Screening for Immigration-Related Health Concerns in a Federally Qualified Health Center Serving a Diverse Latinx Commun
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ORIGINAL PAPER
Screening for Immigration‑Related Health Concerns in a Federally Qualified Health Center Serving a Diverse Latinx Community: A Mixed Methods Study Elena Byhoff1,2 · Emilia H. De Marchis3 · Laura Gottlieb3 · Sophia Halperin‑Goldstein4 · Keith Nokes4,5 · Amy M. LeClair2
© Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Immigration-related concerns can impact health and are an important consideration while caring for a multinational Latinx immigrant community. Patients and caregivers waiting for a non-urgent clinic appointment were randomly screened with one of two social risk screening tools. One tool included a question about “any health or stability concerns related to immigration status.” The other tool did not include an immigration health question. Immediately following, respondents were invited to participate in a semi-structured interview regarding their social risk screening experience. 201 screens were completed, and 20 patients agreed to an interview. There were no significant sociodemographic differences between groups. Of those screened for immigration, 11% reported a concern. In both arms, interviewees felt that social risk screening was acceptable in a clinic setting. Questions about immigration are timely, important, and relevant, and can be considered when implementing social assessments in communities where there are high levels of trust in providers. Keywords Screening · Social determinants of health · Immigrants · Community health center
Background Immigration status impacts health and access to care at least as significantly as other social determinants [1, 2]. However, none of the publicly-available evidence-based screening tools include questions about immigration status [3–7]. The Supreme Court has recently upheld proposed changes in the public charge rule—receipt of public benefits, including Disclaimers The views expressed in the submitted article are the authors’ and not an official position of the institution or funder. * Elena Byhoff [email protected] 1
Department of Medicine, Tufts Medical Center, 800 Washington St, Box #63, Boston, USA
2
Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA 02111, USA
3
Department of Family Medicine, University of California San Francisco, San Francisco, CA, USA
4
Tufts University School of Medicine, Boston, MA, USA
5
Department of Family Medicine, Greater Lawrence Family Health Center, Boston, MA, USA
public insurance and food benefits, can make people ineligible for obtaining or renewing legal permanent resident status [8–13]. Such changes will directly negatively impact health by increasing food insecurity, financial hardship, stress, and exclusion from health care [14–16]. Immigration and Customs Enforcement raids are stoking fear across immigrant communities, contributing also to indirect exclusions from health care and social services based on fear of detainment or deportation [16–18]. Sensitivity to documentation status is founda
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