Structural inequities and lack of resources put vulnerable refugee communities at great risk. Refugees flee their country of origin to escape persecution and flee from war, famine and torture. Resettled refugee communities become particularly vulnerable during times of crisis due to limited English proficiency and poor social determinants of health (SDOH), which create barriers to attaining and sustaining health and wellbeing for themselves and their families. The purpose of this case study was to evaluate SDOH among a refugee community in the Southeastern United States. We surveyed the community twice during a 1-year period to assess various elements of SDOH. Among a primarily African and Southeast Asian refugee community, 76% reported difficulty paying for food, housing and healthcare during the first round of surveys. During the second round of surveys at the beginning of the Coronavirus pandemic, 70% reported lost income; 58% indicated concern about paying bills. There was little change during the 12-month study period, showing that SDOH are an enduring measure of poor health and wellbeing for this vulnerable refugee community.

中文翻译：

---

难民社区的公共卫生危机：健康的社会决定因素变化不大，可以保持卫生差距。

结构上的不平等和缺乏资源使脆弱的难民社区处于极大的危险之中。难民逃离原籍国逃避迫害，逃离战争，饥荒和酷刑。由于英语水平有限和健康的社会决定因素（SDOH）差，在危机时期，重新安置的难民社区变得特别脆弱，这为他们及其家人的获得和维持健康与福祉创造了障碍。本案例研究的目的是评估美国东南部一个难民社区中的SDOH。我们在1年内两次对社区进行了调查，以评估SDOH的各种要素。在主要是非洲和东南亚的难民社区中，有76％的人表示在第一轮调查中难以支付食物，住房和医疗费用。在冠状病毒大流行开始的第二轮调查中，有70％的人报告了收入损失。58％的人表示担心支付账单。在为期12个月的研究期内，变化很小，这表明SDOH是该脆弱难民社区健康和福祉的持久衡量标准。