Burden of Mental Illness and Non-communicable Diseases and Risk Factors for Mental Illness Among Refugees in Buffalo, NY, 2004–2014

  • Wudeneh MulugetaEmail author
  • Hong Xue
  • Myron Glick
  • Jungwon Min
  • Michael F. Noe
  • Youfa Wang



Limited is known about mental illness and non-communicable diseases (NCDs) and their risk factors among refugees. These were studied using data collected from a refugee population in Buffalo, NY.


Longitudinal data collected on 1055 adults (> 18 years) at a large refugee health center in Buffalo, NY, during 2004–2014 were used. Main outcomes were hypertension, diabetes, tobacco use, obesity, overweight/obesity, and mental illness. Risk factors were assessed using multivariate regression models.


Compared to those without mental illness, refugees with mental illness had higher rates of hypertension (16.9 vs 28.4%, P < 0.001), diabetes (8.4 vs 13.6%, P = 0.03), tobacco use (9.3 vs 18.3%, P < 0.001), obesity (13.0 vs 25.4%, P < 0.001), and overweight/obesity rates (45.0 vs 61.5%, P < 0.001). During 2004–2014, obesity rates increased among those with mental illness (25.4 to 36.7%, P < 0.001) and without mental illness (13.0 to 24.5%, P < 0.001). The overall mental illness prevalence among refugees was 16%, ranging from 6.9% among Asians to 43.9% among Cubans. Women were more likely to have mental illness (odds ratio = 2.45; 95% confidence interval [CI] = 1.68–3.58) than men. Refugees who lived longer in the USA were more likely to carry psychiatric diagnoses (OR = 1.12; 95% CI = 1.04–1.21).


Mental illness rates varied considerably across various refugee groups. Rates of obesity and NCDs among refugees with mental illness were higher than among those without mental disorders. Gender, region of origin, and length of stay in the USA were associated with mental illness. Accurate and culturally sensitive screenings and assessments of mental illness are needed to reduce these health disparities.


Refugee Mental illness Non-communicable diseases Obesity Health disparity 



We would like to thank Mrs. Jessie Mossop, Information Services and Reporting Manager at Jericho Road Community Health Center, for her assistance in data retrieval. The content of the paper is solely the responsibility of the authors and does not necessarily represent the official views of the funders. This study was partly supported by research grants from the National Institute of Health (NIH, U54 HD070725, 1R01HD064685-01A1). The U54 project (U54 HD070725) is funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) and the Office of the Director, National Institutes of Health (OD). Dr. Youfa Wang is the principle investigator of the grants.


This study was partly supported by research grants to Dr. Youfa Wang from the National Institute of Health (NIH, U54 HD070725, 1R01HD064685-01A1). The U54 project (U54 HD070725) is funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) and the Office of the Director, National Institutes of Health (OD).

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

Institutional review board (IRB) approval was received from the State University of New York at Buffalo for the study. For this type of study, formal consent is not required.


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Copyright information

© W. Montague Cobb-NMA Health Institute 2018

Authors and Affiliations

  • Wudeneh Mulugeta
    • 1
    Email author
  • Hong Xue
    • 2
  • Myron Glick
    • 3
  • Jungwon Min
    • 2
  • Michael F. Noe
    • 4
  • Youfa Wang
    • 2
    • 5
  1. 1.Department of Medicine, Cambridge Health AllianceHarvard Medical SchoolRevereUSA
  2. 2.Systems-Oriented Global Childhood Obesity Intervention Program, Fisher Institute of Health and Well-being, College of HealthBall State UniversityMuncieUSA
  3. 3.Jericho Road Community Health CenterBuffaloUSA
  4. 4.Department of Epidemiology and Environmental Health, School of Public Health and Health ProfessionsUniversity at BuffaloBuffaloUSA
  5. 5.Department of Nutrition and Health Sciences College of HealthBall State UniversityMuncieUSA

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