P0665 - Addressing Barriers to Healthcare for Refugee and Immigrant Children

Background: Children of refugee and immigrant families continue to face significant challenges in terms of accessing healthcare in the United States. From a healthcare systems standpoint, very few states offer medical coverage to children regardless of immigration status. Additional obstacles that hinder healthcare accessibility for this population include disparities in health literacy, language barriers, lack of trust in the healthcare system, cultural differences, and financial constraints. This poses challenges, as the risk for children developing chronic diseases is higher in the refugee and immigrant population. Healthcare systems need to determine ways to provide equitable care to these vulnerable populations. Mobile Health Clinics (MHCs) have been utilized as one model to bring healthcare to vulnerable populations. MHCs have specifically shown to be beneficial in providing healthcare to racial and ethnic minorities. One study revealed 37% of all MHC visits identified as non-white, and 43% identified as Hispanic or Latin.

Objective: This quality assessment study sought to understand the extent and types of limitations to healthcare among the refugee and immigrant populations and to explore solutions to address this issue. This primary objective was assessed by determining the number and proportion of refugee and immigrant families who lacked access to dental or medical care. Potential solutions were explored by determining families’ current usage of available health resources such as the Emergency Department (ED) and by assessing families’ willingness to utilize an MHC in their community.

Design/

Results: Written questionnaires were distributed to the target population. Questionnaires were translated into the individual’s native language including: Spanish, Dari, Arabic, Burmese, and Swahili. Of the 87 surveys collected, 26% of families reported that their children lacked a regular physician, while 39% of children lacked an established dental provider. Regarding utilization, 54% reported seeking medical treatment at the ED at least once in the last 12 months. Further, 90% of families reported they would use an MHC if one were available in their community.

Conclusion: With the growing number of refugee and immigrant children in the United States, as well as their increased risk of developing chronic diseases, it is critical to assess current limitations to health care among this population and determine ways to effectively address them. This analysis revealed that despite lack of access to primary care, families are willing to seek medical care in the ED and utilize an MHC in their community. An MHC may prove a valuable tool in improving the health and wellness of refugees and immigrants by addressing the major barrier to care: lack of access. Further research is necessary to determine whether reported ED usage was an appropriate utilization of healthcare resources and if access through an MHC could decrease non-emergent ED usage within this population.