Study finds health care access support is lacking for young Iraqi refugees

By Remekca Owens

Dr. Glenn Flores (left) and medical student David Vermette are working to eliminate obstacles to health care access.
Dr. Glenn Flores (left) and medical student David Vermette are working to eliminate obstacles to health care access.

UT Southwestern Medical Center pediatric physician-researchers recently examined the health care access barriers facing children who are Iraqi refugees.

The study, published in the Journal of Immigrant & Minority Health, also included potential interventions to improve the refugees’ access to health care. From 2008 to 2012, approximately 72,000 Iraqis were resettled in the U.S., including 8 percent in Texas, representing one out of every five refugees resettled in the U.S.

“Many Iraqi refugees have been exposed to tremendous violence prior to resettlement, and children are significantly impacted, with high rates of post-traumatic stress disorder (PTSD), infectious diseases, and nutritional deficiencies,” said Dr. Glenn Flores, Professor of Pediatrics and Clinical Sciences, and senior author of the study. “We wanted to investigate the gaps in current public policy that limit their access to sufficient health care once they are settled in the United States.”

In the study, researchers conducted four focus groups using consecutive sampling of Iraqi refugee parents who have resided in the U.S. for eight months to five years. The findings from the focus groups and interviews identified issues such as provider availability, Medicaid maintenance and renewal, language issues, and inadequate recognition of post-traumatic stress disorder as barriers to care for their children.

“Under the current policy, refugees are expected to be settled, self-sufficient, and acclimated after resources such as the eight-month Refugee Cash Assistance and Refugee Medical Assistance expire,” said David Vermette, third-year medical student and first author of the study. “Unfortunately, it doesn’t work that way in reality.”

Researchers found that while socio-cultural assistance such as English language tutoring and support from other refugees continues, system-related support completely expires after eight months. Potential interventions listed in the study include establishing community-oriented efforts to educate parents on Medicaid renewal, obtaining services, and accessing specialists.

Next steps include examining the applicability of existing culturally-appropriate mental health interventions for Iraqi adult refugees and PTSD among the Iraqi child refugee population. Researchers also plan to investigate and pilot potential interventions to improve health insurance renewal options beyond the expiration of case management services. 

###

Dr. Flores holds the Judith and Charles Ginsburg Chair in Pediatrics.