User:Cassidy Shapiro/sandbox

Migrant health, refugee health or immigrant health is the field of study on the health effects experienced by people who have moved to another area of the world, either by choice or as a result of unsafe circumstances such as war. The health of these displaced populations is mainly affected by infectious disease, mental health, and chronic diseases that are common in the country in which these displaced persons eventually settle. This is largely due to factors such as the migrant's geographic origin, conditions of refugee camps where the migrant lived, and personal, physical, and psychological conditions of the migrant, either pre-existing or acquired while traveling from their homeland to a camp or eventually to their new home. It is common for people entering new countries for resettlement to undergo a comprehensive health assessment - In the United States, The Federal Refugee Act of 1980 recommends that all refugees are administered proper health screening. The Office of Refugee Resettlement (ORR) housed in the Department of Health and Human Services (DHHS) is charged with funding and oversight of this effort. Three medical interventions are either required or recommended in order to contain infectious disease and reduce the medical burdens that may be associated with refugee resettlement. First is a mandatory overseas screening for all refugees and immigrants, then a recommended domestic screening for refugees, and finally a required medical component to the Adjustment of Status (Green Card) process.

Cultural competence[edit | edit source]

When doctors or other health professionals work with refugee populations, it is necessary to strive for cultural competence. Refugees most often come from war-torn situations combined with prolonged time in refugee camps. Some of the educated among them may speak some English and may have knowledge of Western culture. However, some refugees from rural areas may speak only a local dialect and have very little if any knowledge of the Western world. Health care providers seeing refugees for their domestic screening are often the refugee's first experience with Western style medical care. Physicians, nurses and other health care providers would do well to learn about the cultural background of their refugee patients and ensure that a professional bi-lingual/bi-cultural medical interpreter is present for their encounters. Interpreters should not be a relative or friend of the refugee. A r2015 systematic review found that healthcare providers face challenges in taking care of immigrants health.^[2] Often physicians face law restraints prohibiting them from providing proper healthcare for refugees, because they do not have legal right to have access to all healthcare resources.^[2]

In striving for cultural competence, a physician must be sure to consider all of the cultures at play: the refugee's culture, the physician's culture, and the inherent culture of medicine. As a minority, it is also important to remember that these refugee populations will be subject to various social determinants of health. These conditions coupled with their high incidence of infectious diseases, poor mental health, and susceptibility to chronic diseases result in poor health outcomes for many refugees. To avoid these poor outcomes, it is imperative for physicians treating refugee patients to establish a friendly, trusting physician-patient relationship which will allow them to provide adequate care. Another important step in achieving cultural competence is understanding and respecting refugee's health beliefs. A person's beliefs in regard to their health and disease is largely shaped from the culture they come from. These beliefs also influence how people "perceive, experience, and express" illness. If a physician is capable of administering care with sensitivity to these beliefs, she will find that the quality of care if greatly increased for the patient.

Another important factor that health professionals must take in to consideration is the conceptualization of disease that refugee patients may have, and how these differ from our socially driven and accepted concepts. Although these concepts may differ greatly due to cultural differences, a physician will be better enabled to treat a refugee despite these differences if she has knowledge of the discrepancy prior to meeting the patient.