UB - Community Connections to Improve Refugee Health and Wellbeing

Recent statistics indicate that an astounding 70.8 million people have been forcibly displaced around the world due to war, persecution, or natural disasters. Of the 65.8 million displaced peoples, 25.9 million are refugees. The majority of refugees (99%) resettle in a neighboring country; 1% participate in the refugee resettlement program and resettle in places like Canada, the United States, and Australia, for example. Western New York continues to be a top location for refugee resettlement in the United States.

Buffalo, home to New Americans originating from countries such as Burma, Bhutan, Somalia, and the Democratic Republic of Congo, has simultaneously entered an era of revitalization. Immigrants and refugees contribute to population and economic growth and enrich the community’s neighborhoods, schools, and businesses through enhanced cultural diversity.  However, this era of revitalization comes with unique community challenges. Stark contrasts exist between U.S. culture and customs and those of many refugees’ home countries. Whether coming from Somalia, Burma, or Rwanda, for example, Buffalo’s New Americans must quickly adapt to life in a new community, one marked by different social norms, systems, and policies.

Forced to leave their homes to escape war, persecution, or natural disaster, refugees must cope with many varied traumas of displacement. These traumas may also occur during resettlement. When starting a new life in a new community, families can experience social isolation, lack of economic opportunities, unmet expectations, and discrimination or xenophobia. These stressors can lead to intergenerational trauma, drinking, and financial insecurity, factors that contribute to poor mental health outcomes.

Perspectives on mental health vary from country and culture. In many places around the world, mental health issues are taboo; communities ostracize those who seek mental health care. These beliefs do not go away when moving to a new culture and community. Coping strategies vary depending on their culture, age, and religion. Some who have lost important therapeutic social networks rely on their families to process their stress. Older generations tend to seek care from religious leaders while younger generations are generally more open to enlisting help from Western practitioners. Many note that time and acceptance are the key to healing.

In Buffalo and Western New York, mental health supports vary widely. Several local organizations seek to promote positive coping mechanisms and good mental health and wellbeing for Buffalo’s New Americans through unique methods and delivery.

• BestSelf Behavioral Health, Inc. provides direct mental health care services to refugees through trauma-informed mental health counseling and support services. Although mental health care has a grounding in Western treatment, BestSelf employs New Americans as counselors, interpreters, and patient advocates.
• Buffalo String Works utilizes music to reduce anxiety and create community. Their programs are expanding across the city; 85 children receive weekly music lessons and perform songs from around the world, including ones from their home countries. Children and their extended family benefit from a community that lifts up different cultures through the power of music.
• Grassroots Gardens of Western New York believes that gardening can play a role in improving physical health by improving food security. They focus on the therapeutic benefits of green space; gardens can be spaces where gardeners join and connect with the earth and one another.
• Lafayette International High School implements restorative justice techniques as an alternative to common disciplinary procedures like suspensions. Students meet in restorative circles to resolve issues between one another and between students and teachers. When violence, arguments, and gossip take away from their community, these circles seek to restore what has been lost.
• Some religious leaders promote mindfulness as a therapy for the community to practice and support good mental and physical health while others encourage both religious exercises and care seeking from counselors, psychiatrists, and through pharmacotherapies.

Where we live contributes to our mental and physical health and wellbeing. As a social determinant of health, the neighborhood and built environment directly influences individual and community health and health outcomes.

The quality, affordability, and safety of housing in the City of Buffalo is a public health issue for all city residents. Many of Buffalo’s aging housing stock have not been regularly maintained; inadequate heating and cooling systems, lead paint exposure, and infestations are common. New Americans, who initially have limited income to afford quality housing in safe and secure neighborhoods, begin their lives in Buffalo in houses that may place their health and wellbeing at risk.

For New Americans, language barriers and housing literacy levels compound housing challenges. Individuals who grew up in rural environments may have little knowledge about behaviors and systems that ensure their health and wellbeing, for example, refrigerated food storage, city sanitation, and fire safety and prevention systems. Some New Americans are not proficient in English and many lack knowledge about the policies and systems that govern renting and owning homes in the United States. Discrimination and gentrification add to these challenges. Housing evictions and forced moves have increased while landlords have been known to falsely state they do not accept public assistance or subsidies to pay for rent.

Several programs and resources exist within the City of Buffalo to abate these challenges.

• The International Institute of Buffalo, one of Buffalo’s four refugee resettlement agencies, arranges housing for families upon their arrival in Buffalo. They offer clients-rights courses and books – many in the client’s primary language – that outline the housing issues New Americans may face, as well as how to communicate these issues to landlords.
• Partnership for the Public Good (PPG), a community-based think tank that provides research and advocacy for a broad range of partners in the Buffalo-Niagara region, focuses its programming around community challenges such as poverty, inequality, housing, development, environment, and cultural vitality. PPG is currently researching housing evictions and involuntary mobility, or forced moves, in Buffalo. PPG staff collaborate with residents as well as county and city officials to develop inclusive policy solutions that address the evictions process.
• Housing Opportunities Made Equal (HOME) provides free, comprehensive services for victims of housing discrimination. To enforce fair housing laws, HOME records and investigates reported incidents of discrimination, and provides paralegal counseling, client advocacy, case preparation for legal actions, and emotional support for victims and their families.
• The City of Buffalo Urban Renewal Agency (BURA) is a community-based organization that seeks to promote efficient planning, financing and completion of neighborhood-driven community development projects. Collaborative efforts with community development agencies and city residents aim to enhance an inclusive revitalization of Buffalo. BURA’s website provides information about fair housing, housing discrimination, and landlord and tenant rights in 125 different languages. Harold S. Cardwell, Jr., is the Fair Housing Officer and Contract Compliance Officer of BURA.

Health and wellbeing is also dependent upon the surrounding community environment. Opportunities to reduce social isolation and discrimination while creating a fabric of belonging has the potential to improve social, economic, physical, and mental health and wellbeing.  Inclusive and supportive schools, green spaces, and places for socialization are key components to Buffalo’s revitalization and the building of cohesive, healthy communities. The development or redevelopment of these spaces deserve thoughtful consideration.

Erkin Ozay, assistant professor of architecture at the University at Buffalo, studies the community environment’s influence on the local population. For him, “landscapes of arrival” must include access to urban assets, sources of employment, community-based services, transitional and supportive housing, and spaces for cooperation. His research considers opportunities to promote and encourage community-building to foster social cohesion and stability and to empower community members to envision a positive future.

Community redevelopment has the potential to strengthen community bonds by engaging community members, community developers, and public entities in shared redevelopment efforts. Dr. Yeeli Mui, postdoctoral associate, Community of Excellence in Global Health Equity, University at Buffalo, has explored the community health impacts of vacant housing redevelopment and revitalization efforts in Baltimore, MD. From her studies, redevelopment processes that contribute to mental health outcomes included community readiness, social infrastructure, resource mobilization, and community influence. Positive redevelopment efforts involved community members throughout the process and included them in decision making.

With 15,000 vacant properties, the City of Buffalo has a unique opportunity to provide refugees with training and compensation to deconstruct and rebuild new and affordable living spaces. Two organizations have formed a partnership that could equip refugees with necessary employment skills and. The Society for the Advancement of Construction-Related Arts (SACRA) trains individuals on the artistic and vocational skills needed for the construction market. The Erie County Department of Social Services recruits these trainees who learn key skills while working on local renovations. Programs like these promote community involvement and may lead to positive mental health outcomes and wellbeing for community members and the refugee community.

The annual WNY Refugee Health Summit is co-sponsored by the University at Buffalo’s Community of Excellence in Global Health Equity and School of Public Health and Health Professions’ Office of Global Health Initiatives.

Authors: Jessica Scates, Kristen Almeter, and Ariana Martinez

Recommended Citation: Scates, Jessica; Almeter, Kristen; Martinez, Ariana. Housing for Refugee Health and wellbeing. 6^th annual WNY Refugee Health Summit. Prepared by the Community for Global Health Equity in collaboration with the School of Public Health and Health Professions, University at Buffalo.

Moderator: Samina Raja, Professor, Urban and Regional Planning, University at Buffalo

2019 Planning Committee: Sutanuka Bhattacharjya, Abdi Farah, Theo Herman, Ali Kadhum, Ariana Martinez, Jessica Scates, Steven Sanyu, Chan Myae Thu, Merlyn Vilma

Presenters and Panelists: 
Adnan Abdulsaid, Imam, Jaferi Center
Ingabire Adam, Youth Leader, Massachusetts Avenue Project
Virginia Barron, Executive Director and Co-Founder, Buffalo String Works
Daniel J. Corbitt, Associate Director, Housing Opportunities Made Equal (HOME)
San Da, Monk, Bodhi-Sukha Monastery, Arakan American Buddhist Inc.
Abdi Farah, Community Health Specialist, Community Health Center of Buffalo; Co-founder and Vice Chair, HEAL Intl.
Theo Herman, Medical Case Manager, Evergreen Health
Ali Kadhum, Mental Health Counselor, BestSelf Behavior Health
Katarzyna Kordas, Associate Professor, Epidemiology and Environmental Health; Co-Director, Community of Excellence in Global Health Equity
Jeanette Koncikowski, Executive Director, Grassroots Gardens WNY
Jessica Lazarin, Director, Office for New Americans, City of Buffalo
Yeeli Mui, Postdoctoral Associate, Community of Excellence in Global Health Equity, University at Buffalo
Erkin Özay, Assistant Professor, Department of Architecture, University at Buffalo
Lila Rollo, American Integration Program Coordinator, International Institute of Buffalo
Steven Sanyu, President, Burmese Community Services
Jessica Scates, Coordinator, WNY Refugee Health Summit; Administrative Coordinator, University at Buffalo Community of Excellence in Global Health Equity
John Starkey, Principal, Lafayette International High School
Andrea Ó Súilleabháin, Executive Director, Partnership for the Public Good
Win Thant, Education Coordinator, Buffalo State College
Chan Myae Thu, Community Health Worker, Neighborhood Health Center

Volunteers: Kristen Almeter, Karina Balbuena, Lauren Bennink, Biplab Bhattacharya, Taylor Billings, Macit Citiroglu, Gauri Desai, Juliana DiCecca, Seth Frndak, Becca Hoelzl, Maria Improta, Imari Johnson, Samuel Kaplansky, Derek Moluf, Lissette Palestro, Danielle Pelfrey Duryea, Elena Saez, Avery Sirwatka, Alexander Spensieri, Sandra Szczepanski, Taylor Turner, Christine Uwimbabazi, Yi Wu, Merlyn Vilma

Design and Production: Jessica Scates and Nicole Little

Dr. Katarzyna Kordas, Associate Professor, Epidemiology and Environmental Health; Co-Director, Community of Excellence in Global Health Equity
Jessica Lazarin, Director, Office for New Americans, City of Buffalo
Jessica Scates, Coordinator, WNY Refugee Health Summit

Chan Myae Thu, Community Health Worker, Neighborhood Health Center 
Steven Sanyu, President, Burmese Community Services 
Theo Have, Medical Case Manager, Evergreen Health 
Abdi Farah, Community Health Specialist, Community Health Center of Buffalo; Co-founder and Vice Chair, HEAL Intl.

Lila Rollo, American Integration Program Coordinator, International Institute of Buffalo
Andrea Ó Súilleabháin, Executive Director, Partnership for the Public Good
Daniel J. Corbitt, Associate Director, Housing Opportunities Made Equal (HOME)

Dr. Yeeli Mui, Postdoctoral Associate, Community of Excellence in Global Health Equity, University at Buffalo
Erkin Özay, Assistant Professor, Department of Architecture, University at Buffalo

Community Response: Andrea Ó Súilleabháin, Executive Director, Partnership for the Public Good

John Starkey, Principal, Lafayette International High School
Ali Kadhum, Mental Health Counselor, BestSelf Behavior Health
Jeanette Koncikowski, Executive Director, Grassroots Gardens WNY
Virginia Barron, Executive Director and Co-Founder, Buffalo String Works

San Da, Monk, Bodhi-Sukha Monastery, Arakan American Buddhist Inc.
Adnan Abdulsaid, Imam, Jaferi Center
Ingabire Adam, Youth Leader, Massachusetts Avenue Project
Win Thant, Education Coordinator, Buffalo State College