The new face of refugee resettlement in Wisconsin: what it means for physicians and policy makers.

BACKGROUND Historically, Wisconsin has received refugees from 3 large geographic areas: Southeast Asia, the Former Soviet Union, and the former Republic of Yugoslavia. However, recent trends demonstrate a dramatic increase in the number of countries from which current refugees originate. Further, state migration patterns show that most counties in Wisconsin have sizable per capita refugee populations and can expect more. OBJECTIVE This paper describes past and current refugee resettlement trends and their ramifications on health care delivery, health policy, and social development in Wisconsin. METHODS Statistical data on national, regional, and state refugee resettlement trends was obtained from the US Department of Health and Human Services' Office of Refugee Resettlement and the Wisconsin Department of Workforce Development. Additional data was obtained from Milwaukee-based refugee service agencies. Further, discussions were held with health officials in Barron County and around the Midwest. FINDINGS Beginning in the 1980s, with the influx of Laotian Hmong refugees, and continuing through the late 1990s with the end of the Balkan Wars, Wisconsin has provided safe refuge for thousands of refugees. Over the last 5 years the diversity of refugees being resettled in Wisconsin has accelerated to include an array of countries. This phenomenon has led to an increase in the range of health behaviors and health needs characteristic of these populations. The new face of refugee immigration has profound implications on Wisconsin's health landscape, not only in terms of clinical disease, but also in health policy, planning, and social development.