copyright © 2008 delmar. all rights reserved. chapter 26 immigrant and refugee populations

Copyright © 2008 Delmar. All rights reserved.

Chapter 26

Immigrant and Refugee Populations


2

Migration Patterns

• Estimated 150 million people live outside their native country

• Trends in movement– Sending countries:

• Mexico, Afghanistan, Philippines, Pakistan, China, Colombia


3

Migration Patterns

• Receiving countries:– Germany

– Former Soviet Union

– United States • Accepts more than any other country

– Canada


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


5

Migration

• Migratory or seasonal workers– Low or unskilled laborers– Invited or illegally work seasonally

• Voluntary migration • Refugees


6

Migration

• Premigration factors– Push factors– Pull factors


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


8

Post Migration Factors

• Acculturation– Strategies:

• Assimilation• Integration• Separation• Marginalization


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• Acculturative stress– Language barriers– Financial instability– Social problems


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• Hispanic paradox

• Xenophobic

• Racism

• Resilience


11

Community Context

• Ethnic density– Provide access to ethnic amenities– Social capital

• Socioeconomic issues– Home care

• Fastest growing field

– Migrant farm work


12

Health Problems with Special Implications

• Stress-related chronic health problems– Hypertension– Digestive problems

• Communicable diseases– Tuberculosis– Intestinal parasites– Hepatitis B


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


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


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


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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• U.S. requires immigrants and refugees to submit to medical screening– Detects infectious disease

• Not comprehensive


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• 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


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• Programs should be designed for specific cultural attitudes

• Interpreter needs to be available when necessary

copyright © 2008 delmar. all rights reserved. chapter 26 immigrant and refugee populations

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