Topics: COVID-19, Faculty, Research

December 8, 2020

Beneficence with face mask

For Bhutanese and Burmese refugees in the United States, working in essential industries comes with an increased risk of COVID-19 infection, says a new report from Ball State University.

Of 218 refugees in 23 states who were surveyed from May 15 through June 1, 15 (6.9%) reported being infected with COVID-19.

“A leading suspected risk factor is their role in the essential workforce,” said Mengxi Zhang, an assistant professor of health science in Ball State’s College of Health. “Refugees and other immigrants, especially those with limited English proficiency, are more likely than U.S.-born workers to work in areas with low pay and high risk.

“These areas include food supply chain industries with high risk of exposure to COVID-19 and limited worker protections, as evidenced by multiple outbreaks among workers at packing plants.”

The study, COVID-19 and Immigrant Essential Workers: Bhutanese and Burmese Refugees in the United States, was published in the November issue of Public Health Reports.

Zhang led a team consisting of researchers from the Children’s Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, and Johns Hopkins Bloomberg School of Public Health.

The study also found that infected respondents, compared to respondents who were not infected were:

  • Less likely to have bachelor’s degree (20.0% vs. 52.3%).
  • More likely to have an infected family member (53.3% vs. 3.5%).
  • More likely to be an essential worker (80.0% vs. 39.4%).

Also, the prevalence of COVID-19 was 13.6% (12 of 88) among essential workers and 2.3% (3 of 130) among nonessential workers.

Refugees from Bhutan and Myanmar (previously called Burma) are Asian immigrant populations that merit further attention, Zhang said.

Of refugee communities resettled in the United States in the past decade, they are among the largest (14% and 21% of arrivals, respectively); of Asian-origin, they have among the largest proportions which are not U.S.-born (92% and 85%, respectively).

Zhang points out that public health data on COVID-19 vulnerability among refugees and other immigrants is limited.

“This lack of information is of particular concern for newcomers of Asian origin, as information about COVID-19 among Asian immigrants at higher risk of infection or mortality may be buried among data on nonimmigrant Asian subgroups at lower risk of infection or mortality,” she said. “As a result, the guidance is insufficient on public health communication and prevention strategies that target this fast-growing and culturally, linguistically, and economically diverse sector of the U.S. population.”

Zhang recommends that public health departments improve multilingual education and consider distribution of personal protective equipment to multigenerational households and home caregivers for COVID-19 patients.

“Considering the diversity of refugee and immigrant communities in the United States, we suggest that public health departments engage refugee and other immigrant stakeholders in planning processes to ensure that public health interventions are accessible to these communities.”