Reducing hypovitaminosis D among Somali immigrants in Minnesota: a narrative review

Abstract

Somalia is an East African nation with a history of civil unrest that produced a significant influx of refugees in the United States in the last 25 years. Between 2000 and 2010, 40% of all U.S. Somali refugees settled in Minnesota, which produces new cultural and health challenges for local communities and the state government. One such challenge is vitamin D deficiency, or hypovitaminosis D (Hv-D). Hv-D is developed through insufficient exposure to sunlight and low nutrient intake leading to increased risk for weakness and inflammation, oral health problems, diabetes, cardiovascular and autoimmune diseases, and malignancies. In this narrative review, demographic, geographic, and cultural information about Somali immigration is discussed. Recent data suggests Somalis living in northern climates (Minnesota, US, Helsinki, Finland, Sweden, the United Kingdom) experience significant deficiencies in vitamin D. Vitamin D is stimulated by ultraviolet light exposure, a balanced and healthy diet, and dietary supplementation. High unemployment rates affecting access to health information and clinical services, significant cultural differences, and climate differences predispose this population to Hv-D. Health education and health promotion programming at the community and state level in Minnesota should recognize the risk factors associated with Hv-D and the vulnerability of Somali refugees. Current and future health programming should be reassessed for adequate attention to vitamin D deficiency and cultural competency associated with the Somali immigrant population.