Although a robust literature describes the intergenerational effects of traumatic experiences in various populations, evidence specific to refugee families is scattered and contains wide variations in approaches for examining intergenerational trauma. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria, the purpose of this systematic review was to describe the methodologies and findings of peer-reviewed literature regarding intergenerational trauma in refugee families. In doing so we aimed to critically examine how existing literature characterizes refugee trauma, its long-term effects on descendants, and psychosocial processes of transmission in order to provide recommendations for future research. The results highlight populations upon which current evidence is based, conceptualizations of refugee trauma, effects of parental trauma transmission on descendants’ health and well-being, and mechanisms of transmission and underlying meanings attributed to parental trauma in refugee families. Greater methodological rigor and consistency in future evidence-based research is needed to inform supportive systems that promote the health and well-being of refugees and their descendants.

Disparities in access to primary health care have led to health disadvantages among Latinos and other non-White racial groups. To better identify and understand which policies are most likely to improve health care for Latinos, we examined differences in access to primary care between Latinos with proficient English language skills and Latinos with limited English proficiency (LEP) and estimated the extent of access to primary care providers (PCPs) among Latinos in the U.S. Method: We used agent-based modeling techniques to estimate the effects of English proficiency, insurance coverage, Latinos with LEP seeking care from English-speaking PCPs, distance to PCP, PCP availability, and Spanish-speaking PCP availability on access to primary care. We used NetLogo 6.0 to simulate a community of 10,000 Latinos seeking care for a 6-month period, running 5 controlled experiments to determine if population-level outcomes varied by scenario. Results: Models suggested that Latinos with LEP would likely delay care less often if policies were implemented to expand health insurance coverage, address linguistic barriers and promote an inclusive health care climate for patients with LEP, reduce mobility barriers, increase the number of PCPs, and train more Spanish-speaking PCPs. Conclusions: Findings support results from prior studies suggesting that policies and programs that help Latino patients overcome linguistic and cultural barriers to health care will improve Latinos' access to care.

Minimal research has simultaneously explored the premigration, displacement, and postmigration experiences of loneliness among older adults with a refugee history. Drawing from a constructivist grounded theory study guided by an intersectionality framework, this study aimed to explore the factors influencing loneliness in these three phases among Hmong older adults with a refugee background. Interviews were conducted with 17 Hmong older adults aged 65 and older residing in Northern California. Findings revealed the influencing factors emerging from systems of oppression grounded within the social, political, and cultural context of each phase. Influencing factors of loneliness were identified as betrayal, familial loss, instability, war violence, loss of social status, isolation, diminishing filial piety, language barrier, declining health, and lack of purpose. This study highlights the need for more research, practice, and policy focused on the context of the refugee experience to gain a greater insight into their loneliness experiences.

Summary As refugees of the war in Southeast Asia, Hmong experienced various traumatic events. Evidence suggests the persistence of psychiatric disorders related to trauma in refugees even after prolonged resettlement in their host country. This systematic review aimed to summarize the mental health literature on the Hmong population with a focus on cultural and social factors. The databases PsycINFO, PsycARTICLES, Social Services Abstracts, Web of Science, and PubMed were reviewed for peer-reviewed articles published up to April 2018. Forty articles were included in the final review. Findings Results highlight three primary themes: (1) mental health outcomes were associated with a variety of premigration and postmigration factors, (2) group and community-based treatment and interventions provided promising results, and (3) barriers to mental health care were primarily stigma, communication challenges, discrimination, and mental health literacy. The results of this systematic review shed light on the limited and small studies with the Hmong population. Applications Implications for social work and culture-sensitive research, practice, and policymaking for this population are discussed.