Refugee Policy Implications of U.S. Immigration Medical Screenings: A New Era of Inadmissibility on Health-Related Grounds

Abstract

Refugees frequently face extended delays in their efforts to enter the United States (U.S.) and those who are successful, in many cases, encounter overwhelming obstacles, inadequate resources, and a complex system of legal barriers. Travel restrictions based on equivocal health concerns and a drop in refugee admittance ceilings have complicated the situation. The authors retrieved and analyzed peer-reviewed journal articles, government agency press releases, media postings, epidemiologic factsheets, and relevant lay publications to critically assess U.S. policy regarding refugee resettlement based on health-related grounds. While refugees arguably exhibit an increased incidence of measles and tuberculosis compared with the U.S. population, the legitimacy of the medical examination will be undermined if other diseases that are endemic to refugee populations, yet currently deemed admissible, are used to restrict refugees from entering the U.S. This paper addressees the historic refugee policy of the U.S. and its consequent effect on the health of this vulnerable population. The needs of refugees should be carefully considered in the context of increased disease burden and the associated health care challenges of the country as a whole.

Variations in neonatal mortality, infant mortality, preterm birth and birth weight in England and Wales according to ethnicity and maternal country or region of birth: an analysis of linked national data from 2006 to 2012

“…The finding of health advantages among migrant populations relative to native populations may be considered an epidemiological paradox,27 in view of the possible socioeconomic disadvantages28 and poorer experience of health care29 of the former. A number of potentially complementary factors may explain this paradox,30 including: health selection among some immigrant groups, including the ‘healthy worker’ effect by which healthier, better educated individuals are more likely to successfully migrate in search of work;31 healthier lifestyles among immigrants from some societies (‘cultural buffering’) including lower prevalence of smoking,32 alcohol consumption33 and obesity and immigration policies at destination which may profile and select immigrants on the basis of their health status 34. Subsequent generations may lose these advantages as they adopt health behaviours similar to the native populations.…”

Factors Shaping the Lived Experience of Resettlement for Former Refugees in Regional Australia

“…Impacts of the migration experience include increased risks to health and adverse effects on psycho-social functioning associated with adjusting to a new environment [3,13,16]. Studies mostly focused on former refugees' pre-arrival circumstances [17][18][19][20], with less thought to the experience of resettlement, with its overwhelming obstacles [21] and current realities. Several areas are therefore highlighted as in need of further investigation, including a need to explore and acknowledge experiences of resettlement [5], to pick up where previous studies have fallen short by exploring how trauma impacts experiences of resettlement [11], as well as looking at how discrimination may be experienced in employment and in accessing housing [12,15], particularly in regional areas where barriers to access to health and support services are pronounced [22].…”

Taking stock of vaccine hesitancy among migrants: a scoping review protocol

“…People are often required to vaccinate in order to immigrate. [2][3][4] In contrast, access to vaccination and continuity of care are more challenging for people on the move such as migrants, refugees or nomadic populations. 5 6 Long after they have settled in the host country, vaccination coverage among migrants may still be suboptimal when compared with that of the general population.…”