Griswold Kim S, Pottie Kevin, Kim Isok, Kim Wooksoo, Lin Li
1Department of Family Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, 77 Goodell St., Buffalo, NY 14203 USA.
2Departments of Family Medicine and Epidemiology and Community Medicine, University of Ottawa, Stewart Street, Ottawa, ON K1N 6N5 Canada.
Public Health Rev. 2018 Feb 7;39:3. doi: 10.1186/s40985-018-0082-y. eCollection 2018.
Refugee populations have unequal access to primary care and may not receive appropriate health screening or preventive service recommendations. They encounter numerous health care disadvantages as a consequence of low-income status, race and ethnicity, lower educational achievement, varying degrees of health literacy, and limited English proficiency. Refugees may not initially embrace the concept of preventive care, as these services may have been unavailable in their countries of origin, or may not be congruent with their beliefs on health care. Effective interventions in primary care include the appropriate use of culturally and linguistically trained interpreters for health care visits and use of evidence-based guidelines. Effective approaches for the delivery of preventive health and wellness services require community engagement and collaborations between public health and primary care. In order to provide optimal preventive and longitudinal screening services for refugees, policies and practice should be guided by unimpeded access to robust primary care systems. These systems should implement evidence-based guidelines, comprehensive health coverage, and evaluation of process and preventive care outcomes.
难民群体获得初级保健的机会不平等，可能无法接受适当的健康筛查或获得预防性服务建议。由于低收入状况、种族和族裔、教育程度较低、健康素养程度不同以及英语水平有限，他们面临诸多医疗保健方面的不利因素。难民最初可能不接受预防保健的概念，因为这些服务在他们的原籍国可能无法获得，或者可能与他们对医疗保健的信念不一致。初级保健中的有效干预措施包括在医疗就诊时适当使用经过文化和语言培训的口译员以及采用循证指南。提供预防性健康和保健服务的有效方法需要社区参与以及公共卫生与初级保健之间的合作。为了为难民提供最佳的预防性和纵向筛查服务，政策和实践应以不受阻碍地接入强大的初级保健系统为指导。这些系统应实施循证指南、全面的健康覆盖以及对过程和预防保健结果的评估。
