Effect of US Health Policies on Health Care Access for Marshallese Migrants

McElfish, Pearl A.; Hallgren, Emily; Yamada, Seiji

doi:10.2105/ajph.2014.302452

Cited by 90 publications

(115 citation statements)

References 52 publications

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“…The proportion of uninsured in the sample is more than four times as high as proportions found at the national and state levels (11.7% and 11.8% uninsured, respectively) [64]. This finding is likely due to the lack of Medicaid eligibility for COFA migrants [21, 28]. …”

Section: Discussionmentioning

confidence: 99%

“…At the time of the signing of the COFA in 1986, Marshallese migrants were eligible for government subsidized insurances, such as Medicaid [21, 46]. However, after the passage of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, Marshallese migrants became ineligible for Medicaid [21, 28, 46–49]. Their exclusion was due to the re-categorization of COFA migrants as “non-qualifying immigrants” [21, 28, 46–49].…”

Section: Introductionmentioning

confidence: 99%

“…However, after the passage of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, Marshallese migrants became ineligible for Medicaid [21, 28, 46–49]. Their exclusion was due to the re-categorization of COFA migrants as “non-qualifying immigrants” [21, 28, 46–49]. This status means they are required to purchase private health insurance or enroll in an employer-sponsored insurance plan.…”

Section: Introductionmentioning

confidence: 99%

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Diabetes and Hypertension in Marshallese Adults: Results from Faith-Based Health Screenings

McElfish

Rowland

Long

et al. 2016

J. Racial and Ethnic Health Disparities

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Background The Pacific Islander population in the United States is growing rapidly. However, research on Pacific Islanders in the US is limited, or sometimes misleading due to aggregation with Asian Americans. This project seeks to add to the dearth of health literature by conducting a health assessment of Marshallese in northwest Arkansas. Methods Using a community-based participatory research approach, nine health screening events were conducted at local Marshallese churches. Participants completed the Behavioral Risk Factors Surveillance Survey core questionnaire and diabetes module if applicable. Biometric data, including Hemoglobin A1c, blood pressure, and body mass index, was gathered by an interprofessional team. Results 401 participants completed health screenings. High proportions of diabetes, obesity, and hypertension were found. A high percentage of participants were uninsured, and multiple barriers to health care were found within the sample. Discussion This project represents one of the first broad health assessments of Pacific Islanders in the US. Proportions of diabetes, hypertension, obesity, and uninsured found in the sample are much higher than national proportions.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Diabetes and Hypertension in Marshallese Adults: Results from Faith-Based Health Screenings

McElfish

Rowland

Long

et al. 2016

J. Racial and Ethnic Health Disparities

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“…UAMS used a community-based participatory approach to work with the Marshallese community in Arkansas to identify and address community health concerns. (6,24,(27)(28)(29) Marshallese community members identified faith-based organizations (FBOs) as important to their culture and recommended that we work closely with FBOs. Stakeholders stated that virtually all Marshallese attend at least one FBO on a regular basis.…”

Section: Introductionmentioning

confidence: 99%

“…Other projects are described in prior articles. (6,9,24,(27)(28)(29)(30)(31)(32) In this article, we present the lessons learned from the health screenings.…”

Section: Introductionmentioning

confidence: 99%

Lessons learned through a partnership with Marshallese faith-based organizations to screen for hypertension and diabetes

McElfish¹,

Bing²,

Ayers³

et al. 2018

JRMC

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Background: Marshallese are disproportionately burdened with higher rates of obesity, diabetes, cardiovascular disease, and infectious disease than the general US population. Objective: To describe the lessons learned from conducting health screenings in faith-based organizations in the Marshallese community. Methods: Health screenings were implemented by interprofessional collaboration of faculty and students from the colleges of Medicine, Nursing, Pharmacy, and Health Professions, as well as Marshallese community health workers and faith-based organization leaders. Health screenings took place in Marshallese faith-based organizations in northwest Arkansas. Results: Lessons learned in the study include the importance of cultural protocol, effective communication, partnership with health care providers, logistics of set-up and implementation, and building the capacity of the churches to act on the information received. Conclusion: Working with Marshallese faith-based organizations to conduct health screenings demonstrated an effective strategy in documenting crucial health information, conducting survey research, and connecting the community with health care services.

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Nuclear radiation and prevalence of structural birth defects among infants born to women from the Marshall Islands

Nembhard

McElfish

Collins

et al. 2019

Birth Defects Research

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Background: With their unique history of exposure to extensive nuclear testing between 1946 and 1958, descendants of Marshall Island residents may have underappreciated genetic abnormalities, increasing their risk of birth defects. Methods: We conducted a retrospective cohort study of resident women with at least one singleton live birth between 1997 and 2013 in northwest Arkansas using state birth certificate data linked to data from the Arkansas Reproductive Health Monitoring System, a statewide birth defects registry. We calculated unadjusted and adjusted prevalence ratios (PR) and 95% confidence intervals (CI) from modified Poisson regression analyses for non-Hispanic (NH) whites, NH-blacks, Hispanics and Marshallese, using NH-whites as the reference group. Results: Of the 91,662 singleton births during the study period, 2,488 were to Marshallese women. Due to the relatively small number of Marshallese births, we could not calculate prevalence estimates for some defects. Marshallese infants had higher rates of congenital cataracts (PR = 9.3; 95% CI: 3.1, 27.9). Although the number of defects was low, Marshallese infants also had higher rates of truncus arteriosus (PR = 44.0; 95% CI: 2.2, 896.1). Conclusions: Marshallese infants may have increased risk of specific birth defects, but estimates are unstable because of small sample size so results are inconclusive.Larger population-based studies would allow for further investigation of this potential risk among Marshallese infants.

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Effect of US Health Policies on Health Care Access for Marshallese Migrants

Cited by 90 publications

References 52 publications

Diabetes and Hypertension in Marshallese Adults: Results from Faith-Based Health Screenings

Diabetes and Hypertension in Marshallese Adults: Results from Faith-Based Health Screenings

Lessons learned through a partnership with Marshallese faith-based organizations to screen for hypertension and diabetes

Nuclear radiation and prevalence of structural birth defects among infants born to women from the Marshall Islands

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