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J Health Care Poor Underserved. 2011 May;22(2):506-22. doi: 10.1353/hpu.2011.0047.

Barriers to health care access among refugee asylum seekers.

Author information

1
Mount Sinai School of Medicine, New York, NY 10029, USA. ramin.asgary@mssm.edu

Abstract

OBJECTIVE:

Asylum seekers have poor access to health care. Qualitative data portraying their experience is lacking.

METHODS:

We conducted focus groups and comprehensive interviews with 35 asylum seekers and 15 expert providers/advocacy organization representatives. Purposive sampling was used to recruit subgroups. Interviews were recorded, coded, and analyzed.

RESULTS:

PARTICIPANTS:

85% male, mostly from African countries. Major barriers: a) Internal, including mental illness, fatalism, mistrust, and perceived discrimination; b) Structural, including affordability, limited services, inadequate interpretation, resettlement challenges such as shelter, food, and employment insecurity; health care for urgent care only; and poor cultural competency; c) Barriers in social assimilation, including difficulty navigating a complex system and inadequate community support.

CONCLUSION:

Significant inter-related barriers exist at the individual, provider, and system levels. Strategies to improve access include targeting social programs and mental health services, expanding Medicaid eligibility/enrollment, promoting community-based organizations, enforcing the use of trained medical interpreters, and improving cultural competency.

PMID:
21551930
DOI:
10.1353/hpu.2011.0047
[Indexed for MEDLINE]

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