Call for a moratorium on refugee resettlement: Public health system challenges in assuring the health of the community's most diverse newcomers

Communities are important health determinants for resettled refugee populations.  Officials in designated refugee resettlement communities in New England often claim that the resources to provide these newcomers with employment, quality housing, and the opportunity to learn English are strained due to limited capital and competing local demands.  To explore the complexity of this issue from the standpoint of community leaders as managers of the resettlement process and the refugee resettlement process itself, in-depth interviews with key stakeholders (city officials and administrators of refugee resettlement agencies) in several New England communities were conducted to 1.) describe the community’s ecology (i.e., its social, cultural, political, and economic systems) for refugees; 2.) identify the perceived/actual challenges to refugee resettlement; and 3.) evaluate the needs of the resettled refugee population and the available community resources.  Since where one lives is an important determinant in health-related problems for resettled refugee populations, a particular emphasis of this work was to examine the public health issues experienced by the resettled refugees and the role, challenges, and successes of the public health system in working to fulfill the primary prevention mission of public health for their most diverse populations.  This case study represents a microcosm of the public health issues that refugee resettlement communities across the country are experiencing.  Recommendations are presented for how practitioners who assist resettled refugee populations with complex public health issues can promote health and prevent disease via a Health in All Policies approach.