McDonald County, Missouri, is home to many immigrant groups that have moved into the county in the last twenty years. These groups include Hispanic, Somali, Burmese, Sudanese and numerous others. And while these groups do not overlap culturally, they do share one thing - language acts as a barrier to access when it comes to their health.
Farah Barale is a Somali immigrant and has lived in Noel for three and a half years. He said life is good for the Somali community, but the majority of the more than 300 Somali residents struggle with knowing what to eat.
“[The] Somali communities... they don't know how to get a balanced diet or nutrition for them, different type of food like vegetable, fruits," Barale said. “Most of the people just use rice or spaghetti... I know that most of them they don't know how to get a balance in nutrition.”
Debbie Scheel has been a nurse practitioner at the Southwest City Community Clinic for 20 years and said nutrition is definitely a problem for the Somali community. But it is also common among most of the immigrant groups in McDonald County.
She said she asks patients what they eat and they often respond - “spaghetti and tomatoes." She said they only buy groceries they recognize and don’t seem to eat much protein. Not meat. Not fish. Not beans.
Many of her patients are foreign born immigrants, who live in either Southwest City or Noel. She said she believes their lack of nutrition can actually be tied back to the language barriers they face in the United States.
“If you traveled to another county where you don’t speak the language or read the language and you go in a grocery store and they have lots of stuff to pick from... you don't have a clue what you are picking up,” Scheel said.
She said without language competency, immigrants struggle with making good food choices, which can lead to higher rates of obesity and hypertension. Scheel said she is beginning to see higher rates of these diseases in the Hispanic community compared to when they arrived in McDonald County, some ten or more years ago.
So, three organizations have come together to begin an Immigrant Education Grant in the community as a preventative intervention. This grant, which began this year, will teach county residents about nutrition and other health issues. It is being funded through the Missouri Foundation for health, which, full disclosure, also partially funds the KBIA Health and Wealth desk.
The grant is in its infant stages, but the grant partners – the McDonald County Health Department, the University of Missouri Extension and the International Institute of St. Louis –are finishing up a survey of the community. These surveys ask what health issues the communities would like to learn more about and are being done in the the immigrants' native languages.
The surveys are being provided in five different languages, which include English, Spanish, Somali, Arabic and Karen. Additionally, the surveys are being distributed to the community at ESL classes, churches, by a man who helps the Hispanic community with their taxes and at the African Grocery.
If you would like to see what types of questions are being asked in the community-wide survey, you can view them - here.
“Like Nelson Mandela said - If you speak to me in a learned language, which is not my mother tongue, you speak to my mind. If you speak to me in my mother tongue, you speak to my heart,” Lydia Kaume said. She is a nutrition specialist for the University of Missouri Extension.
Kaume is herself an immigrant, coming to the US from Kenya about 9 years ago, and she has been working closely with the immigrant communities in McDonald County.
She said she believes by reaching out to the ethnic groups in their own languages, the grant partners will get a more accurate read of what health education the community actually needs. Kaume said she’s had many conversations about health issues with the different groups.
“I have spoken to the Burmese community and I've spoken to the Latino community. I've spoken to the Somali community,” Kaume said. “They are all very very interested in learning how to live healthier lifestyles because they can tell. They can tell they are gaining weight. They can tell, they don't know what to eat.”
Each member of the Immigrant Education grant team is responsible for different aspects of the program. The International Institute will work with area clinics on cultural competency, the Health Department will focus on navigating the health care system and health topics and the MU extension will address nutrition and chronic disease management.
Paige Behm, the director of the Health department, said the surveys will all be collected by the beginning of May. Educational materials will be compiled and translated throughout 2015, and classes will begin in earnest at the beginning of 2016.
Behm added that the program will eventually go beyond the borders of McDonald County.
“We'll develop these presentations on these different topics and then those can be utilized in other counties maybe that are facing the same issues,” Behm said. “It's kind of a model project."