Academic journal article Journal of Cultural Diversity

Listening to the Experts: Provider Recommendations on the Health Needs of Immigrants and Refugees

Academic journal article Journal of Cultural Diversity

Listening to the Experts: Provider Recommendations on the Health Needs of Immigrants and Refugees

Article excerpt

Abstract: The purpose of this qualitative, exploratory study was to better understand the needs of immigrants and refugees and how they are affected by poverty and post-immigration stresses. Data were obtained through indepth interviews with 62 health and social service providers working with immigrants in the state of Minnesota. Although the state is home to many refugees who were victims of torture or severe deprivation in their home countries, the majority of providers defined the principal needs of their clients as affordable housing, jobs, and access to health services rather than needs related to health conditions or services per se. The providers' open-ended comments painted a picture of the ways in which post-immigration experiences lead to tangible stresses that compromise immigrants' health and well-being.

Key Words: Immigrants, Refugees, Barriers to Access, Mental Health, Poverty

A growing body of literature describes what has come to be known as the "healthy migrant" phenomenon - the fact that immigrants to the United States (Fuentes- Afflick, Hessol, & Perez-Stable, 1999; Muening & Fahs, 2002; Neria, 2000; Singh & Siahpush, 2001), Canada (Hyman, 2001), Australia (Australian Institute of Health and Welfare, 2000), and Western Europe (Razum, Zeeb, & Rohrmann, 2000; Toma, 2001) are often healthier than native-born residents in their new countries of residence. Over time, however, the migrant health advantage diminishes dramatically.

Providers who work directly with immigrants and refugees represent an important group of key informants who can help researchers better understand this paradox (Singh & Siahpush, 2001). As professionals who work directly with immigrants, they are in a unique position to shed light on the needs of their clients and on experiences, networks, and differential access to services that may affect immigrant health behaviors and outcomes. Nevertheless, few studies have documented provider observations and recommendations regarding immigrant health. In this exploratory study, we investigated provider perceptions of the needs of their clients and the social context of health in Minnesota, a state that has experienced dramatic increases in the numbers of foreign-born residents over the past decade. Data were obtained through in-depth, face-to-face interviews with a sample of 62 health and social service providers working in clinics, hospitals, and mental health facilities. Interview topics addressed what providers perceived to be the main needs of their clients, reports from their clients of experiences with discrimination or racism, and provider recommendations regarding needed services as well as how to prepare culturally competent staff.


Immigrants and Health Disparities

While immigrants to the U.S. do have higher rates of some infectious diseases than native-born residents, they are generally better off on measures of health risk factors, chronic conditions, and mortality. Singh and Siahpush (2001) used data from the National Longitudinal Mortality Study (1979-1989) and found that immigrant men and women had significantly lower risks of mortality than their U.S.-born counterparts. Muennig and Fahs (2002) compared hospital utilization and mortality rates of foreign-born and U.S.-born residents in New York and concluded that immigrants were healthier and had significantly longer life expectancies than natives. They estimated that the over-all cost of providing hospital-based care to the foreign-born residents in New York would be $611 million less than care for an equivalent number of U.S.-born persons in 1996. The healthy migrant phenomenon has also been observed in Canada (Hyman, 2001) and Western Europe (Razum, Zeeb, & Rohrmann, 2000; Swerdlow, 1991; Toma, 2001). Hyman (2001), of Health Canada, for example, has done an extensive review of the literature on immigration and health and concluded: "In Canada, national health survey data show that recent immigrants, particularly from non-European countries, are in better health than their Canadian-born counterparts" (p. …

Search by... Author
Show... All Results Primary Sources Peer-reviewed


An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.