 Health
Refugees face special health challenges, both as new arrivals into the United States and after they have been in the United States for some time. Forced migration may expose people to a host of health and mental health risk factors.
It is helpful to think of the health challenges to refugees in terms of the stages they go through in getting to the United States, starting with conditions in their country before leaving (pre-migration), their travels to the United States, including time in refugee camps (migration), and their eventual settlement in the United States. These special health challenges include the possibility of coming from regions of the world with high rates of certain diseases and different health care delivery customs, and the fact that migration to the Western world brings with it an increased susceptibility to certain chronic health conditions.
General Background
To address the special health challenges of refugees, ORR provides guidance, resources and oversight for refugee medical assistance, initial refugee medical screening and refugee health/mental health technical assistance and consultation.
To assure necessary expertise and human resources, ORR maintains intra-agency agreements with other Department of Health and Human Services (HHS) programs: the Office of Global Health Affairs (OGHA) and the Substance Abuse and Mental Health Services Administration (SAMHSA), Refugee Mental Health Program. Together they make up the ORR led Federal Refugee Health Team.
An additional Federal partner for refugee health technical assistance is the Centers for Disease Control and Prevention’s Division of Global Migration and Quarantine (DGMQ). DGMQ provides expertise related to contagious diseases in newly arriving refugee populations.
Medical Screening
Refugees undergo medical screening overseas that specifically focuses on medical eligibility for the U.S. Refugee Program. Upon arrival in the U.S. or soon after, however, refugees are advised to undergo a medical screening. The US-based medical screenings managed by State and local health departments or their proxies should focus on a wider range of medical conditions and on the general health of new arrivals. The purposes of the U.S.-based medical screening are to protect the public health of U.S. citizens and provide refugees with a level of health and well-being required for and supportive of successful resettlement in the U.S.
The ORR Refugee Health Team provides technical guidance on post-arrival medical screenings and communicates with local-level officials on the substance of these screenings. Additionally, the ORR Refugee Health Team monitors the health burden of incoming populations and provides guidance to the resettlement communities on the management of medical conditions, both chronic and communicable. Through close communications with State and local health departments, various federal agencies, non-governmental and international organizations, the ORR Refugee Health Team works to ensure that medical screenings are thorough and appropriate for any given population in the process of resettlement.
Medical Screening Guidelines
Medical Screening guidelines for treating malaria in arriving refugees can be found on the following CDC website:
http://www.cdc.gov/ncidod/dq/refugee/rh_guide/domestic.htm
Medical Screening guidelines for treating intestinal parasites in arriving refugees can be found on the following CDC website:
http://www.cdc.gov/ncidod/dq/refugee/rh_guide/ip/index.htm
Health Promotion & Disease Prevention
To help develop and implement health promotion and disease prevention activities and programs within refugee communities, ORR launched a refugee health promotion and disease prevention initiative entitled “Points of Wellness: Partnering for refugee health & well-being”.
Overall, Points of Wellness aims to:
- Increase awareness and interest in health promotion and disease prevention programs.
- Promote a holistic approach to refugee health & well-being.
- Promote and strengthen protective and healing factors during resettlement.
- Increase the long-term health and well-being of refugees.
Points of Wellness objectives are being met by:
- Encouraging the development of community partnerships for maintaining and improving the physical and mental health of refugees.
- Providing technical assistance on how to develop, fund, manage and implement health promotion and disease prevention programs.
- Supporting systems of care that address refugee health in an integrated, seamless way.
Points of Wellness Resources:
- A refugee health listserv was established to share information among refugee health providers, researchers and policy makers. To access the Listserv go to http://list.nih.gov, click on Browse and then look for REFUGEEHEALTH-L.
- Current publications include a Refugee Health Promotion and Disease Prevention Toolkit and An Annotated Bibliography on Refugee Mental Health. Both products may be viewed and downloaded at: http://www.refugeewellbeing.samhsa.gov/products.aspx.
Interim Final Rule
- Q and A’s - Interim Final Rule (IFR) Changes (pdf 38KB)
- Updates to Medical Examination of Aliens Interim Final Rule (IFR) (pdf 185 KB)
Contact Information
Marta Brenden
Management Specialist and Refugee Health Project Director
Office of Refugee Resettlement (ORR)
370 L’Enfant Promenade, SW 8 th Floor
Washington , DC 20447
Tel: 202-205-3589
Fax: 202-401-5772
Marta.Brenden@acf.hhs.gov
www.acf.hhs.gov/programs/orr