Expanding on Conventional Refugee Health Trajectories

Traditional profiles of refugee arrivals are limited to epidemiological data regarding prevalence of health conditions. A mixed methods approach examined the expansive possibilities of community perspectives contributing to refugee health. Quantitative data compared the established national markers from a CDC/DHHS dataset of refugee health priorities and a dataset of 6,863 refugees screened for illness upon their arrival to Illinois. Qualitative data was collected in the form of 11 interviews with refugee service providers across the United States. Refugee health priorities were juxtaposed to qualitative data to better understand the health issues facing refugee communities and their prioritization at national and local levels. Several themes emerged from the qualitative analysis that corresponded with different levels of socioecological models (Bronfenbrenner, 1971) and the immigrant health trajectory (Edberg, Cleary, and Vyas). Quantitative differences existed between the nationally established health priorities and from the Chicago refugee sample; similarly, priorities identified from service provider interviews were different from the national prioritization scheme. The interviews with refugee service providers produced thematic results regarding protective actions being performed by refugee service institutions, barriers (built environment and social support eligibility) that impede refugee health, structural violence affecting the mental health of refugees, and insufficient support for nuanced health issues. Misaligned priorities at different levels of refugee health ecology and marginalization consequent to both discrimination and anti-immigrant political rhetoric highlight the need for more engagement of, and access for, refugees in directing resettlement.