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Reasons for Health Care Disparities for Sudanese Refugees

Introduction

Recognizing and appropriately treating mental health problems among new immigrants and refugees in primary care poses a challenge because of differences in language and culture and because of specific stressors associated with migration and resettlement. We aimed to identify risk factors and strategies in the approach to mental health assessment and to prevention and treatment of common mental health problems for immigrants in primary care (Lustig, Kia-Keating et al. 24).

The migration trajectory can be divided into three components: pre-migration, migration and post-migration resettlement. Each phase is associated with specific risks and exposures. The prevalence of specific types of mental health problems is influenced by the nature of the migration experience, in terms of adversity experienced before, during and after resettlement (Ehntholt & Yule : 1197). Specific challenges in migrant mental health include communication difficulties because of language and cultural differences; the effect of cultural shaping of symptoms and illness behaviour on diagnosis, coping and treatment; differences in family structure and process affecting adaptation, acculturation and intergenerational conflict; and aspects of acceptance by the receiving society that affect employment, social status and integration. These issues can be addressed through specific inquiry, the use of trained interpreters and culture brokers, meetings with families, and consultation with community organizations.

Discussion

Many of the Somalis and Sudanese in Iowa are classified as refugees by the United States, and are legal residents of the state. As such, they are entitled to a number of health, human service, and economic forms of government assistance for a limited time. Language and transportation, then, are the most significant barriers to care for this group if they have financial access to health (Asgary, Metalios, et al: 164). Somalia and the Sudan are two of the world's poorest, most violent countries. Mortality and morbidity rates are extremely high for many infectious diseases. Lifespans are among the shortest in the world due to violence and illness; with many people back home not living past age 45 years.

Many of the Somalis and Sudanese arriving in Iowa have undergone profound levels of hardship and human rights abuses. Many have witnessed or personally experienced war injuries, starvation, rape, and torture. Most had very poor access to medical care in their home countries, and thus typically present with multiple significant physical, mental, and dental health concerns in the United States. As with Bosnian ...