Chapter 9Health Considerations for Newly Arrived Immigrants & Refugees

William M. Stauffer

Historically, the Yellow Book has addressed travel health issues for US residents visiting countries outside the United States. In this increasingly mobile world, the discipline of travel medicine is evolving to recognize nontraditional groups who cross international boundaries into and out of the United States. One such group includes people who originate in other countries and migrate to the United States, either temporarily or permanently. Recognized migrants to the United States include immigrants (documented and undocumented), refugees, asylum seekers, and adoptees. In addition, students and corporate workers are frequent visitors to the United States. Many clinics serving the traditional travel population also function as contact points with the US medical system for these populations, particularly for immigrants and refugees. This section provides resources to assist clinicians and organizations that serve these populations to access up-to-date patient-care guidelines, online education materials, and print resources.

CLINICAL REFERENCES

Organizational Guidelines

• Centers for Disease Control and Prevention: predeparture and postarrival presumptive treatment and medical screening guidelines for refugees relocating to the United States available at www.cdc.gov/immigrantrefugee health/exams/medical-examination.html
• American Academy of Pediatrics: online Red Book guidance on medical screening and vaccination issues in adoptees, refugees, and immigrants at http://aapredbook.aappublications.org  
• Canadian Collaboration for Immigrant and Refugee Health: clinical preventive guidelines for primary care for newly arriving immgrants and refugees at www.ccirh.uottawa.ca

Websites

• Centers for Disease Control and Prevention
  • Division of Global Migration and Quarantine: information on immigrants and refugees who are resettling in the United States plus resources at www.cdc.gov/immigrantrefugeehealth/index.html
  • Division of Parasitic Diseases and Malaria: clinical and public policy information on parasitic diseases at www.cdc.gov/parasites and www.cdc.gov/malaria/
  • Travelers’ Health: health information for international travelers at www.cdc.gov/travel
  • International Emergency and Refugee Health Branch: health information pertaining to complex humanitarian emergencies at www.cdc.gov/globalhealth/ierh
• Minnesota Department of Health: multiple resources for clinicians in refugee health at www.health.state.mn.us/divs/idepc/refugee/hcp/index.html
• Healthy Roads Media: health education materials, including video, in a variety of languages at http://healthyroadsmedia.org
• EthnoMed: information about cultural beliefs, medical issues, and other related issues pertinent to the health care of recent immigrants at http://ethnomed.org/ethnomed
• Health Information Translations: set of common hospital signs with multiple translations at www.healthinfotranslations.com
• Medical Leadership Council on Cultural Proficiency: database of patient information resources in a variety of languages and organizations providing services in languages other than English at www.medicalleadership.org/resources/patient_education.shtml
• Refugee Health Information Network: multilingual information for clinicians, refugees, and asylum seekers in print, audio, and video formats at www.rhin.org
• US Committee for Refugees and Immigrants: toolkits on multiple health issues for clinicians, immigrants, and communities in multiple languages at www.refugees.org/resources/for-refugees-immigrants/health
• US Citizenship and Immigration Services: information regarding adjustment of status at www.uscis.gov 

Reference Books

Textbooks with a Focus on Migrant Health

• Immigrant Medicine. Walker PF, Barnett ED, editors. Philadelphia: Saunders; 2007.
• Migration Medicine and Health: Principles and Practice. Gushulak BD, MacPherson D, editors. Hamilton, ON: BC Decker; 2006.
• Travel Medicine and Migrant Health. Lockie C, Walker E, Calvert L, Cossar J, Knill-Jones R, Raeside F, editors. Edinburgh: Churchill Livingstone; 2000.
• Refugee and Immigrant Health. A Handbook for Health Professionals. Kemp C, Rasbridge LA, editors. New York: Cambridge University Press; 2004.

Textbooks with a Focus on Tropical Diseases

• Atlas of Tropical Medicine and Parasitology. 6th ed. Peters W, Pasvol G, editors. Mosby; 2006.
• Douglas and Bennett’s Principles & Practice of Infectious Diseases. 5th ed. Mandell GL, Bennett JE, Dolin R, editors. Philadelphia: Churchill Livingstone; 2000.
• Hunter’s Tropical Medicine and Emerging Infectious Diseases. 8th ed. Hunter GW, Strickland GT, Magill AJ, editors. Philadelphia: WB Saunders Company; 2000.
• Manson’s Tropical Diseases. 22nd ed. Cook GC, Zumla AI, editors. Edinburgh, UK: Saunders Ltd; 2008.
• Tropical Infectious Diseases. 2nd ed. Guerrant RL, Walker DH, Weller PF, editors. Philadelphia: Churchill Livingstone; 2006.

GENERAL RESOURCES

Reading Lists

• Global Health Education Consortium’s Global Health Bibliography: bibliography of selected citations for use by students and faculty in global health at http://globalhealthedu.org/resources/Pages/GlobalHealthBibliography.aspx
• University of Minnesota reading list on refugee and immigrant health: comprehensive reading list for people interested in refugee and immigrant health at http://www.globalhealth.umn.edu/residenttraining/reading/home.html

Educational Opportunities

• University of Minnesota/CDC ASTMH-accredited course in global health: focus on immigrant and refugee health at www.globalhealth.umn.edu/globalhealthcourse/home.html (in-person course) and www.globalhealth.umn.edu/onlinetrainingglobalhealth/home.html (online course)
• ASTMH-accredited courses in tropical and travel medicine: list of ASTMH-accredited tropical and travel medicine courses at www.astmh.org/Approved_Diploma_Courses/2867.htm

Non-CDC Organizations

• US Department of Health and Human Services
  • Office of Refugee Resettlement: www.acf.hhs.gov/programs/orr
  • Office of Global Health Affairs: www.globalhealth.gov
• United Nations High Commissioner for Refugees: www.unhcr.org/cgi-bin/texis/vtx/home
• World Health Organization refugee page: www.who.int/topics/refugees/en
• American Society of Tropical Medicine and Hygiene: www.astmh.org
• International Organization for Migration: www.iom.int
• International Society of Travel Medicine Health of Migrants and Refugees Committee: www.istm.org/WebF...
• Global Health Education Consortium: http://globalhealtheducation.org
• Global Health Council: www.globalhealth.org

Other Resources

• Pre-travel handouts for non-English-speaking patients (multiple topics in over 15 languages): www.tropical.umn.edu/T...
• The Providers’ Guide to Quality and Culture: http://erc.msh.org/mainpa...