Dealing with Disparities in Food Acquisition Among Refugees (DDFAR)

Window-Buffalo NY, Rik-shaw, 2012, Modified.

Window-Buffalo NY, Rik-shaw, 2012, Modified

Recent Publication

Alexandra Judelsohn, Heather Orom, Daniela Leon & Samina Raja (2020) Refuge in new food environments? The role of urban planning in facilitating food equity for new Americans, Journal of Urban Affairs, DOI: 10.1080/07352166.2019.1705845

At the end of 2014, 19.5 million people were reported to be refugees in the world, and the number has continued to rise.  In 2014, 4,085 refugees were resettled in New York State, with Erie County receiving the highest number. Resettlement is meant to be a durable, long-term habitation solution so refugees can lead full, healthy lives. However, refugees are often resettled in neighborhoods that expose populations to a variety of health risks. 

In Erie County, refugees are resettled on the East Side and West Side of Buffalo, where the housing stock is older with greater likelihood of lead and asbestos use compared to the rest of the county. Soil and water bodies in such neighborhoods tend to be contaminated with heavy metals and other toxins, and fewer amenities, such as supermarkets, are available. It is plausible that the “durable long-term habitation solution” that resettlement is intended to offer may, in fact, be placing refugees at place-based chronic health risks.

Of concern to this project is the way in which the post-resettlement experience shapes food-related experiences of refugees. Existing literature suggests that exposure to new low-cost low-nutrient dense food, low socioeconomic status, limited employment opportunities,viii and delayed acculturation leads to chronic diseases among resettled refugees. The formation of diet-related chronic disease among resettled refugees is well documented in the public health literature. However, existing scholarship on refugee health explores diet-related outcomes and dietary behaviors largely through the lens of a single discipline - a shortcoming we intend to address.

Our proposal seeks to gain a broad understanding of how Burmese-American residents acquire healthy, affordable, and culturally acceptable foods in their new country. A pilot project will characterize the food acquisition practices of Burmese-Americans at least six months post resettlement. We will explore how these food acquisition practices, and perceptions of health risks tied to food acquisition practices are influenced by their environment, their membership in co-ethnic networks, cultural preferences, and personal history of trauma. Ultimately, we intend to use the pilot data to develop more comprehensive projects that explore how food-related disparities among refugee populations may be alleviated through local government policy reform.

The public health literature tends to emphasize the role of individual decision making in diet decisions although a growing body of literature has begun to examine the role of broader social and environmental determinants on health. On the other hand, existing urban planning and policy literature has an overly deterministic view of the link between built environment and human health, and fails to acknowledge the complex factors that drive health behaviors. Existing literature also creates a disempowering narrative that largely views low-resource individuals, including immigrants and refugees, as having no agency/ability to improve their new habitat. Our proposal will address these disconnects by bringing together a transdisciplinary group of scholars to concurrently gain a broader understanding of the social and environmental drivers that influence access to affordable, nutritious, and culturally acceptable foods for Burmese-Americans, while seeking to highlight and support the ability of Burmese-Americans to be forces of change within Buffalo’s neighborhoods.

DDFAR is a transdisciploinary exploration of the influence of social, environmental, cultural and personal determinants on food acquisition practices among the Burmese Americans. This project was funded by the Community for Global Health Equity with an aim to examine how Burmese-American residents acquire healthy, affordable, and culturally acceptable foods in the city of Buffalo.  In particular, DDFAR focuses on examining how Burmese-Americans adapt food acquisition practices in a new country, how they perceive health risks that are tied to these practices, and how these practices may change their food environment.

Articles and Reflections

  • Breaking Down Patient-Doctor Language Barriers
    When I started my first week of primary care as a resident physician, I was not expecting to use greetings such as “Bonjour” and “Ahlan wa Sahlan” as part of my interactions with my patients, but that was the reality of working in a city that is ranked among the top ten places for refugee resettlement.

Publications and Presentations

Alexandra Judelsohn, Heather Orom, Daniela Leon & Samina Raja (2020) Refuge in new food environments? The role of urban planning in facilitating food equity for new Americans, Journal of Urban Affairs, DOI: 10.1080/07352166.2019.1705845

Orom, H., Judelsohn, A., Raja, S., Kim, I., Diaz Del Carpio, R. (November, 2018). Opportunities for supporting a healthy diet among refugees from Burma. Paper to be presented at the annual meeting of the American Public Health Association, San Diego, CA.

Orom, H., Schmit, L., Judelsohn, A., Sosnowski, N. A., Aye Nay Na Sa, Kim, L., Diaz Del Carpio, R., Raja, S. (April, 2018). Awareness of chronic disease risk is low among Burmese refugees. Poster presented at the annual meeting of the Society of Behavioral Medicine, New Orleans, LA.

Refugees and Food Experiences Publication, Growing Food Connections, April 2018.

Entress, Sharon, Alexandra Judelsohn, Brenda Stynes and Samina Raja. “Refugees and Food Experiences: Insights from Research in Buffalo, NY.” Translating Research for Policy Series. Growing Food Connections Project, 2018.

Local governments can build capacity of individuals and networks in refugee communities to improve access to culturally preferred, nutritious foods in resettlement cities.

Planning the City of Good (and New) Neights, Journal of Built Environment.

Judelsohn, A., Orom, H., Kim, I., Sa, A., Khan, H., DeVito, R., Diaz, R., Raja, S. (2017) Planning the City of Good (and New) Neighbours: Refugees' Experiences of the Food Environment in Buffalo, New York. Built Environment 43(3), 426-224.

Our Team

Heather Orom

Associate Professor and Director of Graduate Studies

Department of Community Health and Health Behavior

304 Kimball Tower Buffalo, NY 14214

Phone: 716-829-6682; Fax: 716-829-6040



Alex Judelsohn

Programs Manager

Global Health Equity

Samina Raja

Co-Director and Founding Co-Lead, Community for Global Health Equity; Co-Lead, Food Equity Team; Project Lead, Plan REFUGE; Professor

Urban and Regional Planning

233C Hayes Hall

Phone: 716-829-5881


Isok Kim

Associate Professor

School of Social Work

667 Baldy Hall

Phone: 716-645-1252


Roberto Diaz Del Carpio

Clinical Assistant Professor

Department of Medicine

Hertel Elmwood Internal Medicine Center 900 Hertel Ave. Buffalo, NY 14216

Phone: 716-871-1571