User:Smartin gpp/sandbox

Area and Sector
Refugee health in the United States - This article gives a good background about the basis of how the US refugee population requires more specialized healthcare due to their experiences. It explains in detail the process of health screening and initially connecting people to healthcare services, and gives links to how certain states, including California, go about addressing refugee health needs. While the article explains a few aspects of refugee health, including mental health and short descriptions of dental health and diet, there are still many details and aspects of holistic and culturally appropriate health absent from this article. I plan to add a section on women's health within the "Special Health Considerations for Refugees" section, focusing on domestic violence, reproductive health, and other women's health concerns for my "Area" piece. In the context of my Practice Experience, this will help me to learn and understand common health conditions of individuals I will be working with. For my "Sector" piece, I plan on adding a section on barriers to healthcare for refugees in the United States, such as language, documentation requirements, etc. Since my PE involves connecting individuals to healthcare services, knowing the barriers this population faces will help me to navigate this system and help them access services.

From Refugee Health in the United States Article - Special Health Considerations for Refugees Section
"Because of the often hasty circumstances of their departures from their origin countries, refugees usually lose access to their medical records, and continuity of care is difficult to establish upon entry to the United States. This is a significant problem, especially for refugees with chronic and mental health conditions. Further, after arrival in the U.S., refugees may face obstacles to accessing care because of limited English proficiency and uncertainty of how to navigate the U.S. healthcare system."

Add: [Once accessing care, ensuring that the treatment refugees receive is culturally appropriate may serve as another obstacle to maintaining a healthy life after resettlement. ]

Article Evaluation
I am evaluating the Refugee health in the United States Page.


 * Is everything in the article relevant to the article topic? Is there anything that distracted you? What else could be improved?
 * The article has two main sections: 'Special health considerations for refugees' and 'Medical Screening,' which are both relevant and important background information categories that are helpful in getting a background in refugee healthcare. The health considerations section contains background on why this population needs specialized healthcare and gives an overview of mental health, dental health, lead poisoning, infant mortality, and diet, which begins to point out different aspects of healthcare.  The medical screening section is slightly more detailed and technical, providing an overview of how refugees obtain healthcare in the United states through the laws and programs in place.  This section, because it is more extensive, distracts from the aspects and issues related to refugee health and healthcare itself, and its significance for this particular population.
 * Is any information out of date? Is anything missing that could be added?
 * The information in the article seems mostly up to date. The article includes many links to other pages with more information on subtopics within the text, and the sources are all fairly recent, within the last 10-15 years.
 * The article is missing many other aspects that contribute to a holistic view of healthcare, such as social health, womens health, chronic illness, food security, etc. It also lacks information about barriers to healthcare and the importance of culturally appropriate healthcare for the refugee population.
 * Is the article neutral? Are there any claims that appear heavily biased toward a particular position?
 * The article's tone appears to be neutral in describing both the need for special health considerations of refugees, as well as, the different policies and processes related to medical screening and connecting refugees with healthcare services. I think I approached the article with my own bias, however, since access to healthcare and refugee/human rights are an area that can be heavily politicized.
 * Are there viewpoints that are over-represented, or underrepresented?
 * With respect to the section on medical screening, the article does a good job of laying out what and how is needed to access healthcare services from the government standpoint. However, it may be helpful to approach this information from the point of view of refugees, such as how they go about these processes of medical screening to access care.
 * Check a few citations. Do the links work? Does the source support the claims in the article?
 * All of the links I tried worked, and the sources provide information and data that supports the claims and statements made by the article.
 * Is each fact referenced with an appropriate, reliable reference? Where does the information come from? Are these neutral sources? If biased, is that bias noted?
 * At the end of the article, there is a sample programs section where links are listed to different state programs, however there is no text explaining or summarizing them. They seem sloppily thrown into the article.  The other references reflect reliable, accurate data from WHO, CDC, and various scientific journals that is appropriate in the context of the article.
 * What kinds of conversations, if any, are going on behind the scenes about how to represent this topic?
 * There are only 3 people who have made comments on this talk page, all related to minor edits, so there is not much discussion or change involving this article happening behind the scenes.
 * How is the article rated? Is it a part of any WikiProjects?
 * The article is part of the United States, Medicine, International Relations, and Human rights WikiProjects.
 * How does the way Wikipedia discusses this topic differ from the way we've talked about it in class?
 * In class we discuss how the issues we are studying impact and are impacted by social and cultural frameworks. I found it interesting that this article did not really address the cultural applications which provide obstacles or special conditions that influence the refugee experience with healthcare in the US.

Sector
When finding and selecting articles for my sector, a pattern I have noticed is that most articles related to barriers to accessing healthcare for refugees in the US is that they are all slightly biased. The articles all state or imply the need for a better system for refugees to access the healthcare they need. Most of the articles do this with a neutral tone, but this viewpoint is prevalent with the sources I am finding that fit the supplementary information I am looking for.

==== "Assessing Barriers to Healthcare Access Among Refugees Living in San Antonio, Texas" ==== In this article, a group of medical doctors from the University of Texas conducted a cross-sectional survey to identify and better understand structural barriers to accessing healthcare among the refugee population at a refugee health clinic in San Antonio. Their results reflect that language, transportation, and money are the major barriers preventing individuals in this population from accessing healthcare, causing this group of doctors to argue for programs that provide more individualized resources and services. The information discussing transportation barriers for refugees is particularly useful in this article. The data shows that not having a car makes transportation difficult, and that using public transportation such as the bus system is still difficult due to cost or trying to navigate the map and schedule of these options. Another useful fact derived from this article is the point about how translation services, which in theory should address the language barrier that refugees face, are not available in all languages and specifically those needed by the population in this area. As a result, individuals were not as inclined to schedule appointments because they were not able to communicate. I think that this article is particularly useful in terms of my PE because Sacramento is a fairly spread out city, and although there are light rail and bus systems, transportation to hospitals or other healthcare facilities is a barrier that the IRC department I am working for highlights. Understanding this as a broader systematic issue relating to my PE organization can allow me to better prepare myself by looking into the Sacramento transit system prior to starting my PE work, in addition to, finding alternative or individualized care options more conveniently located for clients. On the broader scale, it also reflects that transportation is not an issue particular to one city or locality, but that barriers of transportation have greater underlying social context tying back to other barriers such as cost and communication. For my sector article, I plan on referencing the information on transportation barriers including difficulties using public transportation if refugees also do not own cars. I also want to reference the point made about the lack of available languages for translation services when discussing language barriers.

==== Barriers to Healthcare Access Among Refugees with Disabilities and Chronic Health Conditions Resettled in the US Midwest ==== The study conducted in this article consisted of interviewing resettled refugees in the Midwest living with a disability or chronic health condition, as well as, individuals providing this population with healthcare. It argues that the main barriers to accessing healthcare in this population are health insurance, language, and simply navigating the health system itself. A main concept of this article is the difficulty in accessing and understanding the health insurance and healthcare system in order to obtain care. It emphasizes through the health insurance, language, and navigation barriers that it is extremely difficult for refugees with special health conditions to find appropriate treatment and the specialized care they need. In the context of my PE, this article reinforces that I need to educate and familiarize myself with healthcare and health insurance systems, since the majority of my job description is helping to connect individuals with more complex health conditions--such as the ones in this article--with services and appropriate treatment. It also points out the importance of adequately being able to describe a person's health needs, which is also something I need to be aware of coming into my PE. When looking at the bigger picture, this article serves as a good framework to understand how these barriers can be broken down to systemic, organizational, and personal issues that stem from the greater arena that is the experience of poverty for the refugee population. For my sector article, this article provides good points of analysis relating to health insurance barriers such as the generalization of care or the problems with fitting into the requirements to receive care that I plan on referencing as I write.

==== Understanding Refugees' Perceptions of Healthcare in the United States ==== This article conducted focus groups in order to assess refugee opinions about their experiences with the United States healthcare system in order to identify and better understand their barriers, as well as, preferences with the healthcare they are receiving at the population level. The results of this study assert that the major themes brought up by groups of refugees were difference in expectations, miscommunication, and lack of trust between provider and patient. I think that the arguments and results found in this article can be connected to a greater framework of the need for culturally appropriate healthcare. This connects the ideas of trust, communication, and expectations and values when providing health care treatment or connecting with services, and impact the refugee experience with the healthcare system as a whole. This is relevant in better understanding and preparing for my PE because I will be trying to connect refugee individuals with healthcare services that should be culturally appropriate. In addition, I need to be aware of cultural and life experience differences since I will technically be a step in the ladder of these refugees attaining services. For my sector article, I plan on integrating how these differences in expectations and communication relate to culturally appropriate care, and how this in and of itself can be a barrier to healthcare.

==== Make Refugee Health Great Again ==== In this brief article, Phillbrick argues that the healthcare system can be improved to better serve the refugee population by addressing language barriers, insurance, navigating the healthcare system, and cultural awareness through channels of providing care. The Somali woman's struggle to get pills that were Kosher in order to respect her religious beliefs is an example of how culturally appropriate care and treatment is a barrier to refugee individuals adequately being treated by the healthcare system. In the context of my PE, I can apply this example and the other main ideas of this article to reaffirm the importance of being aware and respectful of different cultures when interacting with refugee individuals as I am doing work. As someone who will be working to connect individuals with treatment and services, especially those that could be mental health related, another realm of background information this is leading me to explore is ways to navigate and seek out culturally appropriate care. I can also use this example to strengthen my sector article to better explain how and why culturally appropriate care can serve as a barrier to accessing treatment and health services.

==== Falling through the Coverage Cracks ==== This article explores the discrepancies between the coverage refugees and immigrants should receive through the Affordable Care Act and their actual access to healthcare services. It describes the public medical and health resources that refugees have access to, as well as, provides context on the history and physical impact of this government policy. While refugees have better access to healthcare than other immigrants, they still face challenges with getting connected to this coverage. One claim that the article supported was that when trying to accessing care, whether or not an individual who is a refugee has the correct documentation may make it difficult to qualify for care in the first place. This article helps to give me context into the health insurance background and coverage that people who are refugees may be experiencing. For my PE, I will be working with individuals who are newly resettling and supporting them by helping connect them to appropriate healthcare services, which is only a portion of their resettlement process. I will be working with individuals facing various barriers to the healthcare system or may be at differing levels of care, so it is helpful to have some knowledge of how these individuals should be insured based on government policy. With this background knowledge, I can hopefully also fill in the cracks of their health coverage to make sure they are receiving the services they need.

==== Prevalence of Chronic Disease and Insurance Coverage among Refugees in the United States ==== This article provides the results of a survey conducted to understand the extent of chronic health conditions experienced by refugees in the United States in terms of what groups of people within this population are most affected and what diseases are most prevalent. It also sought to identify how refugees experienced healthcare long term after resettlement, and specifically how this impacts individuals who have chronic medical conditions. One main point that stood out to me was the background the article gave surrounding how the main health care refugees receive is public insurance rather than private. It also found that the majority of this healthcare is available immediately upon arrival and resettlement, but is harder to access later down the line. As part of my position within my PE org, I will be helping refugees connect to health insurance and make service plans to make sure they are getting the care or treatment that they need. Most of the individuals I will interact with will most likely experience chronic or special health conditions that require more specialized care. Therefore, this article gives me the background information to understand the context of health conditions that are prevalent within the refugee population, as well as, their experience with health insurance and care long term.

==== Rethinking Urban Refugee Resettlement ==== In this article, interviews were conducted in both urban and rural communities in order to analyze the living conditions within the communities refugees are resettling in. More specifically, this article examines the housing, food, safety, and employment insecurity that refugees experience where they are resettled. One relevant fact from this article I found is that the living conditions of resettlement or housing insecurity upon coming to the United States further impact refugees' health by inserting them into communities or situations where access to care is limited. Despite limited access geographically or physically upon resettlement, I interpret that the other issues with housing and food insecurity, as well as, community conflict and unsafe living conditions that refugees face can further have an impact on individual health both physically and mentally. I can apply the information from this article to better understand my PE because I will be working with refugees in the process of resettling in urban communities throughout the Sacramento area. Having an understanding of the problems with living conditions surrounding resettlement serves as another reminder of the importance of holistic support and access to appropriate healthcare services, which my PE org works to provide to its clients.

Area
==== Refugee Women's Reproductive Health in Early Resettlement ==== The study conducted by this article argues for the need of reproductive services such as cervical and breast cancer screenings for refugee women due to the low number of women who were screened compared to the large women with reproductive health needs. It also gives important context to how breast and cervical cancer screenings are important ways to assess sexual health, and points out disparities between the lack of screenings and education among refugee women compared to high rates of screening among all American women. A key point brought up by this article was the the association between women not being screened for cervical and breast cancer to also not being tested for sexually transmitted diseases. In connecting to my practice experience, the information provided by this article is relevant because it provides extensive background information on how and why assessing reproductive health through screenings can have a greater impact on the health experience of refugee women. Since my PE position specifically deals with women who are seeking more specialized health care services, having this knowledge on the significance of these screenings on identifying other health issues is something to keep in mind as I help to connect individuals to care. In terms of my area article, the information outlined in the background information of the study, as well as the results, can be used to help explain and give examples of the female refugee experience with reproductive and sexual health to add depth to the general topic of women refugee health.

==== Vietnamese Immigrant and Refugee Women's Mental Health ==== In this article, the data collected by this study highlights that language proficiency, economic stress, and maternal stress all impact the mental health of Vietnamese female refugees. They also point out that many of these stressors can be associated with the traumatic experiences or the stress to adapt and conform to the new culture of the United States that these women have experienced. One concept that stood out to me in this article was the impact of financial and linguistic stress contributing to mental health, in addition to traumatic experiences. This relates to the bigger idea that health for any population is influenced by a variety of different factors and should be analyzed from a holistic perspective. In the context of my area article, I plan to include this information on mental health and the various stressors found in this study in order to give a more detailed, holistic representation of the women refugee health experience. The concepts from this article can also be related to my PE in that my position will deal with female refugees and working to connect them to more specialized health services. Having this framework related to how these women might experience mental health gives me a background in how to be respectful and hopefully provide them with appropriate care. It also gives good background on how language and pressure to conform to culture influences their mental health, which reinforces the importance of culturally important care and is something I should be cognizant of when working with individuals through my PE.

==== Syrian Refugee Women's Reasons for Not Reporting Violence ==== This article outlines the experience of domestic violence among Syrian refugee women, and reports that keeping silent about these experiences can be influenced by factors related to cultural taboo or unstable home life. Another key finding highlighted by this article was the lack of support and service related to domestic violence and receiving help as reported by the refugee women. One key idea that came up in this article was the culture of privacy surrounding domestic violence, and how this was not considered to be an issue that needed healthcare intervention. This can be connected to the ideological framework of the Frasier piece discussed in class, where a domestic issue is made public and is taken up by private and institutional channels as a greater systemic poverty need. As a part of PE, I will be working directly with refugee women who could have experience with domestic violence, whether or not they are deciding to report. Having this background information highlighting cultural and social implications and stress experienced by these women that is culturally specific is helpful in being understanding and respectful when providing support and connecting them to appropriate health services. I also plan on addressing domestic violence and using this article as reference to this topic within the women's health section for my area article, since this is a unique and important experience within the realm of women and refugee health, specifically.

==== Experiences of Trauma... ==== This article talks about how mental health resulting from traumatic experiences uniquely affects women. It specifically focuses on female refugee experiences with PTSD after resettlement in the US and their interactions with the healthcare system and mental health services. The part of this article that resonated with me most illustrated that while many men, women, and children are exposed to traumatic situations, women are more likely to experience PTSD, anxiety and other mental health conditions as a result because they are more prone to inter-personal trauma such as family separation, domestic violence or rape. This helps break down the experience of refugees experiencing mental health repercussions after resettlement and contextualizes how women, specifically, are affected my mental health conditions. The content in this article can be applied to my PE because part of my job will be conducting basic health screenings for mainly female refugees, many of whom have suffered traumatic experiences. Having an understanding of how these women may experience mental health conditions upon resettlement allows me to be respectful of what they may be going through, and hopefully break down barriers to access so that they can receive treatment that is culturally appropriate and fits their needs.

==== Use of maternal health services: comparing refugee, immigrant and US-born populations ==== This article looks at whether or not lack of prenatal and other forms of maternal/reproductive health care is the result of lack of access to these services due to inadequate insurance coverage, or whether cultural or social factors have greater influence. This involved investigating the degree of health insurance coverage for reproductive health services, as well as, the reasons for refugee women not using these services. One key finding of this article was that while refugee mothers are less likely to access prenatal and maternal services due to social and economic barriers, they are often more susceptible to cesarean sections, low birth rate, and other health issues. This is relevant to my PE because I will be interacting with female refugees through my PE org in efforts to connect them to appropriate healthcare services, so it is important that I understand the economic and social barriers preventing these women from utilizing reproductive and maternal health services, even if they are available. These barriers relate to those mentioned in my sector article sources, reemphasizing that these are barriers that women face in various ways of trying interacting with the healthcare system in the United States. I can use this knowledge to be respectful of the individuals I work with and make an effort to be respectful of their expectations and needs for treatment and still connect them to the care they need.

==== Sexual and gender-based violence against refugee women ==== In this article, the experiences of women refugees resettling in the EU are shared in order to better understand the occurrence of gender-based violence and the need for better medical and psychological treatment. It uses interviews with women who have resettled in Greece, France, and Serbia and covers a variety of experiences, including war-based violence, violence during migration, and violence within the family. An important assertion made by this article was that while men also experience sexual violence, women are an especially vulnerable population because of shifting gender roles and power dynamics as they flee their home country and migrate and resettle in a new place. Another key finding from the article is that in addition to personal and social barriers to reporting their experiences, refugee women simply do not have access to appropriate medical and psychological services needed for treatment, which continues to make them a vulnerable population after resettlement. The information derived from this article can be directly applied to my practice experience because I will be conducting screenings for individuals and connecting them to specialized care, which could include support for domestic violence experiences. Therefore, this information illustrates the importance of and need for my organization and the department I am working for specifically in helping to give these refugee women a safe, confidential space to seek appropriate healthcare relating to domestic violence.

==== Syrian Women and the Refugee Crisis: Surviving the Conflict, Building Peace, and Taking New Gender Roles ==== This article seeks to challenge the notion that Syrian women experiencing war and displacement are simply a vulnerable group rather than agents for peace and change. It gives background on gender roles in Syrian society, gender-based violence occurring through the political conflict in the nation, and their influence in rebuilding their communities socially, economically, and politically. One concept in this article that stood out to me discussed how culturally influenced gender roles may influence health concerns and access to treatment for female refugees, especially within the realm of reproductive, domestic violence, and psychological care. This put it into perspective for me how gender roles and culture in both the home and resettlement country can both influence a woman's inability to access healthcare or be involved in rebuilding her life after resettlement. In applying this information to my PE, I think it is pertinent because I need to be aware of the cultural norms and gender roles of the host country of the individuals I interact with, as well as how those may differ from the ones I am used to here in the US in order to be respectful when working with them. This article also points out that I need to be aware of female refugees as a vulnerable population, emphasizing the importance of my specific role and department I am working for within my PE org in helping connect women to specialized health services.

Area
Refugee women - This Wiki article gives a good background on refugee women and even includes a section on refugee women's health. I plan to link this page and its information to the section I am adding to the "Womens Health" section I plan to add to the Refugee health in the United States page.

Sector
WHO: Overcoming migrants' barriers to health

CDC: Immigrant and Refugee Health

Plans

 * Add information on...
 * Reproductive health
 * Maternal Health
 * Breast and Ovarian Cancer
 * Mental Health
 * Domestic Violence

Contributions
Refugee women have unique and challenging concerns in terms of accessing healthcare after resettlement in the United States. This includes reproductive and maternal health, mental health, and domestic violence. Culturally influenced gender roles may influence health concerns and access to treatment for female refugees, especially within the realm of reproductive, domestic violence, and psychological care. It can be difficult to obtain appropriate preventative or specialized care to treat these medical concerns with the limited healthcare options available to refugee women.

This is especially apparent in terms of reproductive healthcare, where there is a low number of women screened for cervical and breast cancer compared to the large women with reproductive health needs. These screenings, in addition to other preventative services like STD testing and birth control options are important ways to assess sexual health, but many women are not able to receive these services for cultural or systemic reasons and may suffer more serious health conditions as a result. In addition to birth control, female refugees were less likely to access prenatal and maternal care than native born or other immigrant US populations despite receiving equal coverage in the United States. While refugee mothers are less likely to access prenatal and maternal services due to social and economic barriers, they are often more susceptible to cesarean sections, low birth rate, and other health issues.

Mental health is another issue faced by many refugee women which may result from their experience in their home country and the process of migrating and settling in the US. In a study conducted by Chris Brown in 2010, the results highlight that language proficiency, economic stress, and maternal stress all impact the mental health of Vietnamese female refugees. They also point out that much of this stress can be associated with the traumatic experiences or the stress to adapt and conform to the new culture of the United States that these women have experienced. While many men, women, and children are exposed to traumatic situations, women are more likely to experience PTSD, anxiety and other mental health conditions as a result because they are more prone to inter-personal trauma such as family separation, domestic violence or rape.

Another health issue that affects refugee women disproportionately is sexual and gender based violence. While men also experience sexual violence, women are an especially vulnerable population because of shifting gender roles and power dynamics as they flee their home country and migrate and resettle in a new place. Gender based violence is prevalent in both the home country and the country of resettlement as an instrument of war, in resettlement camps, and in families and communities throughout the resettlement process. This sexual violence is also present for refugee women through the form of trafficking during migration from their home country. Refugee women are exposed to many forms of gender-based violence in addition to the experience of domestic violence, and attaining care can be difficult due to failure to report these issues because of cultural taboo or unstable home life and the lack of support and service related to domestic violence and receiving help as reported by the refugee women. In addition to personal and social barriers to reporting their experiences, refugee women simply do not have access to appropriate medical and psychological services needed for treatment, which continues to make them a vulnerable population after resettlement.

Plans

 * Add information on...
 * Language barriers
 * Documentation barriers
 * Transportation barriers
 * also related to documentation, need drivers license, etc
 * Health Insurance
 * Culturally appropriate care

Fixing "special considerations" intro:

Contributions
underlined and italicized means preexisting text // [in brackets means new text]

'' Because of the often hasty circumstances of their departures from their origin countries, refugees usually lose access to their medical records, and continuity of care is difficult to establish upon entry to the United States. [ ''In addition, the living conditions of resettlement or housing insecurity upon coming to the United States further impact refugees' health by inserting them into communities or situations where access to care is limited. '' This is a significant problem, especially for refugees with chronic and mental health conditions. '' [Unlike the most of the immigrant population, refugee health is of particular concern because the conditions of their immigration include experiences that may negatively impact their physical or mental health. ] '' Further, after arrival in the U.S., refugees may face obstacles to accessing care because of limited English proficiency and uncertainty of how to navigate the U.S. healthcare system. '''Once accessing care, ensuring that the treatment refugees receive is culturally appropriate may serve as another obstacle to maintaining a healthy life after resettlement. '  (*this is my edit/addition but it has already been added to the page*)

[There are various barriers to both accessing healthcare and achieving treatment or services that many refugees experience upon entering the country. In efforts to accessing care, having the correct documentation may make it difficult to qualify for care in the first place. With documentation, navigating the healthcare system and their health insurance policies can make obtaining treatment confusing and difficult. The US health insurance system is complicated - especially for refugees - in that they only receive 8 months of general care after resettlement and there are many different federal, private, and nonprofit organizations that are involved in this process. If individuals need any form of more specialized care, it is difficult to obtain.

Once gaining coverage, utilizing the available care introduces other obstacles. Language may serve as another complication, because if an individual is unable to communicate with their medical provider, receiving appropriate treatment is difficult. Having access to an interpreter and one that speaks the appropriate language is generally uncommon. Many find it difficult to have the money and the means of transportation to get coverage and treatment, as well. In the case of treatment, especially among individuals with chronic or mental health conditions, having care that is culturally appropriate can impact the refugee experience with healthcare too. Difference in cultural background and experience can mean that refugees may have different ideas about when to ask for care, assessing health concerns and associated treatment. As a result, many refugees are less inclined to access care because the United States healthcare model may not align with their cultural beliefs or values. In a 2017 study, a Somali woman's struggle to get pills that were Kosher in order to respect her religious beliefs is an example of how culturally appropriate care and treatment is a barrier to refugee individuals adequately being treated by the healthcare system. ]

[With these barriers in mind, there are steps being taken to improve the process for acquiring care and promote a positive healthcare experience.]  For improving refugee health  [instance],  [there are]  individuals who can act as "cultural brokers" could  [to] '' help refugees to access medical services, locate pharmacies, learn about their medications, and schedule follow-up treatment. Establishing communication between policymakers, front line providers of refugee medical care, and refugees can allow for improvements in refugee health policy outcomes. Also, making sure that refugees receive continuing, thorough assessments of their mental and physical health, health promotion materials in their own language, and access to specialist services (especially in cases of torture or violence) can improve the standard of health among refugee populations. '' The main health care refugees receive is public insurance rather than private, and the majority of this healthcare is available immediately upon arrival and resettlement, but is harder to access later down the line.

'' In 2013, a study done by Tod Hamilton was looking to find if the post-migrant health of black immigrants to the United States varied across their countries with different conditions. The study found that their health was more favorable when migrating from a country with relatively higher ratio of enrollment in primary, secondary, and tertiary education, where tertiary education is any education pursued after high school. Immigrants who were migrating from countries with relatively lower levels of income inequality and higher life expectancies at birth were more likely to experience more favorable health than individuals born in the receiving country. After the researcher controlled for country conditions, African immigrants to the United States reported better health than non-African immigrants. ''

'' A longitudinal study found that late life immigrants were less likely to suffer from cancer and also had less chronic conditions that individuals born in the U.S.. Late life immigrants were defined as individuals who were 70 years or older and had only been in the immigrant-receiving country (United States) for less than 15 years. However, these late life immigrants had worse self-reported health than the native-born individuals. ''