Almoussa Maya, Mattei Josiemer
Department of Molecular and Cellular Biology, Harvard College Faculty of Arts and Sciences, Cambridge, MA, USA.
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Ethn Health. 2023 Apr;28(3):399-412. doi: 10.1080/13557858.2022.2052712. Epub 2022 Mar 21.
Refugees and immigrants often experience challenges pre- and post-settlement that expose them to risk factors of cardiovascular disease (CVD). Literature on CVD among the growing population of African refugees and immigrants in the United States (US) is scant. This narrative review aimed to evaluate existing studies reporting on CVD and its risk factors among African refugees and immigrants in the US, and to recognize limitations in the current research, policy, and healthcare for adequate CVD-related care for African refugees and immigrants.
Articles on African refugee and/or immigrant health were searched on PubMed using multiple key search terms. Studies conducted between 1995 and 2020 and reporting on CVD-related measures in individuals from African countries of origin were included. Six articles were found discussing refugee health only and seven articles discussed refugee and immigrant health together.
Overall, the studies showed the varying prevalence of CVD risk factors, mostly depending on the country of origin. Worsening cardiometabolic health with longer residency in the US was generally reported. Refugee-only studies relied mostly on medical records data, while refugee and immigrant studies used both medical records and primary data collection. Limitations in data pertain to the geographical representation of both African countries (predominantly from Somalia despite migrants arriving from diverse African countries) and of regions of settling in the US (predominantly the north/northeast), scarce longitudinal studies, and lack of distinction between refugees and immigrants. Multiple social and structural barriers to cardiovascular health were identified, mostly related to cultural and linguistic challenges and to inadequate or complex health insurance and healthcare systems.
The cardiovascular health of African refugees and immigrants remains understudied and underserved. Further research and interventions to alleviate barriers and improve cardiovascular health in African refugees and immigrants in the US should be developed using culturally appropriate, accessible, flexible, and multifaceted strategies.
难民和移民在定居前后常常面临各种挑战，这些挑战使他们暴露于心血管疾病（CVD）的风险因素之下。关于美国不断增长的非洲难民和移民群体中心血管疾病的文献很少。本叙述性综述旨在评估现有关于美国非洲难民和移民中心血管疾病及其风险因素的研究，并认识到当前研究、政策和医疗保健在为非洲难民和移民提供充分的心血管疾病相关护理方面的局限性。
使用多个关键搜索词在PubMed上搜索关于非洲难民和/或移民健康的文章。纳入了1995年至2020年期间进行的、报告来自非洲原籍国个体心血管疾病相关指标的研究。发现6篇文章仅讨论了难民健康，7篇文章同时讨论了难民和移民健康。
总体而言，研究表明心血管疾病风险因素的患病率各不相同，主要取决于原籍国。普遍报告称，在美国居住时间越长，心脏代谢健康状况越差。仅针对难民的研究大多依赖医疗记录数据，而关于难民和移民的研究则同时使用了医疗记录和原始数据收集方法。数据方面的局限性涉及非洲国家（尽管移民来自不同的非洲国家，但主要来自索马里）以及美国定居地区（主要是北部/东北部）的地理代表性、纵向研究稀缺，以及难民和移民之间缺乏区分。确定了心血管健康面临的多个社会和结构障碍，主要与文化和语言挑战以及不充分或复杂的医疗保险和医疗保健系统有关。
非洲难民和移民的心血管健康仍然研究不足且服务欠缺。应采用文化上合适、可及、灵活且多方面的策略，开展进一步的研究和干预措施，以消除障碍并改善美国非洲难民和移民的心血管健康。
