The 130th Annual Meeting of APHA

3230.0: Monday, November 11, 2002 - 3:00 PM

Abstract #49043

An analysis of refugee-associated disease prevalence and utilization in Multnomah County, Portland, Oregon

Jay D. Kravitz, MD, MPH, FACPM, Department of Public Health and Preventive Medicine, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, CB669, Portland, OR 97201, 503.494.2559,, David M. Balmer, MD, MPH, FACPM, Marion-Polk Community Health Plan, 198 Commercial St. SE, Suite 240, Salem, OR 97301, and Patricia A. Kullberg, MD, MPH, Multnomah County Health Department, 426 SW Stark St., Portland, OR 97204.

This study sought to determine disease prevalence and utilization variation among refugee groups. Between 1994 and 1999, more than 7,000 persons with the designation, “refugee status,” were relocated in metropolitan Portland. Little was known, medically, about this diverse population originating from global locations affected by war, political unrest, and poverty. The Multnomah County Health Department provides primary health care to 50,000 patients of various ethnic backgrounds, including recently arrived refugees. We conducted a retrospective cohort study of 6,709 refugees, seeking ambulatory services between 1994-1998, using computerized claims data. Russians, Croatians, Bosnians, Vietnamese, Cubans, and Somalis represented 96% of all persons studied. Most refugees were young families, although Vietnamese tended to be older with grown children; 67% of Cubans were young, unaccompanied males. The greatest frequencies of medical conditions identified were dental caries, tuberculosis, hepatitides, intestinal parasites, dermatological conditions, nutritional deficiencies, psychiatric conditions, and substance abuse. More than 50% of refugees had a positive Mantoux, Vietnamese suffering the greatest burden. Eastern European and Vietnamese patients had similar prevalences of diabetes. Russians had higher rates of hypertension, stroke, and heart failure. Nutritional deficiencies, psychological problems, and substance abuse were low and probably underreported. Cultural differences between providers and patients; weighted attention to more pressing clinical and preventive services; unrecognized somatisization; omissions or misclassification in data processing; or immigration exclusion of persons with higher morbidity may explain discrepancies between observed and expected findings. This research was intended to assist planners in the development of culturally sensitive, cost-effective services for newly arriving refugees.

Learning Objectives:

Keywords: Refugees, Disease Data

Presenting author's disclosure statement:
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.

Serving Cultural and Linguistic Minorities in the Community

The 130th Annual Meeting of APHA