Addressing refugee health through evidence-based policies: a case study

Bocanegra, Heike Thiel de; Carter‐Pokras, Olivia; Ingleby, J. David; Pottie, Kevin; Tchangalova, Nedelina; Allen, Sophia I.; Smith-Gagen, Julie; Hidalgo, Bertha

doi:10.1016/j.annepidem.2017.05.010

Cited by 16 publications

(11 citation statements)

References 38 publications

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“…However, the results indicated civic attitudes as a mediator between health status and civic engagement. Improving health among immigrants and refugees through culturallyappropriate practice and support groups, health information provision, counselling, and evidence-based policies can enhance the level of civic engagement through strengthening civic attitudes (de Bocanegra et al, 2018;Shishehgar et al, 2017). In other words, health status not only directly predicts civic attitudes, but also indirectly influences the level of civic engagement.…”

Section: Discussionmentioning

confidence: 99%

Civic Attitudes and Engagement Among Middle Eastern and North African Refugees and Immigrants in the U.S.

Alamdari

2020

ASW

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Given the importance of civic engagement to the well-being of immigrants and refugees and their communities, the goal of the current study was to investigate civic attitudes among immigrants and refugees from the Middle East and North Africa (MENA). First, the researcher examined predictors of civic attitudes. Second, the mediating effect of attitudes between the potential predictors (i.e., gender, health status, English proficiency, and the U.S. length of stay) and level of civic engagement was investigated. The researcher recruited 145 respondents to complete online and paper-based surveys. Using linear regression models, the results show that health and English language proficiency significantly predict civic attitudes among this group. Attitudes also mediated between health status and level of civic engagement. This study provides some implications for social work, resettlement programs, health policies, and civic organizations that can be beneficial for the target group as well as for the host communities.

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Section: Discussionmentioning

confidence: 99%

Civic Attitudes and Engagement Among Middle Eastern and North African Refugees and Immigrants in the U.S.

Alamdari

2020

ASW

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“…However, many countries restrict the access of newly arriving ASR to regular healthcare services [2]. This may hinder need-based healthcare utilization, impact the health of ASR, and lead to inequalities in health [3,4]. Monitoring the access to healthcare of ASR is therefore an important public health task.…”

Section: Main Text Backgroundmentioning

confidence: 99%

Inequalities in access to healthcare by local policy model among newly arrived refugees: evidence from population-based studies in two German states

Wenner

Biddle

Gottlieb

et al. 2021

Preprint

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Background Access to healthcare is restricted for newly arriving asylum seekers and refugees (ASR) in many receiving countries, which may lead to inequalities in health. In Germany, regular access and full entitlement to healthcare (equivalent to statutory health insurance, SHI) is only granted after a waiting time of 18 months. During this time of restricted entitlements, local authorities implement different access models to regulate asylum seekers' access to healthcare: the electronic health card (EHC) or the healthcare voucher (HV). This paper examines inequalities in access to healthcare by comparing healthcare utilization by ASR under the terms of different local models (i.e., regular access equivalent to SHI, EHC, and HV). Methods We used data from three population-based, cross-sectional surveys among newly arrived ASR (N=863) and analyzed six outcome measures: specialist and general practitioner (GP) utilization, unmet needs for specialist and GP services, emergency department use and avoidable hospitalization. Using logistic regression, we calculated odds ratios (OR) and 95% confidence intervals for all outcome measures, while considering need by adjusting for socio-demographic characteristics and health-related covariates. Results Compared to ASR with regular access, ASR under the HV model showed lower needs-adjusted odds of specialist utilization (OR=0.41 [0.24-0.66]) and a tendency towards lower GP (OR=0.61 [0.33-1.16]) and emergency department utilization (OR=0.74 [0.48-1.14]). ASR under the EHC model showed a tendency toward higher specialist unmet needs (OR= 1.89 [0.98-3.64]) and avoidable hospitalizations (OR=1.69 [0.87-3.30]) compared to ASR with regular access. A comparison between EHC and HV showed higher odds for specialist utilization under the EHC model as compared to the HV model (OR=2.39 [1.03-5.52]). Conclusion ASR using the HV are disadvantaged in their access to healthcare compared to ASR having either an EHC or regular access. Given equal need, they use specialist (and partly also GP) services less. The identified inequalities constitute inequities in access to healthcare that could be reduced by policy change from HV to the EHC model during the initial 18 months waiting time, or by granting ASR regular healthcare access upon arrival. Minor differences in unmet needs, emergency department use and avoidable hospitalization between the models deserve further exploration in future studies.

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“…Epidemiology and public health principles inform policy and can help develop responsive health systems [ 6 ]. Newly resettled refugees, for example, undergo a medical screening process which typically focuses on communicable diseases such as tuberculosis, HIV, and hepatitis [ 7 ].…”

Section: Medical Screening For Resettled Refugeesmentioning

confidence: 99%

“… Enhance training of epidemiologists in policy delivery and immigrant community engagement and enhance public health and primary care collaborations. Based on Bocanegra, et al [ 6 ] …”

Section: Health Assessmentsmentioning

confidence: 99%

Strengthening effective preventive services for refugee populations: toward communities of solution

Griswold

Pottie

et al. 2018

Public Health Rev

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Refugee populations have unequal access to primary care and may not receive appropriate health screening or preventive service recommendations. They encounter numerous health care disadvantages as a consequence of low-income status, race and ethnicity, lower educational achievement, varying degrees of health literacy, and limited English proficiency. Refugees may not initially embrace the concept of preventive care, as these services may have been unavailable in their countries of origin, or may not be congruent with their beliefs on health care. Effective interventions in primary care include the appropriate use of culturally and linguistically trained interpreters for health care visits and use of evidence-based guidelines. Effective approaches for the delivery of preventive health and wellness services require community engagement and collaborations between public health and primary care. In order to provide optimal preventive and longitudinal screening services for refugees, policies and practice should be guided by unimpeded access to robust primary care systems. These systems should implement evidence-based guidelines, comprehensive health coverage, and evaluation of process and preventive care outcomes.

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Addressing refugee health through evidence-based policies: a case study

Cited by 16 publications

References 38 publications

Civic Attitudes and Engagement Among Middle Eastern and North African Refugees and Immigrants in the U.S.

Civic Attitudes and Engagement Among Middle Eastern and North African Refugees and Immigrants in the U.S.

Inequalities in access to healthcare by local policy model among newly arrived refugees: evidence from population-based studies in two German states

Strengthening effective preventive services for refugee populations: toward communities of solution

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