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Refugee health at risk from takeaway diet

10 December 20140 comments

Refugees in Australia are at risk of obesity or poor health because of the prevalence and convenience of cheap junk food in areas where many live, a new study suggests.

Researchers at Curtain and Griffith Universities say refugees are often resettled in areas with many unhealthy food outlets and poor access to fresh fruit and vegetables.

Newly arrived refugees often have little money to spend on food. They also often don’t have access to a car or nearby public transport, diminishing their ability to make healthy food choices, the researchers say.

“This situation is leading to an unhealthy assimilation. By adopting unhealthy diets, refugees are at risk of excess weight gain. In turn, that can lead to chronic illnesses such as type 2 diabetes, cardiovascular disease, arthritis and osteoporosis,” said Curtain University researcher Dr Ori Gudes.

The report said that for refugees, many pre-existing factors impacted on food choices. These include housing insecurity, employment, financial hardship, changed social status and adapting to a new culture and environment. Parents may prioritise other settlement needs, such as settling children into school and earning an income, ahead of their own health.

Also, many newly arrived refugees are contending with significant mental health issues.

A study that tracked 7,000 refugees in resettlement found nine per cent of adults and 11 per cent of children had post-traumatic stress disorder and five per cent of adults suffered major depression.

Pre-arrival factors that have the potential to influence diet and nutrition during settlement include prolonged deprivation, contaminated water, untreated or undiagnosed illnesses such as parasitic infections and chronic diarrhoea, and dental problems that may cause difficulties eating.

In Australia, refugees are faced with often unfamiliar western food, different food preparation styles, changes to lifestyle and exercise, lack of nutritional education and reduced local access to affordable food, the study says.

“They may not be able to access the traditional foods they’re used to and prefer. And their poor financial situation, coupled with a lack of family support and multiple psychosocial stressors, greatly diminishes their ability to make healthy food choices,” Dr Gudes said.

The researchers mapped the availability of food outlets and vegetable consumption among a group of resettled African refugees in Woodridge, in Queensland’s Logan Central area.

Woodridge has a total population of 20,650. There are 0.9 fast food outlets per 1,000 people and only 0.1 healthy food outlets per 1,000 people.

They asked 28 participants to complete a questionnaire on household vegetable availability and consumption. The participants ranged in age from 19 to 52 and had lived in Australia for an average of 4.5 years.

The researchers also mapped the routes from each of the 28 participants’ households to their nearest food outlet.

Within a radius of two kilometres from their home, the participants had access to three healthy food outlets, with a median distance of 841 metres and walking time of 10.5 minutes.

But they had access to 19 fast food outlets, with a median distance of 641 metres and walking time of eight minutes.

“We found participants who lived near a healthy food outlet such as a supermarket or farmers’ market had a higher intake of vegetables than those who lived further away. The critical threshold was around 400 metres,” Dr Gudes said.

“Those who had significantly better access to takeaways and convenience food shops favoured unhealthy food,” he said.

The researchers said the problem required a strategic multilevel response.

“Public health policymakers need to work with refugee communities to develop and implement health promotion strategies to improve diet and nutrition early in the settlement process,” Dr Gudes said.

“First, initial health assessments must identify nutritional deficiencies and take into consideration the impacts of malnutrition.

“Second, newly arrived communities need more information and education about the nutritional value of Western foods, how to assess their healthiness and how to substitute unhealthy foods with more nutritious options. Dietitians and social workers also need to be trained to address cultural differences and traditional preferences,” he said.

Dr Gudes said a culturally sensitive model to “train the trainers” could help newly arrived refugees adapt to their new food environment.

“This is when one individual from the community is trained, then teaches the skills to others and so on. The training could increase awareness of available healthy Western food, improve cooking skills and educate community members about the impact of unhealthy diets on health.

“Finally, and most importantly, governments need to act on the heavy distribution of unhealthy food outlets and lack of access to healthy foods, particularly in refugee settlement areas,” he said.

Laurie Nowell
AMES Senior Journalist