Meaning of Healthy Living Among Bhutanese Refugees Resettled in the United States: Photovoice Embedded in Community-Based Participatory Research

Background and Objective: Bhutanese refugees in the United States face intersecting health disparities shaped by trauma, cultural disruption, and systemic barriers. Despite growing attention to refugee health, little is known about how this community defines and practices healthy living post-resettlement. This study explores Bhutanese refugees' lived experiences of health using participatory, culturally grounded methods. Methods: Using photovoice within a community-based participatory research framework, 24 Bhutanese participants and 6 peer facilitators engaged in photodocumentation and community wellness workshops. Participants captured images related to healthy living and discussed their meanings in collective sessions. Thematic analysis of photonarratives was codeveloped with community members. Results: Four themes emerged: (1) Land as memory and identity, where loss of agrarian life symbolized disconnection from health and culture; (2) Food as cultural survival, as traditional eating practices supported well-being and adaptation; (3) Health navigation in a system not built for us, showing how chronic illness and healthcare inaccessibility were mitigated by community-led support; and (4) Spiritual continuity as healing, where faith, ritual, and language sustained emotional and cultural resilience. Conclusion: Health among Bhutanese refugees is relational, culturally embedded, and shaped by collective resilience. Effective interventions must integrate cultural continuity, peer leadership, and place-based strategies.