of refugees aged 0-16 years from Washington and Pennsylvania and compared them with an age and sex-matched nonrefugee low-income sample from Washington. Data included anthropometric measurements from the initial screening medical visit and subsequent primary care visits. Multilevel linear mixed-effects regression models evaluated the change in BMIz or WFLz trajectory. RESULTS: The study included 512 refugee and 1175 nonrefugee children. The unadjusted prevalence of overweight/obesity increased from 8.9% to 20% (P <.001) for 2- to 16-yearold refugees from baseline to 10-24 months. Refugees (2-16 years old) had a steeper increase in their BMIz per 12 months compared with nonrefugees (coefficient 0.18 vs 0.03; P <.001). Refugees <2 years old had a less steep increase in their WFLz per 12 months compared with nonrefugees (coefficient 0.12 vs 0.36, P =.002). CONCLUSIONS: Older refugee children exhibited a higher risk of obesity than nonrefugees, whereas refugees <2 years old exhibited a slower increase in their risk of obesity than nonrefugee children. All age groups experienced increasing obesity prevalence. Targeted and culturally tailored obesity prevention interventions may mitigate health and nutrition inequities among refugee children. Copyright © 2016 by the American Academy of Pediatrics.

Author Keywords

[No Keywords available]

Index Keywords

Vulnerable Populations vulnerable population primary medical care refugee multicenter study lowest income group public health service physiology clinical trial health disparity predictive value sex ratio human risk assessment Refugees child nutrition Overweight statistics and numerical data controlled study weight height ratio priority journal comparative study ethnology Pennsylvania Washington child growth United States Centers for Disease Control and Prevention (U.S.) Humans Adolescent male preschool child female risk factor Child, Preschool prevalence Article Retrospective Studies Predictive Value of Tests body weight growth curve Sex Distribution age distribution Case-Control Studies anthropometry retrospective study body mass body height nutritional status Pediatric Obesity Body Mass Index childhood obesity Child Development case control study Reference Values reference value Child
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85008313701&doi=10.1542%2fpeds.2016-0953&partnerID=40&md5=6a5986a07fb5e234b155f90d9f8078ab
DOI: 10.1542/peds.2016-0953
ISSN: 00314005
Cited by: 12
Original Language: English