IMMIGRATION AFFECTS NUTRITION 1

Immigration Affects Nutrition:

An Analysis of Immigration Status and Diet-Based Health Changes

Abigail Mattson

Arizona State University

PPE 310: Healthy Learning Communities

Professor Sambach

November 21, 2017

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Introduction

Any time a human being moves to a new place, they will experience a transition period.

Some parts of their transition may positively or negatively impact their life strongly. No human

being is in a more vulnerable place than one who has left behind everything they know to flee

from a country that is dangerous to live in. Refugees and immigrants are some of the most

courageous people on the planet, and they go through a lot when they arrive in a new country.

The purpose of this paper is to examine the affects of an American diet on a refugee or

immigrant who has recently arrived in the United States. A new diet can have a direct effect on a

persons social, emotional, physical, and nutritional health, and may have an indirect affect on a

persons spiritual and intellectual health. This paper will include a literature review, a synthesis

of information, and practical implications to support and improve the healthy diets of all

immigrants and refugees, or any new arrival to our country. We must be able to empower

immigrants and refugees to make healthy nutritional choices when they come to our country, and

we must be aware of the harmful affects our diets can have not just on our lives, but on the lives

of people who are not native to our country. With the knowledge and information this paper

provides, we will be better equipped to assist any new arrival to our country in making positive

dietary choices for themselves and for their families.

Literature Review

Article #1: Dietary Acculturation Research with African Refugees

The purpose of this study was to stimulate research to improve our understanding of the

conflicting and interacting roles that [several variables] play in shaping the health of refugee

populations as they move to the USA (Patil et. al., 2008, p. 343). The researchers identified

five variables that affect immigrant and refugee dietary and nutritional lifestyle changes when
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they come to the United States. These five variables include food availability, economic

constraints, time-constraints or convenience, children, and efficiency of knowledge transfer. In

order to study the impact that these five variables have on the diet of new arrivals in the United

States, the researchers used a combination of data analysis and interviews. The first part of their

method was an assessment of data about the availability of food in regions of Liberia, Somalia,

and the United States. The second section of the study was a series of informal interviews with

refugees from seven different countries. Finally, the researchers used surveys to learn more

about food accessibility for all refugees. After all analyses and interviews were complete, the

researchers found that diets are indeed shifting with greater amount of time in the USA (Patil

et. al., 2008, p. 346). Diets in the US are marked by increased consumption of sweeteners and

calories from sugar, and the longer amount of time that refugees spent in the United States, the

more they chose to integrate these foods into their diets.

Article #2: Immigrants who Participated in the Live Well Healthy Intervention

The Live Well healthy lifestyle intervention was created to prevent weight gain for

recent immigrant mothers and their children. The purpose of this study was to measure the

success of the Live Well program and to discuss self-reported data on changes in diet and

physical activity from the immigrant mothers. Almost 400 mothers and their children attended a

measurement day, in which they filled out a series of surveys to assess their diets, regular

physical activity, and psychosocial or physical characteristics. The researchers found that self-

reported changes in diet and physical activity since migrating to the US were significantly

associated with BMI (Tovar et. al., 2013, p. 457).

Article #3: Participatory Research on Physical Activity and Nutrition in Immigrant Women
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Before they even began this study, the researchers knew that the health of immigrants and

refugees steadily declines after their arrival to the U.S. They stated that immigrants and refugees

arrive to the U.S. healthier than the general population, (Wieland et. al., 2012, p. 225). In

order to determine if a health and wellness intervention would support the sustained health of

women immigrants, Mr. Wieland and his colleagues created this participatory research study for

a community of women immigrants and refugees from four different ethnic groups. The

researchers hosted a six-week program with two classes per week for 45 women. Mr. Wieland

and the other researchers noted that after the intervention, participants were more likely to

exercise regularly (Wieland et. al., 2012, p. 225) and had better weight loss and blood pressure.

Article #4: Interviews from Immigrant Women About Obesity Factors in their New Lifestyles

The researchers who created this study wanted to examine the perceptions that immigrant

women had about obesity and about their new lifestyles in the United States. Focus groups were

created for immigrant women from Brazil, Latin America, and Haiti, and these groups met with

researchers to complete group interviews. After the interviews, the transcripts were analyzed

using two different strategies. For the first analysis, a trained researcher examined the transcripts

to find themes about obesity and lifestyle choices. The second time included an analysis of data

from the transcripts in a community-based, participatory research study. The overall opinions of

the women who participated in the study included three main themes: that there is less time for

preparation of food in the U.S., food is less natural and has more variety, and that there is more

job-related stress in the United States. Ms. Tovar and her colleagues did find that providing

immigrants with appropriate support and education early in the acculturation process has the

potential to help prevent obesity (Tovar et. al., 2012, p. 358).

Synthesis of Information
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All four of these research papers arrived at the same conclusion: that immigrants and

refugees experience a decline in overall health when they live in the United States. However,

two of the research articles studied this topic explicitly, and two of the articles used this

conclusion as the opening statement for their study. In other words, all four studies understood

that the longer immigrants and refugees live in the United States, the worse their health and

overall wellness will be. The third and fourth studies researched the impact that early health

support and interventions can have on the nutritional choices and risk of obesity that immigrant

and refugee women may have. The articles all had one theme in common: that immigrants and

refugees are not prepared to choose or afford healthy food choices when they arrive in the United

States. Researchers in at least three of these studies suggested that people who come to the

United States need help in order to eat healthy and to make positive choices about physical

exercise. There were several different secondary themes in these studies, as they did all have a

slightly different focus. One study focused on the perceptions that immigrant women have about

their own health and nutrition choices, and another study discussed the benefits of programs to

encourage women to exercise regularly. The overall conclusion of these studies is appropriate

support and education early in the acculturative process may helpimmigrants (Tovar et. al.,

2013, p. 362) and may prevent negative health affects during their transition to the U.S.

Practical Implications

The Classroom: Individual and Group Action Plans

As these journal articles demonstrated, refugees and immigrants who are newly arrived to

the United States would benefit from health and wellness interventions or educational workshops

during their first few months in the United States. The practical implication of this research in a

classroom session will be to hold a health and wellness course two nights per week. The course
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will be for adult learners, specifically newly-arrived refugees and immigrants. One night per

week will focus on group learning sessions, and will include topics like types of grocery stores,

how to find a local grocery store, how to budget and plan weekly meals, and recipe suggestions

with inexpensive, healthy food items. The other night of class will host guest speakers who are

dieticians, nutritionists, doctors, teachers, and other health and wellness professionals. These

people will share their own experience, show movie clips or tell stories, and facilitate interactive

activities for the adults who participate in the course. Every adult who comes to the course will

be assigned an American mentor who can befriend them, support them, and connect with them

outside of the class if they would like. The mentor will support the individuals in filling out

personal action plans to help them prepare healthy meals for themselves and their families, and

will support their physical fitness goals.

Event Plan: Bringing Classroom Learning to the Community

The twice-weekly class will meet for six months, from January until July. A culminating

activity for the course will be a small farmers market and community festival, with the purpose

of bringing together community members and classroom participants. The farmers market will

include food items that the participants have grown themselves, or food items from local gardens

and farms they have visited during the six-month class. Participants will also be permitted to

bring textile goods or other crafts they may enjoy making to sell at the farmers market. In

addition to the sale of goods and food, participants must design and facilitate booths with

activities about health and wellness. These activities can be fun for kids and families, and will

share their knowledge with the community.

Community Involvement: this Plan is for Everyone!

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There are several ways I will invite the community to participate in both the twice-

weekly class times and in the summer farmers market festival. First, I will partner with the

Clarkston Community Health Clinic to invite local doctors, dentists, and dieticians to come

speak to the group. Many of the volunteers who already spend their time at the Health Clinic are

former refugees or immigrants themselves, so they will be able to relate to the people who attend

the class. Next, I will partner with a community nonprofit called Something New to bring in

other health and wellness professionals to serve as mentors to the participants. Something New

is a 5013 nonprofit that works with adults and young people in the arts, mentorship, and

community development. Something News over 100 volunteers already serve as mentors in

Clarkston, Georgia, but there are many more people who could use the support and

encouragement that these volunteers add to any group. Finally, I will partner with the Clarkston

Community Center as a location for the classes. The Community Center is a nonprofit as well,

and hosts all kinds of classes for refugees and immigrants in its classrooms and small theater. It

is a great space and would allow our participants to feel at home and in a place where they may

already spend some of their time each week.

Specific Topics and Details to Put This Plan into Action

1. Marketing

In order to find participants for the class and for the farmers market festival, I will partner with

local nonprofits and community organizations in Clarkston who work directly in refugee

resettlement. I will ask resettlement program directors to pass out flyers for the class, and will

ask other community organizations to put up posters around Clarkston. I will also ask

community organizations to include half-page advertisements in their newsletters or other forms

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of communication. Here are three samples of a flyer, a poster, and a newsletter advertisement

for the program:

Do you and your family need help planning delicious meals?

Would you like to be part of a healthy community?
You must be a part of the Health Action Plan!
What: A class for adults who recently arrived in the United States
When: Tuesdays and Thursdays, 6:00-8:00 pm, Starting January 9th
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Where: Clarkston Community Center

Cost: Free!
For more information please email healthaction@somethingnew.org

2. Funding

In order to fund this program, I will apply for a community grant from the City of Clarkston.

This grant will allow us to apply for a location for our summer farmers market festival, and will

pay for us to rent a classroom at the Community Center each week. The volunteers who come to

speak or mentor refugee or immigrant adults each week will not be paid, but will be given

community service hours upon request. The farmers market will also be a fundraiser for the

next years class, and we will ask for donations from hospitals, grocery stores, or universities in

the area. Our donation letters will prove how our class supports the overall health and wellness

of our community, and will encourage healthy lifestyle habits for all those involved. Donors will

be able to sponsor a booth at the summer farmers market and will be able to advertise for their

business at that time.

3. Committee

The Committee for this action plan will include the following individuals:

- Dr. Laura Alyce Makaroff (Family Health Practitioner and volunteer at the Clarkston

Community Health Clinic)

- Lisa Heuss (Dental Hygienist and volunteer at the Clarkston Community Health Clinic)

- Alison Sheldon (Educator and volunteer with Something New)

- Jason Armstrong (Health Administrator, Spanish Translator, and volunteer with Something

New)

- Shawn Samuelson (Marketing Specialist and volunteer with Something New)

- Lindsay Ehlers (Physicians Assistant and volunteer with Something New)

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- Morgan Farnsworth (Information Technology Specialist and volunteer with Something New)

Over 50 other volunteers from the Clarkston Community Health Clinic and Something New will

also be invited to participate in our program. The purpose of the named committee above will be

to coordinate mentors and volunteers, create lesson plans for classes, and to find community

partners to support our summer event.

4. Scheduling

The first class will take place on January 9th, 2018, from 6 8 pm. The second class will be held

on January 11th from 6 8 pm, and classes will be held every Tuesday and Thursday from that

point forward at the Clarkston Community Center. The summer farmers market festival will be

held on Saturday, August 3, 2018, from 8 11 am at the community space outside Refuge

Coffee Shop in Clarkston, Georgia.

5. Engagement

This community action plan will bring hope and life to the Clarkston community in three ways.

First, it will support resettlement agencies by providing a health and wellness course where there

are none currently offered. This course is the first of its kind in Clarkston, and research has

shown that this kind of course makes a significant difference in the overall health and wellness of

immigrants and refugees. Second, this course will bring awareness to the work that the

Clarkston Community Health Clinic does in Clarkston, and will hopefully provide a means for

the Clinic to continue and to grow. As of right now, the clinic operates on a very small budget

and extremely limited time and space. By partnering with the Clinic, we will get their name and

mission out to larger sponsors and to the community as a whole. Finally, this action plan will

improve the quality of life for the people of Clarkston. Families and adults who are healthier are

happier, more able to be active and to enjoy life, and are more involved in their communities.
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This program provides the direct support that adults who are transitioning to the United States

will need to be healthy and to feel good about themselves and their arrival in a new country.

6. Educational Components

There are many educational components to both the classes and the summer farmers market

festival for this project. The classes will enhance each adult immigrant or refugees workplace

success by increasing their English language skills, improving their overall health and happiness,

and connecting them to more people from their community. The classes will also discuss simple

math lessons about finding sale prices for food, using discounts, and budgeting for a weekly

meal plan. Adult students will also have the opportunity to research healthy food options and

stores in their community, and will participate in two or three field trips to those locations. They

will receive foundational science instruction when they have the opportunity to plant their own

small garden, and to participate in the care and upkeep of a local community garden. The

learning success of each participant will be determined in two ways. They will receive a short

doctors examination during the first week of the course, and will participate in two other

examinations at the middle and end of the six-month period. The information gained from these

examinations will be used for research purposes (and all adults must sign a consent waiver). The

second strategy for determining the success of the adult participants will be to evaluate their

participation and creativity during the summer farmers market festival. Each participant will

also complete a survey and brief interview at the conclusion of the course, and their opinions and

self-reflections will be used to inform the next course in 2019.

Conclusion

There are many strategies that one can use to support the health and wellness of

immigrants and refugees who have recently arrived in the United States. The American lifestyle
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and diet can have a negative impact on the overall health and nutrition of anyone who arrives to

the United States, and interventions are needed in order to ensure that all new arrivals are

educated about making healthy nutrition choices for their families. Many immigrants and

refugees are able to self-reflect about lifestyle and diet changes they have made since their

arrival in the United States, but some will need help and support in order to make healthy

choices. The six-month program hosted by Project Action Health is an intervention designed to

educate, support, and empower immigrants and refugees to make healthy choices. The program

will cover six topics that are fundamental to any persons overall wellbeing. These six topics

will include nutritional health, emotional health, social health, physical health, spiritual health,

and emotional health. Project Action Health will partner with other nonprofit organizations in

the Clarkston, Georgia, area, in order to create a healthier community that is more conscious

about nutritional health. The program will also increase community engagement by referring

adult students to community programs and centers, and by hosting a farmers market festival as a

culminating activity at the end of the class. After one year, the program will have impacted the

immediate community in the town of Clarkston and will have affected the lives of 30-40

students. After three years, the program will have gained awareness in the greater Atlanta area

and will have empowered over 150 students. After five years, it is our goal that the program

would become a requirement for all adults who arrive in the United States, and that we would

have had the privilege to support over 300 families. It is programs like these that will

significantly impact the health of all immigrants and refugees who arrive in the United States,

and will give them the knowledge they need to successfully transition to life in a new country.
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References

Healing our Community / Clarkston Community Health Center (n.d.). Retrieved on November

13, 2017, from https://www.clarkstonhealth.org/

Home / Clarkston Community Center (2017). Retrieved on November 13, 2017, from

https://clarkstoncommunitycenter.org/

Patil, C.L., Hadley, C., & Nahayo, P.D. (2009). Unpacking dietary acculturation among new

Americans: results from formative research with African refugees. Journal of Immigrant

and Minority Health, 11(5), 342-358. Retrieved from https://search-proquest-

com.ezproxy1.lib.asu.edu/psycinfo/docview/199566782/fulltextPDF/5383FEF4C7954E5

0PQ/4?accountid=4485

Tovar, A., Boulos, R., Sliwa, S., Must, A., & Gute, D.M. (2014). Baseline socio-demographic

characteristics and self-reported diet and physical activity shifts among recent immigrants

participating in the randomized controlled lifestyle intervention Live Well. Journal of

Immigrant and Minority Health, 16(3), 457-465. Retrieved from https://search-proquest-

com.ezproxy1.lib.asu.edu/psycinfo/docview/1701493722/5383FEF4C7954E50PQ/9?acc

ountid=4485

Tovar, A., Must, A., Metayer, N., Gute, D.M., & Pirie, A. (2013). Immigrating to the US: what

Brazilian, Latin American, and Haitian have to say about changes to their lifestyle that

may be associated with obesity. Journal of Immigrant and Minority Health, 15(2), 357-

364. Retrieved from https://search-proquest-

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Wieland, M.L., Weis, J.A., Palmer, T., Goodson, M., & Loth, S. (2012). Physical activity and

nutrition among immigrant and refugee women: a community-based participatory

research approach. Womens Health Issues, 22(2), 225-232. Retrieved from

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