Health

Study Underscores Community Support as Buffer to PTSD
This report, which focuses on children of Bhutanese and Somali refugees, examines factors that may promote or undermine the mental health and well-being of young children with refugee parents—including factors related to premigration, migration, and resettlement experiences. (…) It is significant that the levels of anxiety and depression reported by parents in the two samples are similar to those of the U.S. adult population overall. This indicates that although these refugee parents may have been exposed to significant trauma prior to resettlement, their mental health has been buffered by strong intimate relationships and significant community support.
Migration Policy Institute, Mental Health Risks and Resilience among Somali and Bhutanese Refugee Parents. 2016

How Low-Skill Jobs Can Downgrade Newcomer Health
This study examines immigrant health data that shed light on how job status predicts physical and mental health. It finds that overqualified workers had higher rates of adverse mental health outcomes, including depression, anxiety, and psychological distress.
Occupational downgrading, overeducation, and overqualification add another dimension to the challenges faced by immigrant workers. For many immigrants, moving to a new country presents the likely possibility of losing occupational status, which has implications for health. Although the link between occupational trajectory and health status for immigrant workers needs further study, it is an issue that occupational health professionals must consider to provide quality services and care that improve the lives of this growing population of workers.
Allison Crollard, A.B. de Castro and Jenny Hsin-Chun Tsai, Occupational Trajectories and Immigrant Worker Health, 2013.

Numbers Too Small to Measure Impact of Affordable Care Act
In 2012, more refugees were resettled to states that have not expanded Medicaid or created state health insurance exchanges. Because many states have small or no refugee resettlement programmes, the difference in distribution of resettlement based on state insurance policies does not reach statistical significance. Future research should explore the effect of these differences in state policies on refugee health outcomes. Policymakers should consider between-state variation in access to insurance when devising refugee resettlement strategies.
P Agrawal, AK Venkatesh, Impact of the Affordable Care Act on Health Insurance Access, Coverage, and Cost for Refugees Resettled in the USA. The Lancet Global Health, 2015

Improving Healthcare for Syrian Refugees, and for All
The United States will admit an additional 10 000 Syrian refugees during the next fiscal year, at which point Syrians will constitute approximately 18% of the total refugee population admitted in  2016. But this is not a public health emergency in the United States. The media attention and national concern about Syrian refugees does provide an opportunity, however, to improve our public health system’s capacity to serve all refugees. With commitment and grit, several communities have increased refugees’ access to quality health services that span the full spectrum from preventive screening to management of complex chronic conditions. These promising practices demonstrate the feasibility of providing efficient, accessible and effective health services for even the most linguistically and economically marginalized members of our communities. As Beth Farmer, the director of International Counseling and Community Services in Washington State put it: “If we fix the healthcare system for refugees—make it understandable and easily accessible—we fix it for everyone” (telephone communication, October 2015).

Clea A. McNeely and Lyn Morland,  The Health of the Newest Americans: How US Public Health Systems Can Support Syrian Refugees. In: American Journal of Public Health: January 2016, Vol. 106, No. 1, pp. 13-15.


Syrian Refugee Children Suffer from PTSD – 10 Times More than U.S. Kids
This Migration Policy Institute report summarizes results from the ground-breaking Bahçeşehir Study of Syrian Refugee Children in Turkey, which found that 45 percent of refugee children displayed symptoms of post-traumatic stress disorder – ten times the prevalence among children around the world – and 44 percent reported symptoms of depression.
Syrian refugee children are also at risk for a range of mental health issues resulting from their traumatic experiences. This report draws on the results of a study on Syrian refugee children, conducted in Islahiye camp in southeast Turkey, which assesses children’s levels of trauma and mental health distress. These children had experienced very high levels of trauma: 79 percent had experience a death in the family; 60 percent had seen someone get kicked, shot at, or physically hurt; and 30 percent had themselves been kicked, shot at, or physically hurt. Almost half (45 percent) displayed symptoms of post-traumatic stress disorder (PTSD) – ten times the prevalence among children around the world – and 44 percent reported symptoms of depression. Approximately one-quarter reported daily psychosomatic pains in their limbs, with one in five suffering from daily headaches. (…) In comparison, in the United States only 1 to 2 percent of prepubescent children and 3 to 8 percent of adolescents are diagnosed with depression.
Selcuk Sirin and Lauren Rogers-Sirin, The Educational and Mental Health of Syrian Refugee Children. Migration Policy Institute, 2015.

What is the Cost of Refugee Health Care?
The two key sources – the ORR Annual Survey from 2014 and ORR Stakeholder Report (2014) – don’t seem to have any data specifically on this question. However, ORR’s Annual Survey gives some interesting clues. For example, some 44% of refugees who participated in this survey still received Medicaid benefits five years after arrival (down from 75% one year after arrival).
The U.S. Office of Refugee Resettlement: Annual Survey of Refugees (pps. 87 to 107). In The 2014 Annual Report to Congress, 2015.

Unmet Medical Needs Worse in the U.S.
As with the native-born, 8% of immigrants in the United States said they had let a medical need go unmet as a result of cost alone. However, immigrants in few other countries – notably Iceland, Canada, and Germany – were less likely than the native-born to report unmet medical needs.
OECD: Indicators of Immigrant Integration. Settling In, 2015.

Do Refugee Employers Offer Healthcare?
Apparently not as much as we would like to think. ORR’s Annual Survey from 2014 finds that while refugees’ average hourly wages increased over their time in the U.S., “the lack of a corresponding increase in employer-sponsored health coverage may indicate difficulty finding quality jobs that can serve as a foundation for stability and upward mobility.”
The U.S. Office of Refugee Resettlement: Annual Survey of Refugees (pps. 87 to 107). In The 2014 Annual Report to Congress, 2015.

Surprisingly Low Healthcare Enrollment Rates
Our research found that complicated eligibility criteria combined with existing data systems and eligibility screening forms and processes made enrollment difficult for both agency staff and immigrant families. Further, logistical barriers—such as the difficulty and expense of providing in-person translation in all languages, and immigrants’ struggles to satisfy in-person application requirements in light of work schedules and limited transportation—prevented other families from applying for benefits. Immigration enforcement policies combined with misperceptions among immigrant families can also create a climate of fear, in which immigrants are unwilling to provide the information needed to access benefits. Therefore, it is not surprising that eligible low-income immigrant families have substantially lower receipt rates for SNAP, TANF, Medicaid, and CHIP benefits than other low-income families.
Julia Gelatt and Heather Koball: Immigrant access to health and human services: Final report, The Urban Institute, 2014.
 
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