Facilitating Health Communication with Immigrant, Refugee, and Migrant Populations Through the Use of Health Literacy and Community Engagement Strategies Proceedings of a Workshop (2017) / Chapter Skim
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3 Accessing and Using Health Care Services
3 Accessing and Using Health Care Services
Pages 17-34
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From page 17... ...
Julia Liou, director of program planning and development at Asian Health Services and manager of the California Healthy Nail Salon Collaborative, described one innovative access point for reaching newly arrived populations. Jesús Quiñones, Guides for Understanding Information and Access (GUIA)
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From page 18... ...
Nelson illustrated the various aspects of the physical health, mental health, and socioeconomic and legal issues relevant specifically to the immigrant, refugee, and migrant populations with stories of some of the patients he and his colleagues have seen in their human rights clinic. The first story he told was of two young men who escaped forced military conscription in Eritrea, fled through Sudan to the Arabian Peninsula, and stowed away on freighters, one to Ecuador, the other to Brazil.
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From page 19... ...
Mental health is another aspect of care that Nelson said he has learned about through his work in the human rights clinic. In medicine, he explained, there are various diseases such as tuberculosis and syphilis that are called great imitators because they present with symptoms that are easily confused with other illnesses.
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From page 20... ...
During the coldest winter of the last 5 years, she was supporting herself exclusively with part time and totally unguaranteed work in an unheated African hair braiding salon, where she slept on the floor at night," said Nelson. "Obviously, it was much worse for her than it was for me, but I felt terrible because here I am a doctor in a county hospital who has some kind of social justice mission and I am trying to marshal the resources that I usually have for patients like this, in terms of social workers and therapists, but the main barrier was that she was an asylum seeker in process and was just not eligible for anything." Fortunately, he added, this story ended well, but that is not always the case, particularly when these individuals are seen by primary care clinicians who do not have training or specific experience to imagine the extent of what immigrants, refugees, and migrants have to contend with in their daily lives.
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From page 21... ...
She and her colleagues became aware of the occupational health problems facing Vietnamese nail salon workers when one of her organization's community health workers, who was conducting outreach and education about diabetes, met one nail salon employee who kept complaining about how 2 This section is based on the presentation by Julia Liou, director of program planning and development at Asian Health Services and manager of the California Healthy Nail Salon Collaborative, and the statements are not endorsed or verified by the National Academies of Sciences, Engineering, and Medicine.
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From page 22... ...
"We started noting that this was an epidemic happening within this community that tended to be overlooked," said Liou. When the Asian Health Services team began looking into the issue, they found a study conducted among Vietnamese nail salon workers in Boston (Roelofs et al., 2008)
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From page 23... ...
Once they started building leadership in the community, the next step was to create a model for change that would include some solutions to address some of the social determinant factors that the workers might not necessarily control. To create the model, they held community meetings and asked workers and owners, most of whom also work in the nail salons, to comment on possible solutions.
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From page 24... ...
SOURCE: Healthy Nail Salon Program as presented by Julia Liou at Facilitating Health Communication with Immigrant, Refugee, and Migrant Populations Through the Use of Health Literate Approaches: A Workshop on March 15, 2017.
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From page 25... ...
Environmental Protection Agency, found that workers in Healthy Nail Salons had reduced chemical exposures and increased knowledge of healthy workplace practices. The California legislature has since passed the Healthy Nail Salon Bill to extend this program statewide, and the Collaborative is working with microloan partners to provide funds to nail salons in the state that want to become Healthy Nail Salons.
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From page 26... ...
The GUIA Program has an appointment reminder system that uses whatever means are necessary to reach its clients, and it coordinates a home visit program to address chronic illnesses, primarily diabetes and hypertension, that includes three home visits over 6 months and monthly calls between visits. During each home visit, the case manager, acting as a community health worker, provides chronic illness education, and a volunteer nurse assesses the client's health and administers specific interventions.
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From page 27... ...
4 This section is based on the presentation by Kari LaScala, health communications special ist with Wisconsin Health Literacy, and the statements are not endorsed or verified by the National Academies of Sciences, Engineering, and Medicine.
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From page 28... ...
LaScala and her colleagues conducted preworkshop and 60-day post-workshop assessments. When Wisconsin Health Literacy staff was developing the workshops for seniors, they spoke with doctors and pharmacists to identify trouble spots that served as the main workshop topics.
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From page 29... ...
Working with the 13 sponsoring community organizations was not without problems, said LaScala, though she called them "phenomenal partners." Some of the organizations were reluctant to renew their participation in the second year given the time and effort involved in recruiting participants and organizing the workshops, the difficulty in predicting the number and language of the participants at a given workshop, and the challenge of conducting the 60-day post-workshop surveys. At least one of the partner organizations told her that they have to prioritize what they are able to do today given the current climate around refugees and immigrants.
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From page 30... ...
She and her colleagues also held press conferences for the ethnic and mainstream media to capitalize on the local champions they had developed relationships with and to get the message out to the broader community about the importance of worker health. Quiñones said that when Casa de Salud was founded, the majority of outreach was done at health fairs and via word of mouth.
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From page 31... ...
She is also aware of smaller groups outside of San Francisco that are working on something similar. Ruth Parker asked Nelson if the term human rights clinic helps or hurts the core mission of providing health care services.
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From page 32... ...
Quiñones replied that his organization does this in part through its advocacy activities, particularly with regard to getting medically necessary services for its patients who do not have access to public assistance programs and therefore do not have insurance. Liou said that she and her colleagues had to step back and think about where nail salon workers and owners are coming from with regard to their fears that wearing masks and gloves will scare off their customers and put them out of business.
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From page 33... ...
Umair Shah, executive director at Harris County Public Health in Houston, Texas, remarked that the refugee health clinics run by the county health department often double as de facto community centers and provide the opportunity to engage the community in ways that go beyond providing health care. Nelson responded that he, in fact, had a meeting later today to figure out how to do just that with Highland Hospital's refugee clinic, which is a separate entity from his clinic that serves asylum seekers.
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From page 34... ...
34 FACILITATING HEALTH COMMUNICATION ers to help them answer their patients' questions. Quiñones said that as of January 2, 2017, Casa de Salud's policy is to cooperate fully with agents in accordance with the law.
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