Advancing Social Justice for Immigrants and Refugees – Completing a Cultural Health Assessment

As a result of climate change, natural disasters, and conflict, the number of immigrants and refugees has increased dramatically in the United States, as well as around the world (UN, 2005). Public health social workers have grown increasingly concerned about the physical and mental health of these immigrants and refugees.

A cultural health assessment helps to promote understanding from a social justice perspective. This method builds upon Drachman three stage immigration model (2004) that addresses pre-migration experiences, transit stresses, the current situation of immigrants and the new culturagram (Congress, 2008) with its focus on health beliefs, access, and care, as well as discrimination and bias.

A cultural health assessment will address the following issues: First, the “push” factors (Lee, 1966) affecting emigration decisions will be identified. What physical and mental health challenges did immigrants encounter – water shortages, economic hardships, malnutrition, hunger, diseases, discrimination, or torture in their homelands? Second, transit experiences, both within their countries of origin as well as international will be explored. What physical, psychological, social deprivation and discrimination did immigrants experience while traveling to their new homes? Finally, has their physical and mental health improved or grown worst after immigration? Have they been able to access and make use of health care in their destination countries? Have they experienced discrimination and bias and how has this impacted on their health? Case examples that illustrate the use of a cultural health assessment as a means to promote social justice with diverse immigrant groups will be presented.