Mishori Ranit, Aleinikoff Shoshana, Davis Dawn
Georgetown University School of Medicine, Washington, DC, USA.
HealthPoint Midway Medical, Des Moines, IA, USA.
Am Fam Physician. 2017 Jul 15;96(2):112-120.
Since 1975, more than 3 million refugees have settled in the United States, fleeing unrest, conflict, and persecution. Refugees represent diverse ethnic, cultural, religious, socioeconomic, and educational backgrounds. Despite this heterogeneity, there are commonalities in the refugee experience. Before resettlement, all refugees must undergo an overseas medical screening to detect conditions that pose a potential health threat in the United States. On arrival, they should undergo an examination to detect diseases with high prevalence in their country of origin or departure. Refugees have higher rates of chronic pain compared with the general population, and their mental health and wellbeing are strongly influenced by their migration history. Refugees have higher rates of mood disorders, posttraumatic stress disorder, and anxiety than the general population. Some refugees have been tortured, which contributes to poorer health. Chronic noncommunicable diseases, such as diabetes mellitus and hypertension, are also prevalent among refugees. Many refugees may be missing routine immunizations and screenings for cancer and chronic diseases. Attention to reproductive health, oral health, and vision care will help identify and address previously unmet needs. Refugees face barriers to care as a result of cultural, language, and socioeconomic factors.
自1975年以来，超过300万难民在美国定居，他们逃离了动荡、冲突和迫害。难民代表着不同的种族、文化、宗教、社会经济和教育背景。尽管存在这种异质性，但难民经历也有一些共同点。在重新安置之前，所有难民都必须接受海外医疗筛查，以检测在美国可能构成潜在健康威胁的疾病。抵达后，他们应接受检查，以检测其原籍国或出发国高发病率的疾病。与普通人群相比，难民患慢性疼痛的比例更高，他们的心理健康和幸福感受到移民历史的强烈影响。难民患情绪障碍、创伤后应激障碍和焦虑症的比例高于普通人群。一些难民遭受过酷刑，这导致他们的健康状况更差。糖尿病和高血压等慢性非传染性疾病在难民中也很普遍。许多难民可能没有进行常规免疫接种以及癌症和慢性病筛查。关注生殖健康、口腔健康和视力保健将有助于识别和满足以前未得到满足的需求。由于文化、语言和社会经济因素，难民在获得医疗服务方面面临障碍。
