Since the early 2000s, Maine has seen quite a substantial rise in immigrant and refugee population growth. To put it into perspective, the total population in Portland, Maine between 2000 to 2010 had increased only by 3% while the racial and ethnic minority population in Portland had increased by 80% (____). Maine has typically admitted a large percentage of its refugees from heavily Muslim populated countries like Somalia and Iraq but as of recent, with the immigrant policies and bans being enforced by the Trump administration, it has significantly lessened the numbers of people entering America overall.
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Nonetheless, with migration brings an increased susceptibility to chronic diseases like diabetes, especially for Somali women.
Somali women The relationship between migration and diabetes can be examined through the refugee and immigrant experience of acculturation to their host country. And as a result, health-related factors like obesity, dietary acculturation, physical inactivity and lack of access or utilization of modern health services become strong causal determinants for this public health issue. On top of the predisposition to having insulin resistance many migrants in non-Western countries have risen in conditions of poverty and their bodies have been ?programmed to tackle hunger and starvation.
The result is that later in life, when exposed to the obesogenic environment of the country of immigration (high-fat diet and sedentary lifestyle), they are particularly prone to stock energy reserves and thereby gain weight (Montesi). This is especially true for Somali immigrants as majority of them are refugees fleeing from their country that is still amidst a civil war today. On top of this predisposition to gaining weight, adjusting their dietary habits is another main concern. The traditional Somali diet is centered around pasta, rice, other carbs, meat, camel and goat milk, and tea with a lot of sugar.
It’s not the most balanced diet but when combined with a more sedentary lifestyle than the lifestyle they knew in Africa, it can lead straight to obesity and diabetes. A sedentary lifestyle is common and convenient especially when the wintery Maine climate, lack of motivation and time are barriers to getting active but according to a focus group study on Somali women and their views on physical activity, these barriers in addition to tradition and religion hold Somali women back.
These obstacles originate from their steadfast following of the Islamic faith. According to Somali customs, wearing revealing and skin-tight Westernized clothing when males are present is forbidden, haram. So the traditional Somali clothing for women is a full-length dress and a hijab which is difficult to get active in (Gerthi). Whether it is done deliberately or not, differences in socioeconomic status and barriers formed by the culture of medicine and healthcare in America put ethnic minorities like Somalis at a higher risk of being under-treated. And even though the probability of developing a chronic disease is higher in foreign-born individuals, they are still more likely to not have their own health insurance coverage.
Plus, many believe not making use of drugs and primary care services is a cheaper and healthier alternative yet underutilization of drugs and primary care services especially for the foreign-born can be anything but cost-effective. In fact, it would most likely produce higher hospitalization rates in the long run due to disease progression and other complications. Especially with Somali immigrants, there is a clear stigma associated to trusting anything related to modern science because of their strong cultural and religious beliefs. EXPAND All in all, more efforts should be made to positively encourage screening and treatment programs, to adapt education programs to specific cultures, and to grow community engagement.
The social determinants of this public health problem are related to how resources are communicated and the advantages and disadvantages to which people are exposed. Certain populations experience consistently lower health statuses than others and require more attention to understand and relieve them of their health issues. Among these, immigrants and particularly refugees constitute a large group of people who have serious needs in regards to their health. Many refugees experience extreme hardship prior to and during flight from persecution, famine and war in their country of origin and continue to experience difficulties upon resettlement in a host country, all of which seriously affect their health status.
FIX: linguistic factors (lack of communication and language barriers being a determinant in immigrant health) play a significant role in the understanding and self-management of diabetes in these populations. health care professionals whose ethnic backgrounds often differ from most of their immigrant patients are frequently unaware of communication barriers that make comprehension and adherence to medical treatments very difficult for immigrant groups FIX. And once again, Refugees and immigrants of every race and religion can be found in any region of the world. They give up everything they know in fear for their lives home, belongings and loved ones for an uncertain future in an unfamiliar land.
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