Case Study: Optimizing Wellness in a Refugee Population

The resettlement of refugees to the United States is a process that can take months or even years. In one city, community leaders formed an interprofessional, multidisciplinary community coalition with an identified goal of forming a Refugee Healthcare Program to treat the unique needs of the immigrant and refugee populations living there. Approximately 10% of the city’s residents are refugees with needs that include inadequate past medical and dental care, exposure to untreated diseases, and experiences that include torture and terrorism.

The Refugee Healthcare Program is being formed with shared resources from many partners, including the area’s primary refugee resettlement agency, the Department of Human Services, and the Department of Public Health. The Refugee Healthcare Program is being designed to provide primary healthcare services in a culturally appropriate and sensitive way, including the use of “cultural health navigators.” These cultural health navigators will be drawn from resettled refugees who work with the interprofessional team to offer interpretation and promote care coordination. Services will be provided in two ways: at a storefront clinic location in the downtown area and, remotely, via a mobile health van visiting schools, retirement communities, shelters, and public housing complexes.


Discussion Questions

  1. List the professionals in health care and other fields whom you would expect to be members of the interprofessional and multidisciplinary community coalition mentioned in this case study who are planning the Refugee Healthcare Program. Identify the specific needs of the refugee population that each professional would be expected to address.
  2. Describe at least two distinct healthcare services that might be offered through the Refugee Healthcare Program (i.e., mental health, well-child care, women’s health, dental), and identify which members of the interprofessional team might collaborate to provide those services comprehensively.
  3. What do you see as the specific roles and responsibilities of “cultural health navigators”?
  4. Describe the anticipated effects of the “cultural health navigators” on patient outcomes and on the cultural competency of those professionals in health care and other fields who are associated with the Refugee Healthcare Program.

Optimizing Wellness in a Refugee Population

  1. Professionals in the Interprofessional and Multidisciplinary Community Coalition:
    • Primary Care Physicians and Nurse Practitioners: They would address the general medical needs of refugees, including chronic conditions, infectious diseases, and preventive care.
    • Dentists: To provide dental care and address dental health needs, which are often neglected in refugee populations.
    • Mental Health Counselors/Psychiatrists: To offer mental health services to address trauma, post-traumatic stress disorder (PTSD), and other psychological issues resulting from experiences like torture and terrorism.
    • Pediatricians: To provide well-child care and immunizations for refugee children.
    • Obstetricians/Gynecologists: To address women’s health needs, including prenatal care, family planning, and reproductive health.
    • Social Workers: To help refugees access social services, navigate the healthcare system, and address social determinants of health like housing and employment.
    • Interpreters/Translators: To facilitate communication between healthcare providers and patients who may not speak English.
    • Community Health Workers: To engage with refugees, build trust, and provide health education within the community.
    • Public Health Experts: To oversee public health initiatives, disease surveillance, and vaccination programs.
    • Cultural Health Navigators: To provide cultural mediation and enhance the understanding of patients’ cultural backgrounds and needs within the healthcare system.
  2. Healthcare Services:
    • Mental Health Services: Mental health professionals, social workers, and cultural health navigators can collaborate to provide counseling, therapy, and support groups to address trauma and mental health concerns among refugees.
    • Well-Child Care: Pediatricians, nurse practitioners, and cultural health navigators can work together to offer well-child check-ups, immunizations, and health education to refugee children and their families.
  3. Roles and Responsibilities of Cultural Health Navigators:
    • Interpretation: They serve as interpreters to bridge language barriers between healthcare providers and patients.
    • Cultural Mediation: They help patients understand and navigate the healthcare system, cultural norms, and practices, making healthcare more accessible.
    • Advocacy: Cultural health navigators advocate for the cultural competency and sensitivity of healthcare providers, ensuring that care aligns with the values and beliefs of the refugee population.
    • Health Education: They provide health education tailored to the cultural context of the refugees, promoting preventive care and healthy behaviors.
    • Building Trust: Cultural health navigators build trust between refugees and healthcare providers by acting as cultural liaisons and addressing concerns and misconceptions.
  4. Anticipated Effects of Cultural Health Navigators:
    • Improved Patient Outcomes: Cultural health navigators can help patients better understand their health conditions, adhere to treatment plans, and access necessary services, ultimately leading to improved health outcomes.
    • Enhanced Cultural Competency: Working with cultural health navigators can educate healthcare professionals about the unique needs, beliefs, and practices of the refugee population, increasing their cultural competency and sensitivity.
    • Increased Trust: Patients are more likely to trust and engage with healthcare providers when cultural health navigators are involved, leading to better communication and more effective care.
    • Reduced Health Disparities: Cultural health navigators can help reduce health disparities by addressing social determinants of health and ensuring equitable access to care for the refugee population.

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