The health and social service needs of immigrants are as varied as the circumstances underlying their migration. Equally complex are the social and cultural factors that influence their access to health care and social services. Among them is the widespread public misperception that receiving publicly funded benefits renders all immigrants 'public charges' and jeopardizes their immigration status; this in the wake of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 ('welfare reform'), which substantially redefined immigrants' eligibility for federal benefits, i.e., Medicaid. While those ineligible for full benefits may be eligible for immunizations, and diagnosis/treatment of communicable diseases (but not chronic disease, antenatal care or mental health), many remain unaware of this. Frequently, Community Health Centers (CHCs) provide the safety net for this marginalized population, particularly recent arrivals. We identified the health and social service needs, preferences and barriers, experienced or perceived, by CHC clients using a multi-faceted approach. This included review of clinical records to define their demographic characteristics and health indicators; client surveys to measure clients' satisfaction with services and their use of alternative/traditional healing modalities; and focus groups of immigrants residing within the catchment areas but not yet enrolled in the CHCs, to identify their expectations of, and barriers to, care or services. Finally, we examined emergency department utilization by these clients to characterize the relationship between receiving primary care at the CHCs and inappropriate or non-urgent use of emergency department services.
Learning Objectives: At the conclusion of this session, the participant will be able to: 1. Recognize challenges of assessing health needs of immigrant clients served by CHCs. 2. Describe approaches of evaluating services provided. 3. Consider how these qualitative and quantitative measures inform public health practice and policy.
Keywords: Immigrants, Community Health Centers
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.