Barriers to health care access among refugee asylum seekers.

Abstract:

OBJECTIVE:Asylum seekers have poor access to health care. Qualitative data portraying their experience is lacking. METHODS:We conducted focus groups and comprehensive interviews with 35 asylum seekers and 15 expert providers/advocacy organization representatives. Purposive sampling was used to recruit subgroups. Interviews were recorded, coded, and analyzed. RESULTS: PARTICIPANTS:85% male, mostly from African countries. Major barriers: a) Internal, including mental illness, fatalism, mistrust, and perceived discrimination; b) Structural, including affordability, limited services, inadequate interpretation, resettlement challenges such as shelter, food, and employment insecurity; health care for urgent care only; and poor cultural competency; c) Barriers in social assimilation, including difficulty navigating a complex system and inadequate community support. CONCLUSION:Significant inter-related barriers exist at the individual, provider, and system levels. Strategies to improve access include targeting social programs and mental health services, expanding Medicaid eligibility/enrollment, promoting community-based organizations, enforcing the use of trained medical interpreters, and improving cultural competency.

authors

Asgary R,Segar N

doi

10.1353/hpu.2011.0047

subject

Has Abstract

pub_date

2011-05-01 00:00:00

pages

506-22

issue

2

eissn

1049-2089

issn

1548-6869

pii

S1548686911200111

journal_volume

22

pub_type

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