MI Arab Population Faces Health Disparities, SDOH, Food Insecurity

Middle Eastern and North African (MENA) people living in southeast Michigan who report unfair treatment are more likely to face social determinants of health, such as food insecurity, that lead to poor health outcomes, according to a new study that underlines ethnic health disparities.

The study conducted by the University of Michigan Rogel Cancer Center aimed to better understand the health needs of MENA people, who represent a big population at the academic health center serves. The Detroit-Metro area is home to one of the nation’s largest MENA populations, with over 210,000 residents from Lebanon, Egypt, Iraq, Yemen, and other Arab countries.

In partnership with the University of Michigan School of Public Health and the Arab Community Center for Economic and Social Services, the Michigan Rogel Cancer Center researchers conducted a cross-sectional survey of MENA individuals.

The study found that several social determinants of health were common among the MENA community. One in three MENA individuals reported transportation as a care access barrier, and one in three MENA people also reported food insecurity. One in four reported financial strain.

“When you drive through Dearborn, where much of the survey took place, it doesn’t look like the makeup of your typical food desert,” Associate Professor of Health Behavior and Health Education at the U-M School of Public Health Minal R. Patel, PhD, MPH, said in a press release. “So we need to unpack that. Food insecurity is multidimensional, and the availability of food is only one component.”

The researchers found that being of Arab descent, speaking Arabic at home, and originating from Egypt, Syria, or Yemen led to a higher prevalence of these social determinants of health. Additionally, living in the US for less than 10 years resulted in a higher social risk factor of 2.8 out of 5 compared to 1.98 for those who had lived in the US for over 20 years.

MENA people who face several of these social risk factors are also more likely to report chronic illness, mental health issues, and worse overall health.

“There are numerous health disparities for the MENA community that are not that different from other racial and ethnic groups where we’re trying to close the gap,” continued Patel, who also serves as a member of the Rogel Cancer Center. “The data show us that this is an important population where we should be focusing our efforts to address health needs.”

The survey results also revealed that 60 percent of participants reported perceived discrimination, 49 percent reported government mistrust, 37 percent reported perception of being treated unfairly, and 17 reported anxiety regarding deportation worry.

Those respondents who reported anxiety surrounding deportation and perception of being treated unfairly had higher rates of social determinants of health.

"We were able to highlight that even though we don’t share a border with a Middle Eastern country, we still have a sizeable population right next door to us that has concerns about immigration,” Patel noted.

There is documented discrimination against Arab Americans in the country, characterized by negative stereotyping, hate crimes, law enforcement harassment, and racial discrimination against Muslims and Arabs, the team wrote. Since 9/11, Arab American immigrants have been accessing fewer public services that appear to be connected to the federal government, including healthcare, the researchers said.

The Trump administration's public charge rule has further spread fears about public assistance access for immigrants. The rule, recently reversed by the Biden Administration, made it harder for certain immigrants to be granted permanent legal status if they have enrolled in certain assistance programs, like SNAP.

The study noted that while some data have shown that Arab Americans have higher socioeconomic status and education levels nationally, that is not the case in the Detroit-Metro area.

“Poverty-related factors may interact in complex ways with immigration context, experiences of discrimination, and economic context of Detroit,” the study authors wrote.

The researchers emphasized that further ethnographic work is needed to understand health disparities that affect MENA communities.

Correction 04/07/2021: A previous version of this article stated that the public charge rule was still in effect. However, the Biden administration reversed the rule in early March.