Abstract
INTRODUCTION: The extent that the dual burden of undernutrition and overnutrition affects refugee children before resettlement in the US is not well described. OBJECTIVE: To describe the prevalence of wasting, stunting, overweight, and obesity among refugee children ages 0-10 years at their overseas medical screening examination prior to resettlement in Washington State (WA), and to compare the nutritional status of refugee children with that of low-income children in WA. METHODS: We analyzed anthropometric measurements of 1047 refugee children ages 0-10 years old to assess their nutritional status at the overseas medical screening examination prior to resettlement in WA from July 2012--June 2014. The prevalence estimates of the nutritional status categories were compared by country of origin. In addition, the nutritional status of refugee children age 0-5 years old were compared to that of low-income children in WA from the Center for Disease Control and Prevention's Pediatric Nutrition Surveillance System. RESULTS: A total of 982 children were eligible for the study, with the majority (65%) from Somalia, Iraq and Burma. Overall, nearly one-half of all refugee children had at least one form of malnutrition (44.9%). Refugee children ages 0-10 years were affected by wasting (17.3%), stunting (20.1%), overweight (7.6%) and obesity (5.9%). Among children 0-5 years old, refugee children had a significantly higher prevalence of wasting (14.3% versus 1.9%, p<0.001) and stunting (21.3% versus 5.5%, p<0.001), and a lower prevalence of obesity (6.2% versus 12.9%, p<0.001) than low-income children in WA. CONCLUSION: The dual burden of under- and over-nutrition among incoming refugee children as well as their overall difference in prevalence of nutritional status categories compared to low-income children in WA provides evidence for the importance of tailored interventions to address the nutritional needs of refugee children.