Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco.
Department of Epidemiology and Biostatistics, University of Maryland, College Park, College Park.
Ann Epidemiol. 2018 Jun;28(6):411-419. doi: 10.1016/j.annepidem.2017.05.010. Epub 2017 May 12.
The cumulative total of persons forced to leave their country for fear of persecution or organized violence reached an unprecedented 24.5 million by the end of 2015. Providing equitable access to appropriate health services for these highly diverse newcomers poses challenges for receiving countries. In this case study, we illustrate the importance of translating epidemiology into policy to address the health needs of refugees by highlighting examples of what works as well as identifying important policy-relevant gaps in knowledge. First, we formed an international working group of epidemiologists and health services researchers to identify available literature on the intersection of epidemiology, policy, and refugee health. Second, we created a synopsis of findings to inform a recommendation for integration of policy and epidemiology to support refugee health in the United States and other high-income receiving countries. Third, we identified eight key areas to guide the involvement of epidemiologists in addressing refugee health concerns. The complexity and uniqueness of refugee health issues, and the need to develop sustainable management information systems, require epidemiologists to expand their repertoire of skills to identify health patterns among arriving refugees, monitor access to appropriately designed health services, address inequities, and communicate with policy makers and multidisciplinary teams.
截至 2015 年底,因遭受迫害或有组织暴力而被迫离开自己国家的人数累计达到了 2450 万,这一数字达到了前所未有的水平。为这些背景各异的新来者提供公平获取适当卫生服务的机会,给接收国带来了挑战。在本案例研究中,我们通过突出展示有效的措施示例并确定知识方面的重要政策相关差距,阐明了将流行病学知识转化为政策以满足难民健康需求的重要性。首先,我们组织了一个由流行病学家和卫生服务研究人员组成的国际工作组,以确定有关流行病学、政策和难民健康交叉问题的现有文献。其次,我们创建了一份研究结果摘要,为在美国和其他高收入接收国支持难民健康整合政策和流行病学提供了建议。第三,我们确定了八个关键领域,以指导流行病学家参与解决难民健康问题。难民健康问题的复杂性和独特性,以及开发可持续管理信息系统的必要性,要求流行病学家扩大其技能组合,以识别抵达难民的健康模式,监测获取适当设计的卫生服务的情况,解决不平等问题,并与政策制定者和多学科团队进行沟通。