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Background: This study explored the health needs, trends of health care utilization, and barriers to care of a diverse population of refugee children resettled in Durham County, North Carolina., Methods: Researchers conducted a retrospective chart review of 327 pediatric (aged 0-21 years) refugee patients who received care at Lincoln Community Health Center from 2016 to 2018., Results: Results describe a low prevalence of infectious diseases, such as human immunodeficiency virus (0%), hepatitis B (2%), and tuberculosis (5%), but a high prevalence of nutritional problems, such as growth stunting (17%), overweight (21%), Vitamin D insufficiency (79% of the 39 tested), and anemia (13%). Subspecialty care was frequently utilized, despite prolonged appointment delays and frequent missed visits., Limitations: Limitations of the study included a small sample size that only considered refugees in one geographic area and one primary care clinic, as well as variability in physician documentation., Conclusions: These findings highlight the need for tailored programs and processes, such as dedicated case management and improved screening practices, in order to facilitate integrated care and promote wellness among this vulnerable group of young refugees., (©2021 by the North Carolina Institute of Medicine and The Duke Endowment. All rights reserved.)

BACKGROUND Resettled refugees are at increased risk of poor health outcomes due to acculturation challenges, logistical barriers, experiences of trauma, and other barriers to care that are poorly understood. Refugee children may be particularly vulnerable due to disruptions in health, well-being, education, and nutrition during the resettlement process. METHOD To describe the health care barriers facing refugees in the North Carolina Triangle area (comprised of Durham, Chapel Hill, Raleigh, and their surrounding areas), we conducted three focus group interviews (in Arabic, French, and Swahili) with 25 refugee parents from Syria, Iraq, Central African Republic, the Democratic Republic of the Congo, and Chad. We also administered a survey to nine organizations that provide services for refugees. RESULTS Focus group responses highlighted the multidimensional nature of health care barriers for refugee families and children, encompassing challenges with acculturation, communication, transportation, finances, and health literacy. Organizations emphasized similar challenges and described their efforts to improve access to services through increased communication, coordination, and seeking new financial support for programs. LIMITATIONS Given the geographic focus of the study, results may not be generalizable to other populations and settings. Men spoke more than women in some focus groups, and participants may have been influenced by more vocal contributors. Furthermore, this study is limited by a lack of health outcomes data. CONCLUSIONS This study suggests that the health care needs of refugees living in the North Carolina Triangle area can be better met by providing comprehensive, coordinated, and culturally relevant care. This could include minimizing the number of visits by integrating multiple services under one roof, providing trauma-informed interpreters, and offering accessible transportation services., (©2020 by the North Carolina Institute of Medicine and The Duke Endowment. All rights reserved.)