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Access to Healthcare Among US Adult Refugees: A Systematic Qualitative Review

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Abstract

Refugees encounter numerous healthcare access barriers in host countries, leading to lower utilization rates and poorer health outcomes. In the US, social inequities and fragmented health systems may exacerbate these disparities. Understanding these factors is necessary to ensure equitable care of refugee populations. A systematic literature review of qualitative studies on US adult refugee healthcare access from January 2000 to June 2021 was performed in accordance with PRISMA. Studies were analyzed deductively and then inductively to incorporate previous findings in other resettlement countries and emergence of US-specific themes. 64 articles representing 16+ countries of origin emerged from the final analysis, yielding nine interrelated themes related to health literacy, cost of services, cultural beliefs, and social supports, among others. The main challenges to refugees’ healthcare access emerge from the interactions of care fragmentation with adverse social determinants. Given diverse barriers, integrated care models are recommended in treating refugee populations.

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Author notes

  1. Rupa S. Valdez and Fern R. Hauck: Co-senior authorship.

Authors and Affiliations

  1. Department of Public Health Sciences, Frank Batten School of Leadership and Public Policy, University of Virginia, Charlottesville, VA, USA

    Chi H. Ho

  2. Claude Moore Health Sciences Library, University of Virginia, Charlottesville, VA, USA

    Andrea H. Denton

  3. Office of Institutional Research, James Madison University, Harrisonburg, VA, USA

    Sarah R. Blackstone & Kara MacIntyre

  4. Department of Epidemiology and Public Health, University of Maryland, Baltimore, Baltimore, MD, USA

    Nadia Saif

  5. College of Nursing, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA

    Mustafa Ozkaynak

  6. Department of Public Health Sciences, Department of Engineering Systems and Environment, University of Virginia, Charlottesville, VA, USA

    Rupa S. Valdez

  7. Department of Family Medicine, Department of Public Health Sciences, University of Virginia, PO Box 800729, Charlottesville, VA, 22908-0729, USA

    Fern R. Hauck

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Contributions

F.H., R.S.V., and C.H. conceptualized the study. A.D. performed the literature review. C.H. and N.S. screened abstracts. C.H., A.D., S.B., N.S., and K.M. screened studies, performed the quality assessment, and coded the articles. C.H. synthesized the codes into themes and drafted the manuscript. F.H., R.S.V., M.O., N.S., and K.M. provided feedback on the manuscript. All authors reviewed and approved the final version.

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Correspondence to Fern R. Hauck.

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Ho, C.H., Denton, A.H., Blackstone, S.R. et al. Access to Healthcare Among US Adult Refugees: A Systematic Qualitative Review. J Immigrant Minority Health 25, 1426–1462 (2023). https://doi.org/10.1007/s10903-023-01477-2

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