Cultural Considerations

On this page: Working with Refugees | Diversity in Minnesota | Cultural Holidays

Interpreters must be offered for all contacts with participants with Limited English Proficiency.

Working with Refugees

In general, applications from refugees should be treated in the same manner as any other individual who applies for WIC services. Consider consulting the Minnesota Center of Excellence in Newcomer Health for additional information on how to support refugee families.

Determining Eligibility for WIC

In establishing eligibility for the program, refugee status is not considered. Legal residency or United States citizenship are not Federal requirements for participation in the program.

Residency

In order to meet the WIC program residency requirement, an applicant must live in the state in which he or she applies at the time of application. Refugees might not have a permanent place to live in the state in which they are applying and therefore a waiver may be used for lack of residency documentation as outlined in Section 5.2.2 Residency

Income Determination

Refer to Section 5.2.4 Certification Procedures for information. If a refugee is unable to provide the necessary written documentation, a waiver may be used in these circumstances. If several individuals or families are living together, additional questions to help determine separate households are outlined in the policy.

Nutritional Risk

The local agency is expected to perform a complete nutrition assessment for each refugee applicant, who may be suffering from other medical or dietary nutrition risk factors that require prompt attention and/or referral to a health care provider. While Federal WIC Regulations recognize homelessness as an allowable nutrition risk condition when determining eligibility, a thorough assessment should include obtaining anthropometric and hematologic measurements if able.

WIC Supplemental Foods

Assess the individual situation and issue the appropriate set(s) of benefits that best meets the needs of the applicant and adapt the WIC food package to accommodate their unique needs and circumstances. If homeless, refer to: Section 7.14 Food Package Options for Homeless Participants.

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Diversity in Minnesota

What Does Minnesota's Population Look Like?

Minnesota is home to 5.6 million people. MN population diversity and trends, based on US Census information compiled and summarized by Minnesota Compass (2017), include:

Residents of Color

• Residents of color comprise 21 percent of Minnesota’s total population. This varies by age: 32% of our state’s youngest residents (age 0-4) are of color, compared to 6% of our oldest residents (age 65+).
• Minnesota continues to rank among the states with smaller shares of residents of color (38th). The state has seen a 29% growth in its population of color since 2010, ninth highest among states.
• The Twin Cities region has one of the lowest shares of people of color compared to other major metro areas. That said, the population of color is growing rapidly and expected to make up at least 35% of the region’s overall population by 2035.

Immigrants

• Foreign-born residents from Asia have been Minnesota’s largest immigrant group since 1990, with immigrants from Africa now the second largest immigrant group.
• The majority of immigrants live in the metro 7 county area, although immigrants are transforming many smaller communities around the state, concentrated in areas with employment opportunities.
• The proportion of foreign-born adults who work is nearly the same as native-born adults, 74% and 78% respectively. However, overall poverty rates for immigrants are nearly twice as high.
• Nearly 1 in 6 children (0-19) in Minnesota have at least one immigrant parent, although most of these children were born in the U.S.
• Among our state’s youngest children (0-4), nearly 1 in every 5 is a child of an immigrant.

Illustrations of Minnesota Population Diversity Trends

Participation by Race/Ethnicity Maps (2018)

WIC Participation Charts: Race/Ethnic Comparison for all Women, Infants and Children (2018)

• Select Race from the left-hand menu on this page to see a graph of Persons of Color 1960-2050 (predicted).
• To see graphs of various breakdowns and regions, click on the small arrows in the graph headings.

Refugee Populations

Primary refugees are refugees who are initially resettled in Minnesota.

Primary Refugee Arrivals to Minnesota by Initial County of Resettlement and Country of Origin in 2017

Cumulative Arrivals of Refugees to Minnesota (1979-2017)

• Currently, there is no systematic way to identify all secondary refugees migrating to Minnesota. The Refugee Health Program is generally notified of secondary refugee arrivals by local public health, clinics, or resettlement agencies that collaborate with the program on the “Secondary Refugee Project” to assist with linkage to care.
• Only secondary refugee notifications made to the Refugee Health Program are included in these arrival data summaries.

Map of Secondary Refugee Arrivals to Minnesota, 2020

Secondary Refugee Arrivals to Minnesota by County of Resettlement and Country of Origin, 2020

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Cultural Holidays

Ramadan

Ramadan is observed in the ninth month of the lunar Islamic calendar; therefore, the start of Ramadan shifts approximately 10 days earlier each year. Ramadan involves a physical fast, as well as spiritual reflection, charity, and community celebration.

During Ramadan, fasting involves abstinence from all food or drink, including water, from dawn to sunset. Traditionally, the fast is broken at sunset with dates and water. The sunset meal, iftar, and the pre-dawn meal, suhur, are often shared with family and friends.

Fasting may be exempted for certain situations such as pregnancy, breastfeeding, health concerns, and travel. Prepubescent children and the elderly are also exempt. While a person may be allowed to refrain from fasting, it is a personal choice, and they may choose to participate with guidance from their spiritual advisor and medical provider.

WIC staff can help support our Muslim families during Ramadan. There are several topics that may be valuable to discuss during this time.

• Be sensitive to the topic of fasting since it may be a deeply personal and significant practice. Always ask permission to discuss this subject.
• As always, work with families to honor their traditional foods and mealtime customs.
• Encourage balanced meals and good hydration during the sunset to dawn period. Eating a variety of foods can help ensure that meals are satisfying, and nutritional needs are met during this time.
• Discuss mindful eating and body cues, such as hunger and fullness. This may help those who have been fasting avoid the discomfort of over-eating and encourage enjoyment of mealtimes.
• Strenuous exercise may not be advisable during fasting hours due to lack of hydration, but movement can help with energy level and general health. Discuss options for gentle, joyful movement such as walking or stretching.
• Ask families to share about their Ramadan experience! What are their favorite traditional foods and customs? How have they adapted their traditions during the pandemic?

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