Perceived Neighborhood Characteristics and the Health of Burundian Refugees in the United States

Purpose: This study examines the role refugee perception of neighborhood characteristics, housing, and resettlement experiences on self-rated health and well-being among newly arrived and recently resettled Burundian refugees in a small mid-southern rural city. Satisfaction with overall neighborhood characteristics, neighborhood safety, and with relationships to neighbors is considerably and significantly associated with higher self-rated and emotional health status. Typically refugees are initially offered temporary free housing by the host country, in poorer neighborhoods as they transition into permanent resettlement. Methods: A convenient sample of fifty Burundian refugee households recently arrived or resettled participated in the study over a period of eight months. Open-ended questions were used to collect qualitative data on participants’ perception of their neighborhood characteristics and how this related to their resettlement experiences, health and well-being in general.  These participants’ residences were in six different neighborhoods in Knoxville, Tennessee. Findings:  Thematic data analysis revealed perceptions of predominantly highly insecure neighborhoods; cheap or free run-down housing; rampart shootings; and violence sometimes gang-related or drug-related; discrimination on the bus and schools; disconnect with host community; poor housing; and a state of constant worry triggering sad memories of long years of suffering and forced migration.  Conclusions:  The effects of settling in poor or declining neighborhoods and the insecurity, and cultural shock in addition to traumatic war memories complicate the resettlement process. The findings suggest a range of policy and program changes to improve housing circumstances of newly arrived refugees, and facilitate their resettlement and integration into a new society.