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Soc Sci Med. 2010 Jul;71(2):353-61. doi: 10.1016/j.socscimed.2010.04.010. Epub 2010 Apr 29.

Somali immigrant women and the American health care system: discordant beliefs, divergent expectations, and silent worries.

Author information

  • 1School of Nursing, University of California, 4-238 Factor Building, 700 Tiverton Avenue, Los Angeles, CA 90095-6918, United States. cpavlish@sonnet.ucla.edu

Abstract

The civil war in Somalia resulted in massive resettlement of Somali refugees. The largest diaspora of Somali refugees in the United States currently reside in Minnesota. Partnering with three community organizations in 2007-8, we implemented the Community Connections and Collaboration Project to address health disparities that Somali refugees experienced. Specifically, we examined factors that influenced Somali women's health experiences. Utilizing a socio-ecological perspective and a social action research design, we conducted six community-based focus groups with 57 Somali women and interviewed 11 key informants including Somali healthcare professionals. Inductively coding, sorting and reducing data into categories, we analyzed each category for specific patterns. The categorical findings on healthcare experiences are reported here. We found that Somali women's health beliefs related closely to situational factors and contrasted sharply with the biological model that drives Western medicine. These discordant health beliefs resulted in divergent expectations regarding treatment and healthcare interactions. Experiencing unmet expectations, Somali women and their healthcare providers reported multiple frustrations which often diminished perceived quality of health care. Moreover, silent worries about mental health and reproductive decision making surfaced. To provide high quality, transcultural health care, providers must encourage patients to voice their own health explanations, expectations, and worries.

PMID:
20494500
PMCID:
PMC2893335
DOI:
10.1016/j.socscimed.2010.04.010
[PubMed - indexed for MEDLINE]
Free PMC Article
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