Refugees

Hailey Oesterling, Jalina Vidotto, Nicole Baginski

 Refugees
Under United States law, a refugee is someone who:
Is located outside of the United States

Is of special humanitarian concern to the United States

Demonstrates that they were persecuted or fear persecution due to race, religion, nationality, political
opinion, or membership in a particular social group

Is not firmly resettled in another country

Is admissible to the United States

A refugee does not include anyone who ordered, incited, assisted, or otherwise participated in the persecution of any person on account of
race, religion, nationality, membership in a particular social group, or political opinion.

(U.S Citizenship and Immigration Services, 2017)

 Demographics
Fiscal year as of March 2017, admission of refugees:
14,583 from Africa, 37.3%
3,351 from Asia 8.57%
3,152 from Europe 8.06%
1,002 from Latin America/Carribean, 2.56%
17,010 from Near East/South Asia, 43.5%

Top 5 Refugee native languages spoken:

Arabic, Nepali, Somali, Sgaw Karen, Spanish

(Refugee Processing Center, 2016)

Refugee Arrivals by Sex: Fiscal Year 2014:

Total ............... 69,975, 100.0%

Female ............... 33,208, 47.5 %
Male ................. 36,767, 52.5 %

(Mossaad, 2016)
Health Care Disparity
Access to and utilization of preventative health services among refugees

Somali refugee patients utilize less of preventative services compared to non-Somali refugee patients

mammography (15.38 vs. 48.52 %)

colorectal cancer screening (38.46 vs. 73.35 %)

pap smears (48.79 vs. 69.1 %)

influenza vaccination (41.45 vs. 54.73 %)

No significant difference in services for lipid screening, pneumococcal vaccination, or tetanus vaccination

(Morrison, Wieland, Cha, Rahman, & Chaudry, 2012)

Health Disparity
Prevalence of diabetes mellitus among refugee patients

There is a higher prevalence of diabetes among Somali refugee patients than non-Somali refugee patients

12.1 vs 5.3 %

Cohort study including 1007 adult Somali refugee patients cohort and frequency and age matched
non-Somali cohort

(Njeru, Tan, Sauver, Jacobson, Agunwamba, Wilson, Rutten, Damodaran, & Wieland, 2016)
Health Disparity
Prevalence of obesity among refugee patients

There is a higher prevalence of obesity among Somali refugee patients than non-Somali refugee patients

34.6 vs 32.1 %

Cohort study including 1007 adult Somali refugee patients cohort and frequency and age matched
non-Somali cohort

(Njeru, Tan, Sauver, Jacobson, Agunwamba, Wilson, Rutten, Damodaran, & Wieland, 2016)
 Nursing Intervention
Proposed Intervention: The public health nursing intervention of health teaching can decrease health
disparities in the refugee population. This type of intervention relays facts, ideas and skills that can change
the knowledge, attitudes, behaviors, and practices of a population.

A 6-month program consisting of two components should be implemented as an intervention:

1. Learning circles: twice weekly classes that provide a forum for cultural exchange topics, English
classes, and career skills

2. Advocacy: emphasis on health, housing, and other resources for a healthy well-being

Rationale: This program will reduce health disparities experienced by refugee families in urban areas in the
USA by (1) improving access to community resources and communities responsiveness to refugees; (2)
promoting and preserving refugees cultures and valued social roles; (3) increasing English proficiency and
literacy; (4) improving intergenerational respect and communication; and
(5) enhancing refugees empowerment and integration in their communities.

(Goodkind, Githinji, & Isakson, 2011)

 References
Goodkind, J. R., Githinji, A., & Isakson, B. (2011). Reducing health disparities experienced by refugees resettled in urban areas: a
community-based transdisciplinary intervention model. In M. Kirst, N. Schaefer-McDaniel, S. Hwang, & P. O'Campo (Ed.), Converging
disciplines: a transdisciplinary research approach to urban health problems (pp. 41-53). New York, NY: Springer.

Morrison, T. B., Wieland, M.L., Cha, S.S., Rahman, A.S., & Chaudhry R. (2012). Disparities in preventive health services among
Somali immigrants and refugees. Journal of Immigrant & Minority Health, 14(6), 968-974. doi: 10.1007/s10903-012-9632-4

Mossaad, N. (2016). Refugees and Asylees: 2014. Retrieved from

https://www.dhs.gov/sites/default/files/publications/Refugees_Asylees_2014.pdf

Njeru, J.W., Tan, E.M., St. Sauver, J., Jacobson, D.J., Agunwamba, A.A., WIlson, P.M., Rutten, L.J., Damodaran, S., & Wieland, M.L.
(2016). Journal of Immigrant & Minority Health, 18(6), 1343-1349. doi:10.1007/s10903-015-0280-3

Refugee Processing Center. (2016). Admission and Arrivals. Retrieved from http://www.wrapsnet.org/admissions-and-arrivals/

U.S Citizenship and Immigration Services. (2017). Refugees. Retrieved from

https://www.uscis.gov/humanitarian/refugees-asylum/refugees