Identifying the Physical Health Needs of Refugee and Asylum-Seeking Clients at the Center for Victims of Torture in Atlanta, GA: A Special Studies Project Restricted; Files Only

Johnson, Kayla (Spring 2021)

Permanent URL: https://etd.library.emory.edu/concern/etds/br86b495m?locale=en
Published

Abstract

Introduction: This special studies project is an expansion of a Rapid Community Health Assessment (RCHA) that was conducted for the Center for Victims of Torture (CVT) in Atlanta. CVT Georgia serves clients who are either refugees or asylum seekers who have experienced torture. The Center for Victims of Torture (CVT) provides rehabilitation care to address the mental and emotional sequalae of the traumatic experienced by survivors of torture. Many survivors of torture experience physical sequalae as well however the unmet physical needs of CVT clients is unknown. The objective of this study was to identify the physical health needs of clients, as well as barriers and facilitators to accessing care.

Methods: This study employed a mixed methods survey to explore clients’ physical health needs. The survey tool was designed using a community-engaged research (CEnR) approach in order to meet the needs outlined by the partner organization. Descriptive statistics were used to analyze quantitative survey results and qualitative analysis was used to analyze qualitative results.  

Results: Survey results were obtained from 12 CVT clients. Demographics of the respondents included a total of seven asylum seekers and five refugees, 11 countries represented among the respondents, and seven of the 12 respondents required interpretation. All clients reported challenges with accessing healthcare for their physical needs as well as barriers to obtaining, managing and understanding health insurance. The majority of respondents evaluated their physical health as either average health (5/12) or very poor health (4/12). Chronic pain and chronic headaches were the most identified chronic health issue among respondents.

Conclusion: In order to improve unmet physical health needs, CVT should consider: 1) Conducting regular assessments of physical health needs of clients as well as long-term follow ups for identified chronic health problems, 2) Advocating for funding to provide financial assistance to clients for services and prescription medication, 3) Referring or providing in house social work/case management services that can assist clients with obtaining health insurance when appropriate.

Table of Contents

Table of Contents

Chapter 1: Introduction………………….………………………………………8 

Introduction and rationale……………………………………………..…………………………..8

Problem statement……………………………………………..…………………………………..9

Purpose Statement…………………….………………………………………………………….10

Study Goal and Objective………………………………….……………………………………..10

Significance statement………………………………….……………………………………..….11

Chapter 2: Background and Literature Review………………………………12 

Overview of Refugee and Asylum seeking Populations in the United States…………………....12

Definitions and Distinction of Terms and Processes in the United States………………………..12

United States Work and Health Insurance Policies for Refugees and Asylum Seekers……….....16

Trauma and Torture Survivors……………………………………………………………..…….18

Healthcare Needs of Torture Survivors………………………………………………….……….20

Barriers to Healthcare for Refugees and Asylum seekers……………………………….……….21

Addressing Health Needs of Victims of Torture…………………………………………………22

Chapter 3: Methodology…………………………...……………………………23

Population and Sample……………………………….…………………………………….…….23

Procedures…………………………………………..…………………………………………….23

Data Collection Instrument…………………………..………………………………………..….25

Data Entry and Analysis……………..………………………………………………………..….25

Ethical Considerations……………………...…………………………………………………….26

Limitations……………………………………………………………………………….……….26

Programmatic Recommendations……………………………………………………..………….27

Chapter 4: Mixed Method Survey Results……………………………………..28

Demographics…………………………………………………………………………………….28

Introductory and General Questions…………………………………………………………..….29

Chronic Health Issues…………………………………………………………………………….32

Self-Maintenance of Physical Health……………………………………………………………..33

Access to Care and Health Seeking Behaviors……………………………...………………...….34

Barriers, Enablers, and Medical Adherence………………………………..…………………….35

Qualitative Responses to Unresolved Health Concerns……………………………..………..….40

Crosstabs Analysis……………………………………………………………………………….40

Chapter 5: Discussion and Conclusions…………………………...……………41

Qualitative Responses to Defining Health……………………………………………………….41

Self-evaluation of Physical Health……………………………………………………………….43

Health Seeking Behaviors………………………….…………………………………………….44

Barriers and Facilitators……………………………..……………………………………..…….46

Chronic Health Issues & Unresolved Health Issues…………….……………………………….49

Limitations……………………………………………………………………………………….51

Conclusion…………………………………………………..…………………..……………….52

Chapter 6: Programmatic Recommendations for CVT……………….………53

Organization Priorities…………………………………………………………………………...53

Recommendations by Area……………………………………………………………...……….53

References……………………………………………..………………………….56

Appendix A: Mixed Methods Survey Tool……………..………………………59

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