Health status and Healthcare Access of Southeast Asian refugees in the United States: An integrative review

Abstract

Objective: Since 2010, more than 527,000 refugees have resettled in the United States (US), most from Asia, fleeing war, violence, and persecution. However, there is little research that integrates findings about health among Southeast Asian refugees (SEAR). Design:We conducted an integrative review of studies that examined health status, risk factors, and barriers to healthcare access among SEAR in the US. We synthesized findings of studies published from 1980, when the Refugee Act was enacted, to 2022 using five databases. We reviewed 20 articles and data were extracted into a table for synthesis.Results: Participants were from Cambodia, Vietnam, Laos, Burma and the Thailand-Myanmar border. Hypertension (12%-64%), hypercholesterolemia (37%-39%), diabetes (0.6%-27%), heart disease (7%), bone and muscle problems (23%-50%), and chronic pain (8%-51%) were most common physical health problems; and PTSD (45%-86%) and depression (20%-80%) were the most common mental health problems.Trauma, resettlement stress, lack of community or religious engagement were associated with mental health problems. Language differences, transportation, and lack of health insurance were the most significant obstacles to receiving healthcare. Conclusion: SEAR experienced worse physical and mental health than the general US population. Different patterns of disease were identified depending on gender, time settled in the US, and ethnic group. Qualitative and longitudinal studies will elucidate refugees' experience and should guide interventions. K E Y W O R D S access to healthcare, ethnic minority, health disparity, health status, refugees 1 BACKGROUND Nearly 89.3 million people were forcibly displaced from their homes worldwide in 2021, and an additional 10 million were displaced in the first 5 months of 2022. Over 27 million currently displaced persons have been designated as refugees (The Office of the United Nations High Commissioner for Refugees (UNHCR), 2022), meaning that they are people who have fled war, violence, conflict, or persecution and have crossed an international border to find safety in another country (United Nations, n.d.). The number of refugees more than doubled from 2010 to 2020 and continues to rise due to unstable political situations in many countries, with more refugees in the world than ever in history. Many refugees have experienced considerable trauma in their home country and during migration (Sangalang et al., 2019). The United States (US) accepts the most refugees and has had the largest resettlement program in the world since the 1970s (UNHCR, 2022). In the past 45 years about 3,450,000 refugees from throughout the world resettled in the US; 600,900 refugees arrived in the US 324

Effects of Sociodemographic Factors on Access to and Outcomes in Congenital Heart Disease in the United States

“…Like many native U.S.-born CHD and ACHD patients, refugees and asylum seekers often face high levels of mental health issues related to post-traumatic stress disorder, depression, and resettlement stress. Many of the mental health issues are related to unfamiliar jobs and educational systems, lack of social support and discrimination, low educational status, lack of religious and community engagement, and loss of family members/friends, among others [49].…”