A Trajectory Model for Understanding and Assessing Health Disparities in Immigrant/Refugee Communities

Abstract

While numerous factors contributing to racial/ethnic health disparities have been identified, the clustering and interaction of these factors as a syndemic or trajectory has not been well-studied (Starfield in Soc Sci Med 64:1355-1362, 2007; Singer in Soc Sci Med 39(7):931-948, 1994). More importantly, for immigrant/refugee populations, the interaction of contributing factors is not documented adequately enough to provide a solid framework for planning, implementation and evaluation of interventions aimed at reducing disparities. In this paper, the authors draw from the literatures on health disparities and immigrant/refugee health, as well as direct program and research experience, to propose an approach for assessment of the diachronic interaction of ecological factors (a trajectory, or "diachronic ecology") contributing to health disparities among immigrant/refugee populations. It is our hope that this approach will contribute to the important effort to collect data supporting the development of interventions and policies that effectively address the dynamic processes through which health disparities are created, maintained, and changed.

Methodological Challenges in Conducting Research with Refugee Women

“…Refugee women are considered one of the most vulnerable populations in America at risk of stress, mental health conditions and lack of access to medical care (Edberg, Cleary, & Vyas, 2011;Gozdziak, 2004). Many refugee women have experienced gender-based violence, including torture and imprisonment, loss of family members and destruction of their communities prior to resettlement.…”

Adaptive frameworks of chronic pain: daily remakings of pain and care at a Somali refugee women’s health centre

“…In the USA, new immigrant populations experience greater barriers to healthcare 31 32. Refugees are less likely to seek and use medical resources, often because of cultural,33 language,34 economic35 and trust36 barriers. Studies show that race bias may be more pervasive when patients are also immigrants.…”

Park-Use Behavior and Perceptions by Race, Hispanic Origin, and Immigrant Status in Minneapolis, MN: Implications on Park Strategies for Addressing Health Disparities

“…Immigrants, especially those from politically unstable countries, also face greater health risks and disadvantages than the US-born population [3,4]. It is reasonable to expect that health disadvantages faced by race/ethnic minorities and specific immigrant communities may be ameliorated by promoting park use among these communities.…”