Identifying Barriers to Health Care in the Burmese and Bhutanese Refugee Populations of Burlington, Vermont

Methods: Providing effective healthcare to refugees can be challenging. For example, language barriers may impede communication with providers, while financial barriers may prevent utilization of healthcare services. Additionally, refugees may not understand the concept of chronic disease, which may hinder prevention efforts. However, identifying access barriers and assessing understanding of chronic disease in refugee populations is essential if resources are to be effectively allocated by organizations serving these populations. Since 2006, more than 100 Burmese and 200 Bhutanese refugees have resettled in Vermont. Most access healthcare at the Community Health Center (CHC) of Burlington, Vermont. Little was known concerning healthcare barriers faced by these populations, nor how well they understood chronic disease. Methods: We conducted a translator-assisted focus group with members of each population (n=7 Burmese; n=9 Bhutanese) to assess healthcare barriers and understanding of hypertension and type-two diabetes mellitus (T2DM). Results: Language barriers were a concern for both groups, and led to patient/provider miscommunication and an inability to understand prescription medications. Also, both groups had difficulty arranging transportation to medical appointments, paying for healthcare, and transitioning from a limited government-subsidized health insurance plan for new refugees to non-subsidized insurance. Finally, neither group clearly understood hypertension and type-two diabetes. Conclusions: We recommended the CHC improve its translation services, transportation assistance, and insurance transition assistance. We also recommended the CHC improve its chronic disease education programs. Given the lack of literature concerning US healthcare experiences of Burmese and Bhutanese refugees, our results may be useful to other organizations serving these populations.