Immigrant and Refugee Access to Care

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The Migratory Experiences, Access to Health Care and Employment of Immigrant and Refugee Latinos and Latinas Living with HIV in Toronto

The Migratory Experiences, Access to Health Care and Employment of Immigrant and Refugee Latinos and Latinas Living with HIV in Toronto

The biggest problem is that this judge was working to put me out then, or he did not read the documents. At some time, he tried to insinuate that I was here to take advantage of the system, to obtain the papers for free... That was a battle, from one hearing it went to eight or nine sessions. It was three years; every two months hearing the absurd questions try to find contradictions. His strategy was obvious, dismiss this case, arguing that it was not true, but he never could and what happened at the end was that my lawyer was able to show that he was biased, and the judge was changed and with a new judge in less than two hours I was granted refuge; it was a very particular thing… (30-39, gay male). The violence of the refugee determination process is evidenced during the detention experience (Lee and Brotman, 2011) that some of the refugee claimants encounter during their processes. The intersection of stereotypes based on national origin with a non- normative sexual orientation may generate problems during border crossing and the refuge claim process. Some sexual minority refugees are deemed as a security risk. In our sample, one participant mentions being detained when she arrived in Canada. Her
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The Immigrant. Know Your Rights: and Refugee Guide to Affordable Health Care in New York State

The Immigrant. Know Your Rights: and Refugee Guide to Affordable Health Care in New York State

Which plan offers the services I need? The answer to this question depends partly on your health needs. For instance, if you regularly need specialized services, like help with mental illness or substance abuse, it’s important to be sure these services are included in your plan. If you’re young and healthy, you may prefer to pay less and get fewer benefits. But in any case, you want ready access to doctors you trust, and dependable ar- rangements for emergency care if you need it. Think about location, too. If you’re considering a managed care plan that requires you to use only certain doctors, clinics, drugstores, and hospitals, then it’s important to be sure that they can be reached from where you live. And you’ll want to check whether the doctors you’re hoping to see within the network are actually taking new pa- tients, or whether they have waiting lists. Language can also be an important factor. You want to be certain that there are health-care providers within the network you choose who can meet your language and cultural needs.
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Affordable Care Act Implementation in Illinois: Overcoming Barriers to Immigrant Health Care Access

Affordable Care Act Implementation in Illinois: Overcoming Barriers to Immigrant Health Care Access

IFRP works with community members and State staff to clarify what documents are required, assist in collecting documents, explain why these documents are required, and educate mixed-status families regarding the information they need to ensure that these families are aware of their rights to access services. Additionally, IFRP provides comprehensive case management services to each family, including assistance with completion of applications, collecting documents, and accompanying families to the State offices, if needed. The IFRP staff at the program partners track the status of each application until the client is approved or denied the benefits. These services have decreased the burden on overworked State case workers while increasing access for the most vulnerable immigrant families. IFRP has provided trainings to the Illinois Department of Human Services, Rehabilitation Services, Illinois Department of Employment Security, Illinois Department on Aging, Chicago Public Schools, Chicago Food Depository, and individual food pantries on how to work with immigrant and refugee families, immigrant eligibility for public benefits, how to utilize interpreters, domestic violence in immigrant communities, cultural awareness trainings,
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Does an oral health education program increase oral health literacy and access to dental care in a refugee population?

Does an oral health education program increase oral health literacy and access to dental care in a refugee population?

professionals in ethnically diverse communities may be attributed to lack of cultural competence and insufficient diversity among oral health providers (Garcia et al., 2008; HHS, Healthy People: Understanding and Improving Health 2010, 2000; ADHA, 2011). As studies suggest, additional efforts are needed to recruit ethnically diverse individuals into the dental field to better reflect the cultural and ethnical makeup of the diverse populations (CODA, 2010; rescue.org, 2016; Rowland et al, 2006). In addition, greater emphasis needs to be placed on increasing the cultural competence of students in dental and dental hygiene schools (HHS, 2000c; Rowland et al., 2006; CODA, 2013; Horowitz, 2013; ADHA, 2015). This may include increasing the ethnic diversity of students and faculty, adding cultural competence courses with service learning in refugee and immigrant communities, collaborating with international dental and dental hygiene schools on study abroad programs, including guest speakers from ethnically diverse communities, and partnering with client representatives from organizations such as the IISTL. A good example of a culturally competent dental program is the Refugee and Cultural Awareness Program at the University of Buffalo (University of Buffalo, 2016).
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Understanding of latent tuberculosis, its treatment and treatment side effects in immigrant and refugee patients

Understanding of latent tuberculosis, its treatment and treatment side effects in immigrant and refugee patients

tertiary referral hospital had a suboptimal level of under- standing and knowledge of latent TB, its treatment regi- men and treatment side effects. These findings have significant implications for clinical practice. The associ- ation between having an interpreter and low knowledge and understanding is particularly worrying as it suggests that patients requiring an interpreter may be at a disad- vantage, for which use of an interpreter is insufficient to compensate. Medical education programs are needed to improve interpreters’ knowledge about latent TB (and other diseases) in order to transfer accurate health mes- sages to patients. There is currently no specialist training for interpreters in medical vocabulary and no require- ment that there should be such training. Any training that takes place is through self-funded personal develop- ment. Outsourcing of interpreting services may prevent the accumulation of organisational experience in the field or in specific institutions. One possible avenue to address this deficit is offering certified short courses for interpreters who work in health care settings. Similarly, immigrant and refugee populations would benefit from linguistically and culturally appropriate health education. This would be particularly beneficial for refugee patients from non-English speaking backgrounds who may have low health literacy and limited access to accurate infor- mation. Information is available in some languages other than English, but not in the languages most commonly spoken by our patients. Translation is limited by lack of resources. Another, more complex response would be the development of a bilingual health worker role to provide support and education to individual patients and ethnic communities beyond simple interpreting. Findings from this study could help to inform pro- viders of TB care how best to educate and motivate pa- tients from very different cultural and linguistic backgrounds about the importance of adherence to treatment for latent TB.
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A qualitative study on African immigrant and refugee families’ experiences of accessing primary health care services in Manitoba, Canada: it’s not easy!

A qualitative study on African immigrant and refugee families’ experiences of accessing primary health care services in Manitoba, Canada: it’s not easy!

Regarding linguistic and cultural barriers, families were frustrated with being unable to communicate effectively with care providers. Similarly, in a meta-ethnography on immigrant women’s experiences of maternity services in Canada, it was reported that communication was a barrier in accessing care [25]. Health care providers and patients expected the other to do more to overcome the barrier [25]. The families in our study desired care that was ap- propriately translated and culturally relevant. Therefore, to improve access, we make suggestions for more cultur- ally accommodative health care services where care pro- viders reflect upon their cultural values, beliefs, and practices and those of others. Approaches where care pro- viders are more aware of their communication skills and those of others and work towards modifying their care skills to accommodate African immigrants and refugees could be beneficial [44]. We believes culturally competent care could be developed through networks between health care and social service providers and newcomer commu- nities [45]. To reduce linguistic barriers, information shar- ing opportunities could be developed where educational materials that focus on accessing health care services could be presented to new African families in multiple languages.
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Knowledge, Access and Practice: Understanding the Affordable Care Act from the Voices of Somali Immigrant Women in the United States

Knowledge, Access and Practice: Understanding the Affordable Care Act from the Voices of Somali Immigrant Women in the United States

Abstract: Previous literature acknowledges a lack of insurance as a deterrent in seeking healthcare, thus impacting the overall health status of Somali immigrant women (Fran- cis, Griffith, and Leser 2014). This paper builds on the previous literature and addresses the following: a) understand the link between the social determinants of health frame- work and the Affordable Care Act; b) explore Somali women’s attitudes about the feasi- bility of access and knowledge of the Affordable Care Act, specifically the Medicaid ex- pansion and health insurance marketplace; c) address Somali women’s encounters with doctors and practitioners post-enactment of the Affordable Care Act. Using interview data from twenty Somali women, common themes elicited were the following: mis- communication among Somali immigrant women and their healthcare providers, feel- ings of social anxiety and other mental health issues, as well as poor patient and doctor relationships. The project is a community-engaged research study that collects data on individuals’ knowledge with the Affordable Care Act by working with members of sev- eral Somali led organizations to identify additional key issues within the community. Furthermore, this project challenges the complexity of adapting and integrating into an unfamiliar culture due to language barriers and approach to medical practices, i.e. views about medical practices may be due to cultural values and beliefs about health. In con- clusion, this paper provides demographic data about the impact of health disparities on Somali refugees and immigrants by including how they view access to healthcare, iden- tify barriers to information and care provided by health practitioners, and examine their needs in terms of preventive care.
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Health Care for Children of Immigrant Families

Health Care for Children of Immigrant Families

ABSTRACT. The intent of this statement is to inform practitioners about the special health care needs and vulnerabilities of immigrant children and their families and to suggest clinical approaches to various aspects of their care. Immigrant children and their families, a large and diverse population group, have numerous risks to physical health and functioning and may be unfamiliar with our health care services. They often face many bar- riers to care, and their special risks and needs may not be familiar or readily apparent to many health care provid- ers. Recently enacted federal welfare and immigration reform measures may increase the vulnerability of this population by limiting its access to health and social services. For multiple ethical and medical reasons, the American Academy of Pediatrics has historically op- posed, and continues to oppose, denying needed services to any child residing within the borders of the United States.
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Providing Care for Children in Immigrant Families

Providing Care for Children in Immigrant Families

immigration may intersect with religion (eg, Muslim immigrants) and race in complex ways. 264,272–274 Discrimination and immigration enforcement policies may also create fear and uncertainty, which threaten the mental health of immigrant children 275 and their families. 19,236,264,276 Families living on the US-Mexico border face particular risk of mistreatment and victimization. 277 Policies that offer protection from deportation, such as DACA, may confer large mental health bene fi ts for youth and for the children of parenting youth. 278,279 Immigrant children who have been detained and are in immigration proceedings face almost universal traumatic histories and ongoing stress, including actual or threatened separation from their parents at the border. 7 Immigrant children, including unaccompanied children, are not guaranteed a right to legal counsel, and as such, roughly 50% of children arriving in the United States have no one to represent them in immigration court. 280 Lack of guaranteed legal representation for immigrant children and families at risk for deportation is further complicated by funding restrictions; speci fi cally, medical-legal
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Somali Refugee Women’s Perception of Access to Services in the UK

Somali Refugee Women’s Perception of Access to Services in the UK

The primary means by which I gathered and analysed the research information was through audio recording and hand-writing. Before each interview, I asked participants’ permission to record and I also discussed issues of confidentiality and how the data would be protected. It became obvious that most participants were apprehensive about recording the interview. To calm their expressed fears about whether aspects of themselves would appear in the data, I assured them that they could have access to the final research material and also passed on the details of my supervisor to them so that they could make contact to clarify their doubt. In spite of this, eight interviewees did not allow me to tape-record their interviews. In these cases, I hand-wrote their responses whilst listening to their stories as they were translated to me by the translators. Overall I tape-recorded 18 interviewees’ narration and recorded eight interviewees’ manually. The audio-taped interviews captured everything narrated by my participants through the translation, which I later listened to. Therefore I was less burdened than when I had to focus on listening, participating in the interview and writing extensively at the same time. Managing to write and listen to the translators’ report for the eight participants who would not allow me to tape-record their interviews was quite challenging. This affected how much detail I could write down and it also slowed down the interviews as the translators at times had to wait for me to finish writing down a point. I was particularly concerned that the intermittent pauses I caused by trying to write would interrupt the conversational flow between the translators and the interviewees and could lead them to deviate from the topic, or that they might cause translators to forget the information they were to convey to me. The effect of this on the research was that I could not produce a verbatim account of what the translators reported to me. Rather I had to summarise and paraphrase in order to manage the interview time and to avoid too many pauses within the interview. Since the information was filtered through so many processes, the immediacy of the data was reduced.
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Trends in horizontal inequity in access to public health care services by immigrant condition in Spain (2006–2017)

Trends in horizontal inequity in access to public health care services by immigrant condition in Spain (2006–2017)

In line with previous related literature we assume that access to health care services is mainly determined by three groups of characteristics: medical need, socioeco- nomic status and demographic characteristics [2–10]. Medical need is proxied by different variables. First, self- reported measures of individuals’ health state: these include a categorical indicator that records whether indi- viduals considered their general health during the twelve months prior to the survey to be ‘very good’, ‘good’, ‘fair’ and ‘poor’ or ‘very poor’. Second, a set of dummy vari- ables indicating whether the respondents report the presence of any of the seven listed chronic conditions (hypertension, strokes, heart problems, diabetes, choles- terol, cancer or mental health). Additionally, a continu- ous variable indicating the number of chronic conditions not listed above was specified. Third, two dummy vari- ables were used representing whether any acute illness restricts the normal activity of respondents or had con- fined them to bed in the previous two weeks, or whether they had had any accident in which they had been in- jured in the previous twelve months. Fourth, to measure mental health another continuous variable (GHQ-12) was used with the 12-item version of the General Health Questionnaire [14], indicating the mental health of the respondent in a scale from 0 (best possible state) to 12 (worst possible state) [15].
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Refugee Access to Higher Education in the World: A Systematic Review

Refugee Access to Higher Education in the World: A Systematic Review

Há uma série de bolsas de estudo disponíveis para imigrantes e americanos nascidos no exterior. Faculdades e universidades em todo os Estados Unidos estão lutando para ajudar estudantes e estudiosos afetados pela proibição. Massachusetts anunciou uma nova bolsa para um estudante internacional afetado pelo pedido de imigração do presidente Trump. A bolsa de estudos de Wheaton Refugee oferecida pela escola de artes liberais com cerca de 1.600 alunos cobrirá todos os custos de comparecer à faculdade em Norton, Massachusetts. A Universidade Roger Williams, uma escola semi-privada de artes liberais em Rhode Island, ofereceu quatro bolsas de estudo - duas para a faculdade de direito e duas para a escola de arquitetura - para estudantes da Síria, devastada pela guerra. Princeton continuará a apoiar estudantes, professores e funcionários de todas as nacionalidades e fé, e a defender políticas que respeitem simultaneamente os legítimos interesses de segurança desta nação e permitam o movimento livre e vital de estudantes e estudiosos através das fronteiras. Esses alunos enfrentaram dificuldades extraordinárias e acreditamos que é nossa responsabilidade como educadores globais assumirem esse compromisso neste momento (Svrluga, 2017; Strauss, 2017).
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Immigrant Entrepreneurs and Small Business Owners, and their Access to Financial Capital

Immigrant Entrepreneurs and Small Business Owners, and their Access to Financial Capital

(Fairlie 2008). In particular, much recent attention has been drawn to the contributions of immigrant entrepreneurs to the technology and engineering sectors of the economy. Twenty-five percent of engineering and technology companies started in the past decade were founded by immigrants (Wadwha, et al. 2007). These firms had $52 billion in sales and hired 450,000 workers in 2005 in the United States. Previous research also indicates that immigrant entrepreneurs have made important contributions to high-tech areas such as Silicon Valley (Saxenian 1999, 2000). Engineers from China and India run roughly one quarter of all technology businesses started in Silicon Valley. Immigration is also found to increase innovation measured as patents and even have positive spillovers in innovation for others (Hunt and Gauthier-Loiselle 2010, Kerr and Lincoln 2010).
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Differences between immigrant and non immigrant groups in the use of primary medical care; a systematic review

Differences between immigrant and non immigrant groups in the use of primary medical care; a systematic review

Research attention for differences between immigrant and non-immigrant groups in primary care use has increased over the years. Nevertheless, to our knowledge no system- atic attention has been paid to the synthesis of results from the various studies. In our review, literature was sys- tematically reviewed, resulting in the inclusion of 37 stud- ies from 7 countries. With respect to the extent to which countries and immigrant groups differ in primary medical care use from the indigenous majority population, we conclude that no overall consistent pattern could be dis- tinguished with respect to immigrant groups. Generally, immigrant groups do not make an excessive demand upon the primary care system nor do they opt out [29]. However, the significance of differences in use varied across countries. Compared to the other countries, studies performed in the US more often reported significant dif- ferences between immigrant groups and the majority pop- ulation, especially in the direction of a lower use among immigrant groups. As the strength of the primary care sys- tem in the US is found to be substantially weaker than in the other countries, our results suggest a relationship between differences among immigrant and non-immi- grant groups in use and a country's orientation towards primary care. Possibly a strong primary care system posi- tively contributes to equity in access for potentially vul- nerable groups. This issue clearly needs to be addressed in future research as other studies suggest that psychological and cultural characteristics (e.g. adherence to Asian val- ues) in help seeking strategies explain differences in use of care more than health system related characteristics [30]. Other research underlined the relative importance of edu- cation and income for explaining differences in use
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Health Care Needs of Indochinese Refugee Teenagers

Health Care Needs of Indochinese Refugee Teenagers

Although 50% of Indochinese refugees are under 18 years of age, previous studies have emphasized the prevalence of parasites, anemia, tuberculosis, and hepatitis, with few addressing age[r]

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TUBERCULOSIS CARE AND CONTROL IN REFUGEE AND DISPLACED POPULATIONS

TUBERCULOSIS CARE AND CONTROL IN REFUGEE AND DISPLACED POPULATIONS

Reports from health workers and research conducted in 2003 on TB and gender show that the vast majority of patients seeking care in DOTS centres have previously seen a private practitioner for their symptoms. Most patients start treatment as prescribed by the private practitioner. In almost all cases, diagnosis is made on clinical grounds, without sputum examination; treatment is often not appropriate, does not include the DOT component; there is no regular follow up; and no reporting to health authorities by the private practitioner. Personal enquiries in private pharmacies have disclosed that TB treatment is largely available over the counter. Costs of a full course of treatment (six months) is in the range US$ 50–60 and the most frequently prescribed medications include 3- or 4-drug FDCs of uncertain quality. Ethical considerations prevent the ban of import or sale of TB drugs through the private sector because of the current lack of affordable access to DOTS by a large part of the Afghan population. WHO is supporting operational research on TB treatment in the private sector in Kabul, where most doctors operate. As in many other countries, physicians concentrate in major cities. As a consequence of arrangements during the previous political regimes, doctors are not allowed to work exclusively in the private sector but they can run their clinics after working hours in government employment, which is usually very poorly paid. Given that they can be reached through the public sector, this, in theory, makes it easier to address training and advocacy messages to private practitioners.
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Providing Care For Immigrant, Homeless, and Migrant Children

Providing Care For Immigrant, Homeless, and Migrant Children

children in immigrant families may themselves be US citizens, eligible for government-sponsored and other health programs. However, the immigrant sta- tus of their families often influences whether and how these children access such programs. Under current law, there are, for example, health benefits restrictions for lawful immigrants who have arrived in the United States after 1996. These immigrants are barred for 5 years from receiving comprehensive health benefits under Medicaid and the State Chil- dren’s Health Insurance Program (SCHIP), although their families pay taxes and contribute to society. More than 20 states currently provide health insur- ance coverage to legal immigrant children using state-only funds.
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Going Global and Getting Graphic: Critical Multicultural Citizenship Education in an Afterschool Program for Immigrant and Refugee Girls

Going Global and Getting Graphic: Critical Multicultural Citizenship Education in an Afterschool Program for Immigrant and Refugee Girls

This paper is based on two premises. First, immigrant youth need opportunities to engage in dialogue where they grapple with what it means to belong to, and lead powerful lives in, their new country. Second, this kind of dialogue is crucial to fostering critical multicultural citizenship. That is, in order to foster critical multicultural citizenship in immigrant and refugee youth, we need to shift away from pedagogies centered on facts about the U.S. government or exercises aimed at instilling patriotism (e.g., pledging allegiance to the flag) towards a pedagogy that leverages dialogue about democratic values like equality and justice. Yet in U.S. schools that serve large numbers of English language learners and first-generation immigrants, opportunities for dialogue are scarce in classrooms 1 (Valdés, 1998). Youth are more likely to be engaged in classroom activities that focus on the “basics” of language acquisition, like memorizing vocabulary. Furthermore, when it comes to citizenship education, most immigrant youth are exposed to curricula that uphold a homogeneous view of citizenship. As Salinas, Sullivan, and Wacker (2007) argue, much of school-based citizenship education in the United States overlooks the possibilities and tensions associated with diverse cultural, national, and global identities. Embedded in many social studies, government, history, and geography lessons are notions of citizenship that are static and bound to geophysical borders. In fact, analyzing texts and programs for citizenship education, Abowitz and Harnish (2006) found that transnational and critical discourses have yet to alter the dominant framing of citizenship education.
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Healthcare access for refugee women with limited literacy: layers of disadvantage

Healthcare access for refugee women with limited literacy: layers of disadvantage

On arrival in Canada they entered a system that valued self-sufficiency and independence, often leading to feel- ings of shame, dependence, rejection, and even fear. Dyck and McLaren [47] argue that Canada’s neoliberal political climate positively values self-sufficient immi- grants, but negatively values refugees. In a system where the neoliberal values of cost-effectiveness and productiv- ity have entered not only the public but also the domes- tic domain, refugee women with limited literacy skills are valued negatively as a burden to the system and sometimes to their own families (e.g. to their children, who sometimes offer help with translation). According to Dossa [48] in Canada racial minorities are “con- structed as foreigners, desirable for their labour only” (pp.155). Refugee women with limited education, whose skills do not immediately lend them to employability, become socially constructed as problematic, dependent, and unable to adjust to life in Canada [49]. Language barriers and relegation to minority-group status can further contribute to women’s isolation and sense of displacement [50].
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Access to Education: Afghan Refugee Children’s Perceptions on Educational Opportunity

Access to Education: Afghan Refugee Children’s Perceptions on Educational Opportunity

Each group discussion generated revealing age-specific responses. The first was age-group 9—10. These children had migrated in the last two years. There were 11 children in this age group. This seemed to be the most care-free cohort. Because of their vulnerable age, the children did not show much concern about what had happened to them. They seemed oblivious of the enormity of the problem. During the discussion, they shared that 9 out of 11 of them were studying in schools when they were forced to migrate. Those who were studying responded that they loved their schools. They fondly recited the prayers and national anthem they used to recite every morning. They also recollected about their classroom experiences. Surprisingly seven of them still remembered the names of their teachers. They fondly recollected about their friends. They shared that they played, studied and had fun together. What was heartening was the fact that these beautiful children were living a normal, happy and carefree life when suddenly they were forced to migrate. Suddenly being deprived of something you love and cherish is a traumatic experience. Moreover it is easy to adjust without something you have never seen, but once you experience something it becomes a part of life. Three older children said that when they see other children going to school, they feel very bad.
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