Predictors of Interrupted Healthcare Coverage in a National Sample of US Refugees

Baumann, Kyle; Adera, Tilahun

doi:10.1007/s40615-021-01147-9

Cited by 2 publications

(7 citation statements)

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“…The higher risk of a severely deficient USC among refugees resettled in the South is consistent with known health access disparities in the South [ 16 ]. The relatively higher prevalence of interrupted healthcare coverage among refugees resettled in the South could partially lead to a decrease in dependable primary care use and/or an increase in emergency department dependence [ 8 ]. Nevertheless, this finding was not statistically significant after adjustment, and no difference in USC was found in the primary inadequate USC analysis for refugees resettled in the South ( Table 2 ).…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, the US Department of Health and Human Services recently announced a redesign for the 2021 ASR with the goal of improving survey quality and relevance for key stakeholders. The new data will provide opportunity for more robust analyses of refugee resettlement in the US [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

“…The ASR survey design has previously been described in detail [ 8 , 14 ]. Using a stratified probability design with person-level cluster sampling, households, and then persons within each household, were selected for inclusion.…”

Section: Methodsmentioning

confidence: 99%

“…This analysis has multiple limitations, some of which are mentioned in our previous interrupted healthcare manuscript [ 8 ]. First, ASR surveys have had high survey nonresponse rates.…”

Section: Limitationsmentioning

confidence: 99%

“…Between the two, having a USC is a clearer and more powerful predictor of healthcare access [ 7 ]. In our prior article, we studied and discussed predictors of interrupted healthcare coverage among US refugees [ 8 ]. USCs will now be considered.…”

Section: Introductionmentioning

confidence: 99%

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Sociodemographic Characteristics and Inadequate Usual Sources of Healthcare in a National Sample of US Refugees

Baumann

Adera

2022

IJERPH

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Introduction: Refugees resettled into the United States (US) face challenges in accessing adequate healthcare. Knowledge of demographic and social characteristics related to healthcare access among refugees is scarce. This study examines potential sociodemographic predictors of inadequate usual sources of care (USCs)—one key component of healthcare access—within the US refugee population. Methods: The 2016 Annual Survey of Refugees (ASR) involving 4037 refugees resettled into the US served as the data source for this study. Inadequate USC was defined as a USC that was neither a private healthcare provider nor a health clinic. We used multiple binary logistic regression methods to identify sociodemographic predictors of inadequate USCs. In addition, we used multinomial logistic regression to further assess predictors of inadequate USCs with a particular focus on severely deficit USCs (i.e., emergency department dependence and USC absence). Results: Refugees with interrupted healthcare coverage were more likely to have an inadequate USC. Refugees who were young (age 10–19), resettled into the western region of the US, and highly educated were less likely to have an inadequate USC. Refugees with an education level higher than secondary had a significantly lower likelihood of having a severely deficient USC, while refugees with interrupted healthcare were more than twice as likely to have a severely deficient USC. Conclusions: Considering these results alongside our previous healthcare coverage findings provides a more comprehensive understanding of sociodemographic predictors of poor healthcare access among refugees resettled into the US. This improved understanding has the potential to assist early refugee contacts toward more effective healthcare resource allocation and aid policymakers attempting to improve programs linked to refugee healthcare access.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

“…This analysis has multiple limitations, some of which are mentioned in our previous interrupted healthcare manuscript [ 8 ]. First, ASR surveys have had high survey nonresponse rates.…”

Section: Limitationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Sociodemographic Characteristics and Inadequate Usual Sources of Healthcare in a National Sample of US Refugees

Baumann

Adera

2022

IJERPH

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Funding for Refugee Health Research From the National Institutes of Health Between 2000 and 2020

Kaur,

Bridi,

Kaki

et al. 2024

JAMA Netw Open

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ImportanceThe US has historically resettled more refugees than any other country, with over 3.5 million refugees since 1980. The National Institutes of Health (NIH) is the largest public funder of biomedical research and development, but its role in mitigating many health disparities refugees experience through its funded research remains unknown.ObjectiveTo examine the NIH’s research funding patterns on refugee health research over the last 2 decades.Design, Setting, and ParticipantsSecondary analysis of NIH-funded grants between 2000 and 2020 using a cross-sectional study design. The NIH Research Portfolio Online Reporting Tools database was used to find relevant grants. Data were analyzed from November 2021 to September 2022.Main Outcomes and MeasuresNIH grants awarded by year, state, grant type, research area, funding institute, grant duration, and amount funded.ResultsOf 1.7 million NIH grants funded over the 20-year study period, only 78 addressed refugee health. Funded grants were mostly training grants (23 grants [29%]), followed by hypothesis-driven research (R01 grants; 22 grants [28%]), pilot or preliminary investigation proposals (13 grants [17%]), and other types of grants (20 grants [26%]). The most studied research domain was mental health (36 grants [46%]), followed by refugee family dynamics and women’s and children’s health (14 grants [18%]). A total of 26 grants (33%) were funded by the National Institute of Mental Health and 15 (19%) were funded by the National Institute of Child Health and Human Development. Most grants were US-based (60 grants [76%]) and the state of Massachusetts received the greatest amount of funding ($14 825 852 [18%]). In 2020, the NIH allocated about $2.3 million to refugee health research, or less than 0.01% of its $42 billion budget that year. The number of grants funded in each time period did not always reflect changes in the number of refugees resettled in the US over the years.Conclusions and RelevanceThis cross-sectional study found that there remain significant gaps in the understanding of and interventions in the health research needs of refugees locally and along the migratory route. To close these gaps, the NIH should increase its investments in comprehensive studies assessing the physical, mental, and social well-being of this expanding population. This can be achieved by ensuring that all NIH institutes allocate budgets specifically for refugee health research and extend support for the training of refugee researchers.

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Predictors of Interrupted Healthcare Coverage in a National Sample of US Refugees

Cited by 2 publications

References 13 publications

Sociodemographic Characteristics and Inadequate Usual Sources of Healthcare in a National Sample of US Refugees

Sociodemographic Characteristics and Inadequate Usual Sources of Healthcare in a National Sample of US Refugees

Funding for Refugee Health Research From the National Institutes of Health Between 2000 and 2020

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