copyright © 2008 delmar. all rights reserved. chapter 26 immigrant and refugee populations
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Copyright © 2008 Delmar. All rights reserved.
Chapter 26
Immigrant and Refugee Populations
Copyright © 2008 Delmar. All rights reserved.
2
Migration Patterns
• Estimated 150 million people live outside their native country
• Trends in movement– Sending countries:
• Mexico, Afghanistan, Philippines, Pakistan, China, Colombia
Copyright © 2008 Delmar. All rights reserved.
3
Migration Patterns
• Receiving countries:– Germany
– Former Soviet Union
– United States • Accepts more than any other country
– Canada
Copyright © 2008 Delmar. All rights reserved.
4
Immigration Policies
• National policies divide immigrants into three groups:
1. Migrant workers
2. Permanent residents/immigrants
3. Refugees
• U.S. Refugee Protection Act of 2001
Copyright © 2008 Delmar. All rights reserved.
5
Migration
• Migratory or seasonal workers– Low or unskilled laborers– Invited or illegally work seasonally
• Voluntary migration • Refugees
Copyright © 2008 Delmar. All rights reserved.
6
Migration
• Premigration factors– Push factors– Pull factors
Copyright © 2008 Delmar. All rights reserved.
7
Socioenvironmental Conditions
• Immigrants and refugees may bring health problems native to their country of origin– 1986 Chernobyl disaster
• Traumatic migration experiences– Forced migration– Impelled migration
Copyright © 2008 Delmar. All rights reserved.
8
Post Migration Factors
• Acculturation– Strategies:
• Assimilation• Integration• Separation• Marginalization
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9
Post Migration Factors
• Acculturative stress– Language barriers– Financial instability– Social problems
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10
Post Migration Factors
• Hispanic paradox
• Xenophobic
• Racism
• Resilience
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11
Community Context
• Ethnic density– Provide access to ethnic amenities– Social capital
• Socioeconomic issues– Home care
• Fastest growing field
– Migrant farm work
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12
Health Problems with Special Implications
• Stress-related chronic health problems– Hypertension– Digestive problems
• Communicable diseases– Tuberculosis– Intestinal parasites– Hepatitis B
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13
Social Violence
• High rate of post-traumatic stress due to experience of traumatic events– Susceptible to:
• Depression, anxiety, substance abuse• Avoidance, emotional numbing• Nightmares/sleep disorders, irritability• Difficulty concentrating
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14
Social Violence
• May bear physical signs of past abuse– Burn marks, whipping scars, old fractures– Female circumcision– Rape
• Pelvic inflammatory disease• Recurrent UTIs• Scar abscesses• Dyspareunia
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15
Social Violence
• Human trafficking second largest crime industry in the world– Victims come from vulnerable populations– Similar medical problems as domestic
violence and rape victims• Bruises, other signs of battery• STDs, fear, depression
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16
Planning and Implementing Care
• Personal Responsibility and Work Opportunities Act of 1986– May apply for citizenship after residing in the
United States for five years
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17
Planning and Implementing Care
• U.S. requires immigrants and refugees to submit to medical screening– Detects infectious disease
• Not comprehensive
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18
Planning and Implementing Care
• Immigrants and refugees less likely to have health care insurance
• Seek or prefer care from lay healers or use folk remedies
• Public health nurses need to be aware of and sensitive to alternative medicine and practices
Copyright © 2008 Delmar. All rights reserved.
19
Planning and Implementing Care
• Programs should be designed for specific cultural attitudes
• Interpreter needs to be available when necessary
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