Non-Communicable Disease

Bhutanese Refugee Health Profile

Hypertension

Blood pressure is measured during the visa medical exam and during post-arrival screening exams in the United States. Although two or three measurements are required to diagnose an individual with hypertension, single measurements may be used to estimate prevalence of hypertension in a population. The prevalence of high blood pressure increases with age among Bhutanese refugees, as expected; however, the estimated rate of hypertension in adults over the age of 65 (15%) is much lower than that seen in the same age group in the United States (>65%). ¹⁶ Three percent of applicants reported a history of hypertension during their visa medical examination (Table 4).

Table 4: Self-Reported Non-Communicable Health Conditions and Tobacco use During Visa Medical Examinations Among US-Bound Bhutanese Refugees, 2008 – 2011

Non-Communicable Health Condition	Percent
Hypertension	3.0%
Asthma	0.5%
Chronic obstructive pulmonary disease (emphysema)	0.7%
Seizure disorder	0.7%
Major impairment in learning, intelligence, self-care, memory, or communication	0.8%
Major mental disorder including major depression, bipolar disorder, schizophrenia, mental retardation	1.2%
Diabetes mellitus	0.7%
Thyroid disease	0.2%
Visible disabilities including loss of arms and legs	0.5%
History of tobacco use	6.5%
Current tobacco use	4.8%

Note: Other conditions including angina pectoris, cardiac arrhythmia, congenital heart disease, history of stroke with current impairment, drug addiction, or other substance-related disorders including alcohol addiction, malignancy, chronic renal disease, and chronic liver disease were reported by less than 0.2% of applicants. Source: EDN

Lead Poisoning

Bhutanese refugee children do not appear to be at higher risk of lead poisoning than US. children. Only 1.3% of Bhutanese children ≤16 years of age screened in one large resettlement state during 2008–2011 had elevated blood lead levels (≥10 ug/dL). In general, refugee children are thought to be at higher risk for lead poisoning, not only because anemia and malnutrition increase lead absorption but also because of an increased risk for exposure to products containing lead. ²¹

References

National Center for Health Statistics (2011). Health, United States, 2010: With special feature on death and dying. Hyattsville, MD.
Mitchell T, Jentes E, Ortega L, Scalia Sucosky M, Jefferies T, Bajcevic P, Parr V, Jones W, Brown MJ, Painter J. Lead poisoning in United States-bound refugee children: Thailand-Burma border, 2009. Pediatrics. 2012 Feb;129(2):e392-9.