Acculturation and Unmet Health Needs Among Refugees in Omaha, Nebraska

Abstract

This study assessed the association between acculturation and unmet health needs among refugees. Based on data from the Refugee Health Needs Assessment Survey (n = 291) recently conducted in Omaha, Nebraska, Chi square tests and multivariate logistic regressions were estimated to examine how acculturation among refugees was related to their unmet health needs. Relative to refugees who had been in the U.S. for less than 3 years, refugees who had been in the U.S. for 3-5 years were more likely to report lack of health insurance coverage (AOR 2.87, 95% CI 1.19, 6.92) and delaying to see a health care provider due to cost during the 12 months prior to the survey (AOR 4.01, 95% CI 1.18, 13.67). Acculturation among refugees did not necessarily alleviate their unmet health needs. Addressing these needs calls for sustainable medical assistance to refugees that well go beyond the 8-month health insurance coverage currently provided to newly arrived refugees.

Examining Health Care Access for Refugee Children and Families in the North Carolina Triangle Area

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R efugees in the United States face multiple unique challenges related to acculturation, meeting basic needs, and accessing vital services such as health care [1]. Structural and contextual factors, such as "othering" and discrimination, are potential pathways through which acculturation can erode the health of refugees and their descendants [2].

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“…Structural and contextual factors, such as "othering" and discrimination, are potential pathways through which acculturation can erode the health of refugees and their descendants [2]. Although experiences of trauma, displacement, and disruptions in health care are not unique to refugees, the experience of real or threatened danger is a defining characteristic of this population, and traumatic experiences may directly contribute to suboptimal acculturation, health care access, and health outcomes [3].Difficulties in health care access upon arrival in the United States include barriers to navigating complex medical and insurance systems, overcoming language and cultural barriers, institutional mistrust, and the residual impacts of trauma and challenging experiences prior to and during migration [1,4]. These challenges exacerbate health inequities and place families and individuals with refugee status at undue risk for numerous health issues.The barriers to health care faced by newly arrived refugees may be particularly challenging for children, who may fail to receive preventive care, lack proper nutrition, and experience developmental delays, all of which may be due to the often chaotic resettlement process and delayed access to care upon arrival in the United States [5].…”

Barriers to Accessing Acute Care for Newly Arrived Refugees

“…At six to eight months, cash assistance from the government typically ends as does support from the resettlement agency based on the expectation that refugees are self-sufficient after six to eight months of support 2,3. A study evaluating unmet needs of refugees demonstrated that refugees in the U.S. for a longer period of time are more likely to report a lack of health insurance coverage and a delay in seeing a healthcare provider 22. Policymakers should consider extending Refugee Medical Assistance beyond the first eight months as an additional strategy to improve access to health insurance and ensure stable access to care.…”

Assessment of U.S. Health Care Utilization Patterns Among Recently Resettled Refugees Using Data from the 2016 Annual Survey of Refugees

“…Prior analyses have examined how resettled refugees seek care (noting limited long-term follow-up), barriers to accessing services (including language and the complexity of U.S. systems), and insurance coverage dispar-ities (some estimates exceeding 40% uninsured). [4][5][6] Yet, these analyses have been limited in geographic scope and populations included. Updating these analyses is also critical given the ever-evolving refugee context.…”