Immigrants to new countries face a variety of obstacles in their new environments. Those from equatorial regions moving to northern latitudes are often at high risk of vitamin D deficiency. This is due to darker skin types, clothing preference, awareness, and cultural ideals.
In a new study, researchers wanted to determine the prevalence of vitamin D deficiency among refugees from all over the world who immigrated to Canada to help raise awareness of this issue to health care practitioners.
They reviewed 1,217 data charts from 756 children age 0-19 years and 461 women age 20-45 years from the Calgary Refugee Health Program. This program serves refugees arriving to Calgary by screening them, taking a complete medical history, and caring for those in need for 2 years after their arrival. Their initial screening is usually within a couple weeks of their immigration into Calgary.
In total, the refugees came from 35 different countries which were grouped together to represent 4 main geographic regions. Overall, they found the average vitamin D level at initial screeening was 20.8 ng/ml. Looking at the vitamin D levels in each main region, the researchers found:
- From Africa, 47% of children were vitamin D deficient (as defined as a level less than 20 ng/ml) and 23% had levels above 30 ng/ml, while 62% of women were deficient and 16% had levels above 30 ng/ml.
- From Asia, 48% of the children were vitamin D deficient and 10% had levels above 30 ng/ml, while 71% of women were deficient and 5% had levels above 30 ng/ml.
- From the Middle East, 73% of the children were vitamin D deficient and 7% had levels above 30 ng/ml, while 98% of women were deficient and none had levels above 30 ng/ml.
- From South America, 23% of the children were vitamin D deficient and 26% had levels above 30 ng/ml, while 27% of the women were deficient and 19% had levels above 30 ng/ml.
The researchers then broke down some of these regions to see if there were any variations within regions. They found that refugees from North Africa had significantly lower average levels than those from sub-Saharan Africa. Additionally, refugees from Western Asia had significantly lower average levels than those from East Asia.
Populations in both North Africa and Western Asia are predominantly Muslim, leading the researchers to suggest that cultural clothing practices likely contributed to the low levels of vitamin D.
This study was not without some limitations. The researchers weren’t able to gather data on dietary vitamin D intake, exposure to sunlight, or the time since arrival in Canada. Additionally, because of the design of the study, their results can’t necessarily be generalized to other immigrant groups facing different socioeconomic obstacles.
“Refugees are at high risk of being vitamin D deficient; health care providers should be aware of this concern and consider vitamin D supplementation in such patients,” the researchers concluded. “Further research is needed to characterize deficiency among refugees over the time period following their arrival, as well as to define best practices for replacement therapy and to identify barriers for refugees to achieve adequate vitamin D levels.”