Disparities in Preventive Health Services Among Somali Immigrants and Refugees

Abstract

African immigrants and refugees-almost half of them from Somalia-account for one of the fastest-growing groups in the United States. There is reason to suspect that Somali-Americans may be at risk for low completion of recommended preventive health services. This study's aim was to quantify disparities in preventive health services among Somali patients compared with non-Somali patients in an academic primary care practice in Rochester, Minn. It also examined the effect of medical interpreters, emergency department visits, and primary care visits on the completion of preventive services. Rates of pap smears, vaccinations (influenza, pneumococcus, and tetanus), lipid screening, colorectal cancer screening, and mammography were assessed in Somali and non-Somali patients during the second quarter of 2008. Data were collected regarding the utilization of medical interpreters, emergency services, and primary care services among Somali patients. Results were reported using standard descriptive statistics. Of the 91,557 patients identified in the database, 810 were Somali. Somali patients had significantly lower completion rates of colorectal cancer screening, mammography, pap smears, and influenza vaccination than non-Somali patients. Use of medical interpreters and primary care services were generally associated with higher completion rates of preventive services. There are significant discrepancies in the provision of preventive health services to Somali patients compared with that of non-Somali patients. These findings suggest the need to identify the root causes of these discrepancies so that interventions may be crafted to close the gap.

Addressing cancer control needs of African-born immigrants in the US: A systematic literature review

“…32,35 Six were quantitative 23,24,32,34,36,37 and four used qualitative methods. 33,35,38,39 Paper foci included breast cancer prevention 34 and detection, including barriers to genetic testing 24 and barriers to mammography screening.…”

“…The scarce research that includes African immigrants has shown cancer-related disparities across the cancer control continuum. 13,23–28 However, African-born immigrants tend to constitute small percentages of the samples and/or they tend to be lumped with African Americans or Caribbean, or categorized as “African” or “Black foreign-born” without specifying country of origin. 4,9,25 The goal of this paper is to offer a systematic literature review of cancer studies that include African-born populations to suggest venues for further research and interventions that can be implemented in the US.…”

Barriers to cervical cancer screening: A qualitative study among Somali women in Oslo Norway

“…Studies conducted in the United States suggest that cervical cancer-related morbidity and mortality are higher in immigrant than in host populations and that immigrant women may be less likely than non-immigrant women to participate in cervical cancer screening [5]. Somali women have been identified as one particular group less likely to participate in cervical cancer screening [5][6][7]. The cancer registry of Norway (CRN) sends a screening invitation letter, written in Norwegian, to all women between the ages of 25 and 69.…”

Trends in mortality after cancer diagnosis: A nationwide cohort study over 45 years of follow-up in Sweden by country of birth

“…Other studies on health of migrants from war-ravaged regions provided data on health alterations [28] and low participation rates in screening programs [29,30] that all might be contributing to poor survival. The universal coverage of the Swedish health care system and a standing policy for equality in access to health care may lend support to the hypothesis that factors related to the individuals may in part be responsible for differences in survival trends in addition to the factors related to health care providers.…”