266378 Barriers impeding and enablers promoting the health and wellness of Afghan Refugees in the San Francisco Bay Area

Monday, October 29, 2012 : 11:30 AM - 11:45 AM

Valerie Smith, PhD , Department of Communication, California State University, East Bay, Hayward, CA
Background: For more than two decades, Afghans comprised the largest refugee population in the world. With more than 60,000 Afghan refugees in the United States, the largest concentration resides in Northern California. Purpose: As part of a larger dissertation study, this research identified barriers impeding and enablers promoting the health and wellness of female Afghan refugees in the San Francisco Bay Area. Methods: The researcher conducted 40 in-depth qualitative interviews, averaging two hours each and including limited-English proficient women; a focus group; ethnographic participant observation in the local refugee community for more than two years; and consultation with key cultural informants. Maximum variation purposive sampling was used for the interviews. Results: Qualitative analysis of 262 distinct narratives generated several overarching themes. The predominant two barriers consisted of (1) the language barrier and (2) “not knowing the system.” Associated barriers included (3) impoverishment, (4) cultural clashes, (5) the generation gap, and (6) honor and shame. Key themes that enabled refugee wellness were: (1) Developing an ongoing, trusting interpersonal relationship with a “point person” fluent in English and U.S. culture and information systems; (2) learning to speak fluent English; (3) gaining an understanding of how to directly navigate U.S. information systems, such as the health care and social service systems; and, (4) practicing asking questions of professionals in health, human, and social service provider positions. Conclusion: Funding and developing pools of trained “point people” should take high priority since these important interpersonal relationships are central to enhancing the wellness of refugees.

Learning Areas:
Communication and informatics
Diversity and culture
Planning of health education strategies, interventions, and programs

Learning Objectives:
(1) Describe the barriers that Afghan refugees in the San Francisco Bay Area face when trying to access U.S. health, mental health, education, and social services. (2) Differentiate between structural, systemic barriers to accessing services and other barriers. (3) Explain the central role of “point people” in enabling the wellness of refugees. (4) Describe the communicative steps by which a refugee can adjust best to the new country towards promoting self-sufficiency and wellness. (5) List the recommendations related to “point person” outreach programs for effective refugee resettlement and healthy communities.

Keywords: Refugees, Wellness

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am an academic communication researcher focused on health and access barriers and strategies for Afghan refugees. I conducted all phases of this research as part of my dissertation. I have also facilitated the Afghan Health Leadership Consortium in the San Francisco East Bay for seven years and have volunteered extensively with Afghan refugees.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.