Journal of Immigrant and Minority Health

, Volume 16, Issue 5, pp 922–925 | Cite as

Noninfectious Disease Among the Bhutanese Refugee Population at a United States Urban Clinic

  • Gayathri S. Kumar
  • Selina Varma
  • Michael S. Saenger
  • Molly Burleson
  • Brandon A. Kohrt
  • Paul Cantey
Original Paper


A large number of Bhutanese are currently being resettled to the United States. A high prevalence of noninfectious diseases has been noted in some refugee groups, but data on the Bhutanese refugee population are lacking. A retrospective, chart review study was conducted to determine proportion of noninfectious disease among ethnically Nepali Bhutanese refugees (n = 66) seen at the Grady Refugee Clinic (GRC). GRC disease proportions included the following: 52 % of the patients were overweight/obese (n = 34), 23 % were hypertensive (n = 15), 12 % had vitamin B12 deficiency (n = 8), 15 % had depression (n = 10), and 14 % had diabetes (n = 9). Nine (90 %) patients with depression had chronic disease compared to 30 (54 %) of the patients without depression. The study found a substantial burden of chronic disease, micronutrient deficiency, and depression in the GRC. Further research is needed to accurately describe the disease burden in refugee populations and to evaluate pre-resettlement disease prevention strategies to provide a framework for future public health interventions.


Bhutanese Refugee Chronic disease Noninfectious disease 


Conflict of interest

The authors report no conflicts of interest.


  1. 1.
    Blank H, Bowman B, Serdula M, Khan JK, Kohn W, Woodruff BA. Angular stomatitis and riboflavin status among adolescent Bhutanese refugees living in southeastern Nepal. Am J Clin Nutr. 2002;76:430–5.Google Scholar
  2. 2.
    Kohrt BA, Kunz RD, Baldwin JL. “Somatization” and “comorbidity”: a study of jhum–jhum and depression in rural Nepal. Ethos. 2005;33(1):125–47.CrossRefGoogle Scholar
  3. 3.
    Brennan M, Biluhka O, Bosmans M. Refugee health in Nepal: joint UNHCR-WHO evaluation of health and health programmes in Bhutanese refugee camps in Nepal. New York, NY: United Nations High Commissioner for Refugees; 2005.Google Scholar
  4. 4.
    Hutt M. Unbecoming citizens: culture, nationhood, and the flight of Refugees from Bhutan. Oxford: Oxford University Press; 2003.Google Scholar
  5. 5.
    Mills E, Singh S, Roach B, Chong S. Prevalence of mental disorders and torture among Bhutanese refugees in Nepal: a systemic review and its policy implications. Med Confl Surviv. 2008;24(1):5–15.CrossRefPubMedGoogle Scholar
  6. 6.
    Schininà G, Sharma S, Gorbacheva O, Mishra AK: Who am I? Assessment of psychosocial needs and suicide risk factors among Bhutanese refugees in Nepal and after third country resettlement. International Organization for Migration Website. Accessed August 2012.
  7. 7.
    Dookeran NM, Battaglia T, Cochran J, Geltman PL. Chronic disease and its risk factor among refugees and asylees in Massachusetts, 2001–2005. Prev Chronic Dis. 2010;7(3):1–8.Google Scholar
  8. 8.
    National Institutes of Health. Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults—the evidence report. Obes Res. 1998;6:S51–209.CrossRefGoogle Scholar
  9. 9.
    Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, Jones DW, Materson BJ, Oparil S, Wright JT, Roccella EJ. The seventh report of the Joint National Committee on prevention, detection, evaluation and treatment of high blood pressure: the JNC 7 report. JAMA. 2003;289(19):2560–72.CrossRefPubMedGoogle Scholar
  10. 10.
    American Diabetes Association. Clinical practice guidelines. Diabetes Care. 2010;33:S62–9.PubMedCentralCrossRefGoogle Scholar
  11. 11.
    Snow C. Laboratory diagnoses of B12 and folate deficiency: a guide for the primary care physician. Arch Intern Med 1999; 159(12): 1289–1298.Google Scholar
  12. 12.
    Centers for Disease Control and Prevention. Health, United States, 2008. National Center for Health Statistics Website. Accessed June 6, 2010.
  13. 13.
    WHO Global Infobase. WHO Website. Accessed July 2010.
  14. 14.
    Oza-Frank R, Stephenson R, Narayan V. Diabetes prevalence by length of residence of US immigrants. J Immigr Minor Health. 2011;13:1–8.CrossRefPubMedGoogle Scholar
  15. 15.
    Centers for Disease Control and Prevention. Vitamin B12 deficiency in resettled Bhutanese Refugees—United States 2008–2011. MMWR Morb Mortal Wkly Rep. 2011;60(11):343–6.Google Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Gayathri S. Kumar
    • 1
  • Selina Varma
    • 2
  • Michael S. Saenger
    • 1
  • Molly Burleson
    • 2
  • Brandon A. Kohrt
    • 3
  • Paul Cantey
    • 4
  1. 1.Department of Internal MedicineEmory UniversityAtlantaUSA
  2. 2.Rollins School of Public HealthEmory UniversityAtlantaUSA
  3. 3.Department of PsychiatryEmory UniversityAtlantaUSA
  4. 4.Division of Parasitic Diseases and MalariaCenter for Global Health, CDCAtlantaUSA

Personalised recommendations