Understanding service needs and service utilization among older Kurdish refugees and immigrants in the USA

Abstract

This study explored service needs and service utilization among older Kurdish refugees and immigrants in the US. A sample of 70 older Kurds is included and descriptive statistics were utilized. The findings of this study reported that older Kurdish refugees and immigrants are experiencing multiple service needs yet they do not seek help to meet their service needs. This study also highlighted existing barriers to services among older Kurdish refugees and immigrants, which accentuate the need for the development and implementation of culturally competent services for this unique population.

Determinants of resource needs and utilization among refugees over time

“…In fact, increased need for and use of psychological services predicted an increased report of PTSD and depressive symptoms over time. These results seem surprising given the assumption that access to and utilization of institutional resources should improve mental health [5, 7, 32]. Our finding may reflect the possibility that refugees who have declining mental health are more likely to seek psychological help.…”

“…Consistent with this, we found that high pre-displacement trauma exposure predicted higher needs for health care across the 2-year measurement period; however, exposure to pre-displacement trauma was unrelated to the use of health care resources. This difference in needs and utilization suggests highly trauma-exposed refugees report an increased need for health care resources, but for reasons such as language barriers [7], stigma, or not having a regular physician [30], these needs are not met.…”

“…Previous cross-sectional research has found that refugees report a high need for physical and mental health care [4–8], financial support [5,7], translation/language assistance [6,8], and aid in securing safe housing [3]. Throughout this article we refer to these as institutional resources .…”

“…Refugees report a need for social, financial, and health care services upon arrival to the host country [4–7]. Although some of these needs stem from pre-displacement events (e.g., torture), which prompt the need for health care [10–11], other needs such as language training result simply from arriving in a new environment [8].…”

Eritrean Refugees’ Utilization of Antenatal Services in Israel

“…Meta‐reviews have concluded that such utilization is “limited” and “late” (Carolan, : 411), “low” (Correa‐Velez and Ryan, : 14) and “less” and “later” than user rates of host country citizens (e.g., Munro et al., : 283). Numerous case studies also point to refugees’ problematic or low utilization of health services (e.g., Asgary and Segar, ; Correa‐Velez and Ryan, ; Michaan et al., ; Choi et al., ; Langlois et al., ; Gottlieb et al., ), although a few studies argue that there is “no evidence of under‐use” (Kiss et al., : 57), that access for refugees is “relatively good” (El Arab and Sagbakken, ), and that refugees’ demands for health services are “largely met” (Borgschulte et al., : 6). The findings of both positive and negative health service utilization in host countries begs the question of how such use is conceptualized and operationalized, as well as how it is contextualized, that is, what country‐specific legislation relates to refugees and their entitlement to health services in the host country.…”